Positron Emission Tomography/Computed Tomography (PET/CT) Imaging in Patients Diagnosed With a Glioma

Summary

The goal of this clinical trial is to evaluate Positron emission tomography/computed tomography (PET/CT) imaging with the radiotracer 1-(2-\[18F\]fluoroethyl)-l-tryptophan (\[18F\]FETrp) in patients diagnosed with a glioma. This study has 3 aims: * to assess if the \[18F\]FETrp PET/CT can outperform Magnetic Resonance Imaging (MRI) by providing a better treatment target volume in newly diagnosed Stage 4 glioma patients * better differentiate tumor progression from radiation induced MRI changes in post treatment stage 4 gliomas * by giving a drug that can inhibit a pathway to allow objective assessment of treatment effects in low grade gliomas

Interventions

• Minocycline 200mg/day · DRUG

  Minocycline 200mg orally daily to start within 14 days of the first \[18F\]FETrp PET/CT and taken until the second \[18F\]FETrp PET/CT obtained 25-44 days after the start of the Minocycline in Arm 3

• [18F]FETrp PET/CT · DIAGNOSTIC_TEST

  \[18F\]FETrp PET/CT used in all three arms

Published eligibility criteria

Verbatim from the registry. Only the site can decide how these apply to a specific patient.

FOR ARMS 1-3

Inclusion Criteria:

* Age =18 years.
* Patient is able to lie in the PET/CT scanner for at least 60 minutes while undergoing scanning.
* Patient is willing and able to review, understand, and provide written consent for the study procedures and indicates that they are aware of the investigational nature of this study.

Exclusion Criteria:

* Patients who are pregnant or lactating are excluded. Premenopausal women (defined per institutional guidelines) must have a negative pregnancy test (urine or serum) within 7 days of the PET scan.
* Severe increased intracranial pressure, status epilepticus, or other severe or progressing clinical symptoms requiring urgent intervention in the opinion of the treating
* Karnofsky performance score \<60, as determined by one of the clinician co- investigators.

ADDITIONAL CRITERIA FOR ARM 1:

Inclusion Criteria:

* Histopathology/cytopathological diagnosis of a glioblastoma without a history of radiation.
* The tumor is deemed amenable for radiation treatment (pre-radiation planning MRI can be done before or after the PET scan).

ADDITIONAL CRITERIA FOR ARM 2:

Inclusion Criteria:

* Previous histopathology/cytopathological diagnosis of glioblastoma.
* History of glioma radiation.
* Presence of a new or progressing enhancing brain lesion on follow-up clinical MRI suspicious for post-radiation glioma progression or late radiation-induced MRI changes (i.e., radiation injury), at least 7 mm in bidirectional diameter.
* The most recent MRI, used for comparison with the PET/CT, is performed within 4 weeks of the planned PET scan.

ADDITIONAL CRITERIA FOR ARM 3

Inclusion Criteria:

* MRI diagnosis of a brain tumor, previously verified to be a low-grade (WHO grade 2, IDH (isocitrate dehydrogenase) mutant glioma, based on histopathology from biopsy or resection.
* The detected mass on the most recent clinical MRI is at least 7 mm in bidirectional diameter (i.e., twice the PET scanner resolution).
* The tumor does not require urgent (within 1 month) resection, steroid treatment, or radiation.
* The most recent MRI, used for comparison with the PET/CT, is performed within 4 weeks.
* Patient agrees to have a baseline and follow-up PET/CT scan (approximately 1 month later) and interval oral treatment with 200mg/day minocycline.
* Due to planned minocycline treatment, patients will need to have adequate renal function

Exclusion Criteria:

* Active connective tissue disorders, such as lupus or scleroderma.
* History of allergic reaction to minocycline or any tetracyclines.
* Ongoing treatment with warfarin with INR \> 1.5.
* History of colitis during antibiotics treatment.

Sites (1)

• Karmanos Cancer Institute, Detroit, Michigan