Neuroinflammation and Age-associated Brain Pathology: Two Potential Mechanisms of Cognitive Impairment in Ovarian Cancer

University of Alabama at Birmingham

Overview

This clinical study will use the small molecule translocator protein (TSPO) ligand, 18F-labeled DPA- 714, to visualize and quantify neuroinflammation in treatment naivete women with stage 1-4 newly diagnosed ovarian cancer (without brain metastases) prior to starting neoadjuvant chemotherapy treatment (baseline) and within a month of completing first 6 cycles of cytotoxic chemotherapy treatment (follow-up). In addition, we will use the well-characterized small molecule PET(Positron Emission Tomography) tracer, 11C-labeled Pittsburgh compound B (PiB) to visualize and quantify the regional brain distribution of pathological amyloid deposition at baseline only. The brain amyloid PET and MRI data acquired through this study will be correlated with cognitive test data, clinical data, genetic testing, and biospecimens collected in this study.

Study Type

INTERVENTIONAL

Allocation

Purpose

DIAGNOSTIC

Masking

NONE

Conditions

Ovarian Cancer

Interventions

[11C]PiB and 18F-labeled DPA-714 PET scanDRUG

One PET with \[11C\]PiB and One PET with \[18F\]DPA-714 before chemotherapy treatment begins. One more PET with \[18F\]DPA-714 after completion of 3-6 cycles of chemotherapy.

Eligibility

Sex: FEMALEMin age: 50 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. 50 years of age or older 2. Female gender 3. Newly diagnosed treatment naïve women with stage III/IV epithelial ovarian cancer (without known brain metastases). 4. High or mixed affinity binder for TSPO ligands based on genotyping for single nucleotide polymorphism (SNP) rs6971. 5. English is primary language 6. Planned neoadjuvant chemotherapy with platinum and taxane drugs Exclusion Criteria: 1. Contraindication to MRI 2. Pregnancy 3. Lactation 4. Individuals who are unable to participate in the imaging portion due to severity of their medical condition 5. Chronic infectious disease (e.g. HIV, HCV) 6. Chronic inflammatory disease (e.g., fibromyalgia, MS, etc) or autoimmune disease 7. Viral or bacterial illness requiring medical attention and/or antibiotics within 1 month of study participation 8. Blood or blood clotting disorder 9. Cancer that has metastasized to the brain 10. Positive urine hCG test day of procedure or a serum hCG test within 48 hours prior to the administration of \[18F\]DPA-714 and \[11C\]PiB. 11. Currently enrolled in a clinical trial utilizing experimental therapies. 12. Low affinity binder for TSPO ligands based on genotyping for SNP rs6971. 13. Prior brain tumor or other neurological condition known to affect cognition 14. A diagnosis of dementia unrelated to cancer or an adjusted MMSE score \< 24

Outcomes

Primary Outcomes

Measure neuroinflammation by calculating the concentration and regional distribution of activated brain microglia/macrophages using the PET ligand [F-18]DPA-714.

Time frame: Pre-study visit through 3-6 cycles of chemotherapy (each cycle is typically 2 weeks)

Secondary Outcomes

Correlate cognitive impairment before and after beginning cancer therapy with the concentration and regional brain distribution of pathologic amyloid deposition measured with the PET tracer [C-11]PiB prior to beginning therapy.

Time frame: Pre-study visit through 3-6 cycles of chemotherapy (each cycle is typically 2 weeks)

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.