The investigators will determine the proportion of CUP patients in whom the primary tumor can be identified by \[18F\]F-FAPI PET-CT.
Carcinoma of unknown primary origin (CUP) is a diverse group of cancers defined by the presence of metastatic disease with no identified primary tumor after exhaustive diagnostic work-up. Absence of a known targetable primary tumor precludes patients from receiving tumor-specific evidence-based therapies which significantly impacts the life expectancy of CUP patients. In this investigator-initiated and patient association-driven, multi-center, prospective clinical study we aim to detect the primary tumor by PET-CT using the novel radiotracer \[18F\]F-fluoro fibroblast activation protein inhibitor (F-FAPI). We will include 50 patients (aged \>18 year) who have been diagnosed with CUP after standard diagnostic work-up including FDG PET-CT. Participation in the study entails a one-time \[18F\]F-FAPI PET-CT examination in one of the six study centers (UMC Groningen, UMC Utrecht, Antoni van Leeuwenhoek, Radboudumc, Maastricht UMC, Erasmus MC). For the interpretation of images, central reading will be performed and results will be made available to the treating physician with an accompanying recommendation for additional diagnostics and/or treatment. After 6 months, the results of the \[18F\]F-FAPI PET-CT will be compared with patient follow up, including clinical, radiological and pathological outcome parameters. These findings will holistically be discussed in a multidisciplinary Truth Panel meeting to determine a uniform verdict with regard to the clinical value of \[18F\]F-FAPI for CUP. We hypothesize that \[18F\]F-FAPI PET-CT will detect the primary tumor in at least 15% of our CUP patients.¬
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
50
Each patient will receive a FAPI PET-CT.
Antoni van Leeuwenhoekziekenhuis
Amsterdam, Netherlands
RECRUITINGUMC Groningen
Groningen, Netherlands
RECRUITINGMaastricht UMC
Maastricht, Netherlands
RECRUITINGDetection of the primary tumor by [18F]F-FAPI PET-CT
The proportion of CUP patients in whom the primary tumor can be identified by \[18F\]F-FAPI PET-CT
Time frame: 2 years
Sensitivity, specificity, positive- and negative predictive value of [18F]F-FAPI PET-CT
These numbers will be calculated based on correlation between the outcome of the FAPI reading and the clinical outcome for the patient, i.e., correct or incorrect identification of a primary tumor (or not) by additional diagnostics or follow-up determined as such by a dedicated Truth Panel established for this study.
Time frame: 2 years
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Radboud UMC
Nijmegen, Netherlands
RECRUITINGErasmus Medical Center
Rotterdam, Netherlands
RECRUITINGUMC Utrecht
Utrecht, Netherlands
RECRUITING