A study using PET scans to see how well chemotherapy is working in people with cancer that has spread to the liver

Please note this trial is no longer recruiting patients.

This pilot study is looking at whether PET scans can show how well chemotherapy is working in people with breast cancer, bowel cancer or pancreatic cancer that has spread to the liver.

Doctors often use chemotherapy to treat cancer that has spread. They usually do a scan, such as a CT or ultrasound scan, after about 3 or 4 cycles of treatment to see how well the treatment is working.

As chemotherapy can cause side effects, it is better to find out as soon as possible whether the treatment is helping. If it is not working as well as doctors’ hope, they can make changes or stop treatment, depending on the situation.

Doctors think that they can use a different type of scan early on in treatment to help with this. It is called a PET scan. PET scans show up most cancer cells because they grow faster than healthy cells. But in the liver it is more difficult to tell cancer cells from healthy cells. Researchers think that they will be able to see cancer cells that have spread to the liver more clearly by using a new ‘filtering’ technique when checking the PET scan images.

The researchers will compare results from this new technique with a standard PET scan, and to other scans such as CT or ultrasound.

You will not have any direct benefit from taking part in this study, and it is unlikely to change your treatment plan in any way. But the results of the study will be used to help people with cancer in the future.

If you are suitable for this study, and are having treatment at one of the hospitals involved, your doctor may invite you to take part.

Recruitment

Start 01/06/2008

End 19/08/2010

Phase

Pilot

Who can enter

You can enter this trial if you

Have breast cancer, bowel cancer or pancreatic cancer that has spread to your liver
Have at least one new area of cancer within the liver that measures 30mm or more on a scan
Are due to have chemotherapy
Are well enough to take part (Karnofsky performance status of more than 60%)
Have satisfactory blood test results
Are aged between 18 and 80

You cannot enter this trial if you

Have had chemotherapy in the last 2 weeks, or radiotherapy in the last 4 weeks
Are taking a drug called warfarin, to thin your blood
Are having treatment as part of another clinical trial
Have any other medical condition that could affect your taking part in this trial, including (but not limited to) an infection, heart failure or unstable angina
Are pregnant or breastfeeding

Trial design

Doctors hope to recruit 24 patients into this study from 4 London hospitals. If you are suitable for the study, your doctor will ask you if you would like to take part. This is a pilot study. If the new method of scanning is useful, the researchers will go on to develop larger studies involving more people.

Everyone taking part in this study will be due to start chemotherapy for cancer that has spread to the liver. The study will not affect the treatment already planned for you. The chemotherapy you have will depend on your individual situation.

In this study, you have 2 PET scans. You have the first one before you start chemotherapy. And the second one 2 to 3 weeks after you start your treatment.

You have another type of scan, such as a CT or ultrasound scan, after 3 to 4 cycles of treatment. This is so the doctors can see how well the cancer is responding to treatment. You would have this scan even if you were not taking part in this study.

The researchers will compare the standard PET scan images with the images using the new technique. They will also compare these results with the CT or ultrasound scan.

Hospital visits

You will have 2 extra visits to the hospital during your treatment as part of this study. Each visit will last about 2 hours in total.

You have your first PET scan a few days before you start your chemotherapy. You can eat or drink normally before your scan. You may have the scan at a different hospital to where you are having treatment. The researchers will provide a taxi for you, or pay your travel expenses.

Firstly, you will have a fine needle put into a vein in your arm to give the radioactive ‘tracer’. You will then lie down on the scanner bed while the researchers scan your liver.

You will have 3 blood tests during the scan. This is to help measure the activity of the tracer in your body.

You will have your second PET scan 2 to 3 weeks after you start chemotherapy.

Side effects

There is a small amount of radioactivity in the tracer injection. But this shouldn’t cause any side effects.

You may get some discomfort when the needle is put into your vein to give the tracer and to take blood samples. As with any blood test, there may be some mild bruising around the site, but this will clear after a week or two.

There is more information about PET scans on CancerHelp UK.

You can also read about the side effects of chemotherapy for breast cancer, chemotherapy for bowel cancer and chemotherapy for pancreatic cancer on CancerHelp UK.