CompletedInterventional

Assessing response to treatment using imaging with PET/MRI in advanced renal cancer

Advanced kidney cancer happens when cancer cells spread from the kidney to other parts of the body. Doctors often treat this with targeted medicines, but it can take time to know whether these drugs are shrinking or slowing down the tumours. This clinical study, known as the REMAP trial, is testing an advanced imaging tool called a PET/MRI scan. A PET/MRI combines two scans in one: an MRI, which takes sharp pictures of body tissues, and a PET scan, which shows how active the cancer cells are. Participants will have three PET/MRI scans over about six months: one before starting their planned targeted therapy, one at 12 weeks, and one at 24 weeks. Researchers want to see if these scans can show how the cancer is responding much earlier than standard tests. Taking part will not replace or delay your regular cancer treatment.

At a glance

Status

Completed

Sponsor

King's College London

Enrolment target

Start

01 Dec 2016

Estimated completion

31 Jul 2022

Renal cell carcinoma

What is this study about?

Kidney cancer is one of the more common cancers in the UK. When it spreads to other areas of the body, doctors describe it as advanced or metastatic. Treatment often involves targeted medicines designed to slow tumour growth and help people live longer. Currently, doctors monitor tumours using regular CT scans. However, CT scans mainly measure the size of a tumour, which may not change right away even if the cancer medicine is working effectively.

The REMAP study is exploring whether a combined scan called a PET/MRI gives a faster and clearer picture of treatment success. An MRI uses strong magnets and radio waves to create detailed images of organs and soft tissues. A PET scan uses a very small, safe amount of a sugary liquid tracer that active cancer cells absorb. When joined together, the PET/MRI shows both where tumours are and how active they are at a cellular level.

By taking scans at the start of treatment, and then again after 12 and 24 weeks, researchers want to see if changes in tumour activity can show whether a drug is working or if the cancer is becoming resistant. If successful, this research could help doctors make quicker, more informed decisions about cancer drugs in the future, sparing patients from taking treatments that are no longer helping them.

Key takeaways

The REMAP study tests whether combined PET/MRI scans can show how well kidney cancer drugs are working.
Participants have three scans over six months: at the start, at 12 weeks, and at 24 weeks.
Your planned targeted cancer therapy and regular NHS care will remain unchanged.
The scans help doctors look at tumour activity, not just tumour size.
Joining is voluntary, and you can leave the study at any time without giving a reason.

Who may be eligible?

You may be able to take part if you are an adult aged 18 or older with advanced kidney cancer (renal cell carcinoma) that has spread to other parts of your body. You must have at least one measurable area of cancer that is two centimetres or larger, and you should be planning to start a targeted cancer drug. You also need to be well enough to look after yourself and walk around for at least part of the day.

You will not be able to join this study if you cannot safely have an MRI or PET scan. This includes people with certain metal implants, such as older pacemakers, or people whose kidneys are not working well enough to process the scan dyes (an eGFR test score below 50). You are also not eligible if you have had radiotherapy in the past, or if your medical team estimates your life expectancy is under 12 weeks.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

I am aged 18 or over.
I have been diagnosed with kidney cancer that has spread (metastatic renal cell cancer).
I have a tumour area that measures at least 2cm and am planning to start targeted therapy.
I am mobile, able to look after myself, and up and about for most of the day.
I do not have any metal implants or health issues that stop me from having an MRI.
My kidney function is satisfactory (eGFR score of 50 or above).

Answer every question to see your result.

What does participation involve?

If you decide to take part, you will have three PET/MRI scan appointments over about six months (24 weeks). The first scan takes place before you start your new targeted therapy, the second at around 12 weeks, and the third at around 24 weeks. For each scan, you will visit the hospital imaging department, receive a small injection of a sugary tracer into a vein, and wait briefly while it travels through your body. You will then lie flat inside the scanner for around 45 to 60 minutes while pictures are taken. Throughout the study, you will continue taking your prescribed cancer medicines and seeing your regular oncology team as usual.

Potential risks and benefits

Taking part in this study may not directly cure or improve your cancer, but the detailed scans may give your doctors helpful extra information about how your tumours are responding. The findings could also help improve treatment decisions for people with kidney cancer in the future. The risks are generally low. Having a scan involves a small needle prick for the dye and tracer, and some people find lying still inside the scanner noisy or slightly claustrophobic. The PET scan uses a tiny, controlled dose of radiation that is considered safe. Joining is completely voluntary, and you are free to stop participating at any point without it affecting your standard NHS care.

Locations (2)

Some site locations are approximate. We're improving this — please verify with the trial team before travelling.

King’s College London and Guy’s and St Thomas’ PET Centre
City only
London, England
Mount Vernon Cancer Centre
City only
Northwood, England

Common questions

Will taking part change the cancer medicines I receive?

No. You will continue to receive the targeted cancer treatment agreed between you and your regular cancer specialist.

Does a PET/MRI scan hurt?

No, the scan itself is completely painless. You will only feel a quick pinch from the needle when the tracer liquid is injected into your arm.

Is the radiation from the scan dangerous?

The amount of radiation used in the PET tracer is very small and carefully regulated to ensure it is as safe as possible for you.

What if I feel uncomfortable or claustrophobic in small spaces?

The scanner tunnel can feel snug and can be noisy. You should let the imaging team know beforehand, as they can offer support, earplugs, and reassurance during the scan.

Do I have to pay to have these extra scans?

No. Clinical trial scans within the NHS are free of charge, and some hospitals may be able to help cover your travel expenses.

How to find out more

Vicky Goh

vicky.goh@kcl.ac.uk +44 (0)207 188 5538 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.