A Phase 2a, Single-dose, Open-label Study to Evaluate Diagnostic Performance and Safety of Pegsitacianine, an Intraoperative Fluorescence Imaging Agent for the Detection of Cancer, in Patients With Unknown Primary Head and Neck Cancer (ILLUMINATE STUDY)
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ClinicalTrials.gov Identifier: NCT05576974 |
Recruitment Status :
Not yet recruiting
First Posted : October 13, 2022
Last Update Posted : October 17, 2023
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Condition or disease | Intervention/treatment | Phase |
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Head and Neck Cancer Unknown Primary Cancer Head and Neck Squamous Cell Carcinoma | Drug: Pegsitacianine | Phase 2 |
This is a non-randomized, open-label, single-center, safety and imaging feasibility study of Pegsitacianine, an intraoperative fluorescence imaging agent.
The main purpose of this study is to investigate whether Pegsitacianine can be used to image head and neck cancers as well as unknown primary cancer of the head and neck 6-100 hours post dose in patients undergoing routine surgery for biopsy, evaluation, detection or removal of their primary cancer.
The study consists of two Parts.
- Part 1 will be performed in a single dose of 1 mg/kg given such that Pegsitacianine fluorescence can be used to image primary tumors in patients with HNSCC undergoing routine surgery at 6-100 hours, and if needed at an alternate imaging schedule post dose.
- Part 2 will be performed in a single dose of 1 mg/kg given such that Pegsitacianine fluorescence can be used to image primary tumors in patients with unknown primary cancer of the head and neck (UPC) at 6-100 hours, and if needed at an alternate imaging schedule post dose.
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 40 participants |
Allocation: | Non-Randomized |
Intervention Model: | Parallel Assignment |
Intervention Model Description: | In Part 1 the single dose of 1 mg/kg of pegsitacianine given 6-100 hours prior to surgery will be used to image primary tumors in patients with HNSCC to evaluated to verify the diagnostic performance of pegsitacianine fluorescence imaging for detecting primary tumors and metastatic lymph nodes. In Part 2, pegsitacianine the single dose of 1 mg/kg of given 6-100 hours prior to surgery will be used to in patients with unknown primary cancer of the head and neck. These patients typically undergo exam under anesthesia with a laryngoscopy as well as panendoscopy for identifying the source of the metastatic cancer found in the cervical nodes. Subjects for Part 2 may begin dosing at any time during Part 1 thus the two parts can run concurrently. |
Masking: | None (Open Label) |
Masking Description: | Open Label |
Primary Purpose: | Diagnostic |
Official Title: | A Phase 2a, Single-dose, Open-label Study to Evaluate Diagnostic Performance and Safety of Pegsitacianine, an Intraoperative Fluorescence Imaging Agent for the Detection of Cancer, in Patients With Unknown Primary Head and Neck Cancer (ILLUMINATE STUDY) |
Estimated Study Start Date : | July 1, 2024 |
Estimated Primary Completion Date : | December 31, 2027 |
Estimated Study Completion Date : | December 31, 2027 |

Arm | Intervention/treatment |
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Active Comparator: Part 1 - Cohort A
In Part 1 the single dose of 1 mg/kg of pegsitacianine given 6-100 hours prior to surgery will be used to image primary tumors in patients with HNSCC to evaluated to verify the diagnostic performance of pegsitacianine fluorescence imaging for detecting primary tumors and metastatic lymph nodes.
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Drug: Pegsitacianine
Infusion of the Pegsitacianine-Intraoperative fluorescence imaging |
Active Comparator: Part 2 - Cohort B
In Part 2, pegsitacianine the single dose of 1 mg/kg of given 6-100 hours prior to surgery will be used to in patients with unknown primary cancer of the head and neck. These patients typically undergo exam under anesthesia with a laryngoscopy as well as panendoscopy for identifying the source of the metastatic cancer found in the cervical nodes. The diagnostic performance of pegsitacianine fluorescence imaging for detecting primary tumors and metastatic lymph nodes in these patients will be evaluated. All the available data to date will be used to decide the additional tumor type(s), number of patients per tumor type, and number of Group(s) to be enrolled.
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Drug: Pegsitacianine
Infusion of the Pegsitacianine-Intraoperative fluorescence imaging |
- Diagnostics performance and safety of 1 mg/kg Pegsitacianine in patients with HNSCC [ Time Frame: 5 years ]Pegsitacianine fluorescence from in vivo and excised tissues will be imaged using intraoperative and post-operative NIR cameras and will be correlated with the histopathological confirmation of tumor and normal tissues to determine Pegsitacianine's diagnostic performance. Patient safety will be assessed for 10 days (±48 hours) post dose. All patients will be monitored for vital signs and physical examination pretreatment and at various time points up to Day 6 (±24 hours). All patients will be monitored for comprehensive metabolic panel (CMP) and complete blood count (CBC) with differentials pretreatment and at various time points up to Day 10 (±48 hours). All patients will be monitored for TEAEs, and concomitant medication use from the start of dosing up to Day 10 (±48 hours). TEAEs will be followed closely during the study to identify any potential DLTs
- Diagnostics performance and safety of 1 mg/kg Pegsitacianine in patients with UPC [ Time Frame: 5 years ]Pegsitacianine fluorescence from in vivo and excised tissues will be imaged using intraoperative and post-operative NIR cameras and will be correlated with the histopathological confirmation of tumor and normal tissues to determine Pegsitacianine's diagnostic performance. Patient safety will be assessed for 10 days (±48 hours). All patients will be monitored for vital signs and physical examination pretreatment and at various time points up to Day 6 (±48 hours). All patients will be monitored for comprehensive metabolic panel (CMP) and complete blood count (CBC) with differentials pretreatment and at various time points up to Day 10 (±48 hours). All patients will be monitored for TEAEs, and concomitant medication use from the start of dosing up to Day 10 (±48 hours). TEAEs will be followed closely during the study to identify any potential DLTs
- Pegsitacianine fluorescence imaging in HNSCC, UPC primary cancers that are HPV positive and HPV negative [ Time Frame: 5 years ]Pegsitacianine fluorescence from in vivo and excised tissues will be imaged using intraoperative and post-operative NIR cameras and will be correlated with the histopathological confirmation of tumor and normal tissues to determine Pegsitacianine's diagnostic performance. Assessment of use of Pegsitacianine for intra-operative imaging of HNSCC, UPC and metastatic lymph nodes will include quantification of intraoperative and postoperative fluorescence signals from histology confirmed tumor and normal tissues, calculation of TBR and diagnostic performance. Feasibility determination will be based on a combined assessment of intraoperative in vivo and ex vivo fluorescent signals together with ex vivo examinations (histological examination, NIR flatbed scanning).

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Ages Eligible for Study: | 18 Years to 99 Years (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Adults ≥18 years of age
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Biopsy-confirmed diagnosis, for primary or recurrent disease (or high clinical suspicion in the opinion of the Investigator)
- Part 1: Stage 1 to 4 HNSCC
- Part 2: UPC squamous cell carcinoma of the head and neck with metastatic disease to at least a single cervical node, AND no biopsy proven evidence of the primary cancer's location.
- Acceptable hematologic status (as standard surgery protocol requires, as determined by the Investigator), kidney function and liver function. Elevations of creatinine, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, or total bilirubin >1.5× the upper limit of normal [ULN] must be determined to be not clinically significant by the Investigator and approved by the Medical Monitor.
- Documented negative serum pregnancy test for women of childbearing potential (i.e., premenopausal women with intact reproductive organs and women <2 years after menopause)
- Male patients and female patients of child-bearing potential (i.e., premenopausal women with intact reproductive organs and women <2 years after menopause) must agree to and comply with using medically acceptable contraception including surgical sterilization (e.g., hysterectomy, bilateral oophorectomy, bilateral tubal ligation), intrauterine device, oral contraceptive, contraceptive patch, long acting injectable contraceptive, partner's vasectomy, double-barrier method (condom or diaphragm plus spermicide or condom plus diaphragm), or abstinence during the trial and for 6 months thereafter
- Agree to abstain from alcohol consumption from 72 hours before Pegsitacianine administration through completion of Study Day 10 (±48 hours) visit in Part 1 and Part 2.
- Adequate potential for follow up
Exclusion Criteria:
- Tumors at sites of which the surgeon would assess that in vivo intraoperative imaging would not be feasible.
- Life expectancy <12 weeks
- Karnofsky Performance Status <70%
- Hepatic impairment (Child-Pugh score >5) or significant liver disease including active hepatitis or cirrhosis
- Lab values or any sign, symptom, or medical condition that in the opinion of the PI would prevent surgical resection
- Medical or psychiatric conditions that compromise the patient's ability to give informed consent.
- Pregnant or lactating women
- Receiving or planned to receive, during the duration of the study, concomitant medication with a high chance of hepatotoxicity, as judged by the PI based on standard protocols within the study center
- Alcohol consumption within 72 hours before Pegsitacianine administration
- Received an investigational agent within the shorter of 5 half-lives or 30 days before Pegsitacianine dosing
- Inability to adhere to the schedule of assessments or any circumstance that would interfere with the validity of assessments performed in the study
- The PI considers that the patient should not participate in the study

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT05576974
Contact: Baran Sumer, MD | 2146482904 | Baran.Sumer@UTSouthwestern.edu | |
Contact: Asha Varghese, MS | 2146488096 | Asha.Varghese@utsouthwestern.edu |
United States, Texas | |
University of Texas Southwestern Medical Center | |
Dallas, Texas, United States, 75390 | |
Contact 214-648-8096 OTOresearch@utsouthwestern.edu | |
Contact 2146488096 Asha.Varghese@utsouthwestern.edu | |
Principal Investigator: Baran Sumer, MD |
Publications:
Responsible Party: | Baran Sumer, Professor and Chief, Division of Head and Neck Oncology, University of Texas Southwestern Medical Center |
ClinicalTrials.gov Identifier: | NCT05576974 |
Other Study ID Numbers: |
STU-2022-0460 1R01CA266146-01 ( U.S. NIH Grant/Contract ) |
First Posted: | October 13, 2022 Key Record Dates |
Last Update Posted: | October 17, 2023 |
Last Verified: | October 2023 |
Individual Participant Data (IPD) Sharing Statement: | |
Plan to Share IPD: | No |
Studies a U.S. FDA-regulated Drug Product: | Yes |
Studies a U.S. FDA-regulated Device Product: | No |
Head and Neck Neoplasms Squamous Cell Carcinoma of Head and Neck Neoplasms, Unknown Primary Carcinoma, Squamous Cell Carcinoma Neoplasms, Glandular and Epithelial |
Neoplasms by Histologic Type Neoplasms Neoplasms by Site Neoplasm Metastasis Neoplastic Processes Pathologic Processes |