This phase I trial is studying the side effects of fluorine F18 EF5 when given during
positron emission tomography to find oxygen in tumor cells of patients who are undergoing
surgery or biopsy for newly diagnosed brain tumors. Diagnostic procedures using fluorine F
18 EF5 and positron emission tomography to detect tumor hypoxia may help in planning cancer
I. Determine the safety of fluorine F 18 EF5 (^18F-EF5) in patients with newly diagnosed
brain tumors undergoing surgery or biopsy.
Secondary I. Determine the pharmacokinetics and biodistribution of ^18F-EF5 administered
before and after nonradioactive EF5 in these patients.
II. Determine the ability of positron emission tomography (PET) scanning using ^18F-EF5 to
detect tumor hypoxia in these patients.
III. Determine the presence and pattern of nonradioactive EF5 binding by
immunohistochemistry (IHC) and/or flow cytometry in these patients.
IV. Correlate tumor hypoxia, as measured by PET scanning using ^18F-EF5, with EF5 staining
by IHC and/or flow cytometry and recurrence-free survival of these patients.
OUTLINE: Patients are assigned to 1 of 3 groups.
Group 1: Patients receive fluorine F 18 EF5 (^18F-EF5) IV followed by whole brain and whole
body positron emission tomography (PET) scanning OR whole body PET scanning only. Patients
then receive nonradioactive EF5 IV over 1-2 ½ hours.
Group 2: Patients receive nonradioactive EF5 IV over 1-2½ hours followed by ^18F-EF5 IV.
Patients then undergo whole brain and whole body PET scanning.
Group 3: Patients receive nonradioactive EF5 and ^18F-EF5 as in group 2. Patients then
undergo whole brain PET scanning. Approximately one day after EF5 administration, all
patients undergo surgery or biopsy of the tumor AND biopsy of normal skin adjacent to the
Patients are followed at 2-4 weeks and 4-6 weeks after EF5 administration and then every 3
months for 1 year, every 4 months for 1 year, every 6 months for 1 year, and then annually
- Histologically confirmed and/or clinical and imaging evidence of a de novo mass that
is likely to be a brain tumor
- Amenable to debulking surgery or surgical resection or biopsy as standard initial
therapy for the tumor
- Performance status - Karnofsky 70-100%
- At least 3 months
- WBC count ≥ 2,000/mm^3
- Platelet count ≥ 100,000/mm^3
- Bilirubin < 1.2 mg/dL
- Creatinine < 1.3 mg/dL
- No symptomatic congestive heart failure
- No unstable angina pectoris
- No cardiac arrhythmia
- No other significant cardiac condition that would preclude study participation
- Not pregnant or nursing
- Negative pregnancy test
- Fertile patients must use effective contraception during and for 1 month after study
- Weight ≤ 130 kg
- No peripheral neuropathy ≥ grade 3
- No history of allergic reaction attributed to metronidazole
- No other uncontrolled illness
- No psychiatric illness or social situation that would preclude study compliance
- No other medical condition that would preclude study participation