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Magnetic Resonance Imaging-Guided Laser Induced Thermal Therapy for Treatment of Metastatic Brain Tumors

Primary Purpose

Brain Neoplasms

Status
Unknown status
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
MRI-Guided Laser Induced Thermal Therapy
Sponsored by
Visualase, Inc.
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Brain Neoplasms focused on measuring brain, metastasis, neoplasm, tumor, Patients with secondary brain neoplasms, laser therapy, laser interstitial thermal therapy

Eligibility Criteria

undefined - undefined (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Patient or family able and willing to give informed consent.
  • Subjects with metastatic cancer to the brain who have failed at least one conventional therapy (surgery, stereotactic radiosurgery, and/or whole brain radiotherapy).
  • Three or fewer previously treated or untreated lesion(s) in the brain.
  • Tumor size ≤ 3.0 cm in largest diameter.
  • MR imaging is not contraindicated for the patient.
  • Lesion(s) are clearly defined on pre-therapy contrast enhanced MRI scans as determined by the treating surgeon.
  • Able and willing to attend all study visits.
  • Karnofsky Performance Scale score >70 for patients over the age of 15.
  • Lansky Play Scale >70 for patients 15 years of age or younger.

Exclusion Criteria:

  • Patients or family unwilling or unable to give written consent.
  • Patients who cannot physically fit in, or are too heavy for, the MRI scanner.
  • Patients with contra-indications to MRI imaging, such as, but not limited to, pacemakers or defibrillators, non-compatible aneurysm clips, shrapnel, or other internal ferromagnetic objects.
  • Known sensitivity to gadolinium-DTPA.
  • Based on Treatment Planning Imaging (MR and/or CT):

    • Brain edema and/or mass effect that causes midline shift or shift in wall of ventricle of more than 5 mm.
    • Lesions localized in the brain stem.
    • Lesions less than 5mm from primary branches of cerebral vessels, venous sinus, hypophysis or cranial nerves.
    • Evidence of recent (<2 weeks) hemorrhage.
  • Presence of more than 3 brain tumors at the time of enrollment.
  • Symptoms and signs of increased intracranial pressure.
  • Medical issues which prohibit the patient from undergoing surgery (as determined by the treating surgeon, anesthesiologist, IMPAC clinic, referring physician).
  • Patients who are unable to receive corticosteroids.
  • Positive pregnancy test for women of child-bearing age.

Sites / Locations

  • North Shore University HospitalRecruiting

Outcomes

Primary Outcome Measures

Rate of technical success or failure to complete the initial procedure with no associated major complications.

Secondary Outcome Measures

Examination of the extent to which Visualase predictions based on MRTI data match lesion dimensions form post-therapy MRI assessments.
Estimates of durations, required facilities, required personnel, and costs for all aspects of the treatment procedure
Local control of treated lesions as defined by volume of lesions increasing by no more than 25%
Accrual of patient survival post Visualase therapy
Procedure-related morbidity and mortality

Full Information

First Posted
October 29, 2008
Last Updated
December 30, 2009
Sponsor
Visualase, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT00787982
Brief Title
Magnetic Resonance Imaging-Guided Laser Induced Thermal Therapy for Treatment of Metastatic Brain Tumors
Official Title
Pilot Study Evaluating the Feasibility of Real-Time, Magnetic Resonance Thermal Imaging and Magnetic Resonance Imaging-Guided Laser Induced Thermal Therapy for Treatment of Metastatic Brain Tumors
Study Type
Interventional

2. Study Status

Record Verification Date
December 2009
Overall Recruitment Status
Unknown status
Study Start Date
September 2008 (undefined)
Primary Completion Date
September 2009 (Anticipated)
Study Completion Date
September 2010 (Anticipated)

3. Sponsor/Collaborators

Name of the Sponsor
Visualase, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
In this study, the Visualase Thermal Therapy System will be used on metastatic brain tumors that cannot be removed by surgery. Researchers want to find out if it is possible to use this new device in subjects with 1-3 metastatic brain tumor(s), each measuring 3 centimeters (cm) or smaller. The safety of the device will also be studied.
Detailed Description
The Visualase Thermal Therapy System is FDA-cleared for thermal destruction of soft tissue in neurosurgery under MRI guidance. The device combines 3 previously FDA-cleared devices: the Visualase Cooled Laser Application System, which delivers the laser (energy) to the tumor tissue; the PhoTex , Diode Laser Series, which is the laser itself; and the Visualase ENVISION Workstation, which is the computer system that helps the surgeon plan and monitor your treatment. The Visualase Thermal Therapy System will be used in this study to give subjects a type of therapy called Laser Interstitial Thermal Therapy (LITT). LITT uses laser light to heat and destroy the affected tissue; this is sometimes referred to as tissue ablation. In LITT, small fiber-optic applicators are placed directly into the tumor and heating is performed from the inside out, which may lead to the destruction of the tumor. During the heating process, MRTI can be used to watch the temperatures around the applicator to make sure that the tumor receives enough treatment and that the normal tissues around the tumor do not get too hot.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Brain Neoplasms
Keywords
brain, metastasis, neoplasm, tumor, Patients with secondary brain neoplasms, laser therapy, laser interstitial thermal therapy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Anticipated)

8. Arms, Groups, and Interventions

Intervention Type
Device
Intervention Name(s)
MRI-Guided Laser Induced Thermal Therapy
Intervention Description
LITT uses laser light to heat and destroy the affected tissue; this is sometimes referred to as tissue ablation. In LITT, small fiber-optic applicators are placed directly into the tumor and heating is performed from the inside out, which may lead to the destruction of the tumor
Primary Outcome Measure Information:
Title
Rate of technical success or failure to complete the initial procedure with no associated major complications.
Time Frame
within 24 hours following the procedure
Secondary Outcome Measure Information:
Title
Examination of the extent to which Visualase predictions based on MRTI data match lesion dimensions form post-therapy MRI assessments.
Time Frame
Immediately following treatment (day 0)
Title
Estimates of durations, required facilities, required personnel, and costs for all aspects of the treatment procedure
Time Frame
from day 0 to patient release
Title
Local control of treated lesions as defined by volume of lesions increasing by no more than 25%
Time Frame
Day 30, 90, and 180 days post procedure
Title
Accrual of patient survival post Visualase therapy
Time Frame
Sooner of 3 years or patient death
Title
Procedure-related morbidity and mortality
Time Frame
30, 90,180 days post procedure

10. Eligibility

Sex
All
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient or family able and willing to give informed consent. Subjects with metastatic cancer to the brain who have failed at least one conventional therapy (surgery, stereotactic radiosurgery, and/or whole brain radiotherapy). Three or fewer previously treated or untreated lesion(s) in the brain. Tumor size ≤ 3.0 cm in largest diameter. MR imaging is not contraindicated for the patient. Lesion(s) are clearly defined on pre-therapy contrast enhanced MRI scans as determined by the treating surgeon. Able and willing to attend all study visits. Karnofsky Performance Scale score >70 for patients over the age of 15. Lansky Play Scale >70 for patients 15 years of age or younger. Exclusion Criteria: Patients or family unwilling or unable to give written consent. Patients who cannot physically fit in, or are too heavy for, the MRI scanner. Patients with contra-indications to MRI imaging, such as, but not limited to, pacemakers or defibrillators, non-compatible aneurysm clips, shrapnel, or other internal ferromagnetic objects. Known sensitivity to gadolinium-DTPA. Based on Treatment Planning Imaging (MR and/or CT): Brain edema and/or mass effect that causes midline shift or shift in wall of ventricle of more than 5 mm. Lesions localized in the brain stem. Lesions less than 5mm from primary branches of cerebral vessels, venous sinus, hypophysis or cranial nerves. Evidence of recent (<2 weeks) hemorrhage. Presence of more than 3 brain tumors at the time of enrollment. Symptoms and signs of increased intracranial pressure. Medical issues which prohibit the patient from undergoing surgery (as determined by the treating surgeon, anesthesiologist, IMPAC clinic, referring physician). Patients who are unable to receive corticosteroids. Positive pregnancy test for women of child-bearing age.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Pamela Kribs, R.N., BSN
Phone
516-562-3058
Email
pkribs@NSHS.edu
Facility Information:
Facility Name
North Shore University Hospital
City
Manhasset
State/Province
New York
ZIP/Postal Code
11030
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
pamela kribs, R.N.,BSN
Phone
516-562-3058
Email
pkribs@NSHS.edu
First Name & Middle Initial & Last Name & Degree
Michael Schulder, MD

12. IPD Sharing Statement

Links:
URL
http://www.visualaseinc.com
Description
Sponsors website

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Magnetic Resonance Imaging-Guided Laser Induced Thermal Therapy for Treatment of Metastatic Brain Tumors

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