A Study Comparing GLIADEL to Stereotactic Radiosurgery in Metastatic Brain Disease
Primary Purpose
Brain Tumor - Metastatic
Status
Recruiting
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Carmustine 7.7Mg Wafer
Sponsored by
About this trial
This is an interventional treatment trial for Brain Tumor - Metastatic
Eligibility Criteria
Inclusion Criteria:
- Age 18 years or older (Nebraska is 19 years or older)
- Karnofsky Performance Score ≥ 70
- RPA class I or II
- Known or suspected primary solid cancer with metastatic brain tumor(s) - up to four in number and up to 4 cm in size with surgical resection planned for one or two tumors.
- Adequate platelet count (≥ 100,000/mm3), transfusion permitted
- Laboratory values adequate for patient to undergo surgery, including: (transfusion permitted to reach goals)
- Women of childbearing potential must have a negative pregnancy test within 7 days of initiating study
- INR ≤ 1.3
- Estimated survival time of ≥ 3 months as determined by the patient's primary oncologist.
- The subject is willing and able to consent to and abide by the protocol.
Exclusion Criteria:
- Prior treatment to the area of planned resection (surgery, radiation).
- Prior whole brain radiation therapy.
- Diagnosis of lymphoma, germ cell cancer, small cell lung cancer, anaplastic thyroid cancer.
- Leptomeningeal disease
- Neurodegenerative disorder (e.g. dementia).
- Tumor size > 4 cm.
- RPA class III
- Inability or unwillingness to co-operate with the requirements of the protocol
- Any other clinically significant medical disease or condition laboratory abnormality or psychiatric illness that, in the Investigator's opinion, may interfere with protocol adherence or confound efficacy or safety assessment or a subject's ability to give informed consent.
- Participation in other therapeutic clinical trials
Severe pulmonary, cardiac or other systemic disease, specifically:
- New York Heart Association > Grade 2 congestive heart failure within 6 months prior to study entry, unless asymptomatic and well controlled with medication
- Uncontrolled or significant cardiovascular disease, clinically significant ventricular arrhythmia, clinically significant pulmonary disease
- Subjects who have any other disease, either metabolic or psychological, which as per the Investigator assessment may affect the subject's compliance or place the subject at higher risk of potential treatment complications.
- The subject has a bleeding diathesis, or must take anticoagulants, or antiplatelet agents including NSAIDs (non-steroidal anti-inflammatory drugs), at the time of scheduled resection that cannot be stopped for surgery.
- Inability to obtain MRI studies.
Sites / Locations
- Henry Ford
- University of Nebraska Medical CenterRecruiting
- Ohio State University
Arms of the Study
Arm 1
Arm 2
Arm Type
No Intervention
Experimental
Arm Label
Standard of Care Arm
GLIADEL Arm
Arm Description
The tumor will be removed surgically. Within 6 weeks after surgery, the resection will be treated with stereotactic radiosurgery (SRS).
Once the tumor has been removed, GLIADEL wafers will be applied to the resection cavity. The number of wafers used will be determined by the size of the cavity. Enough wafers should be used so that as much of the cavity is covered as possible.
Outcomes
Primary Outcome Measures
Efficacy of GLIADEL compared to Stereotactic Radiosurgery (SRS)
The primary outcome is to evaluate the efficacy of GLIADEL local chemotherapy compared to Stereotactic Radiosurgery (SRS) in preventing local recurrence after resection of a metastatic brain tumor (local recurrence at surgical site).
Secondary Outcome Measures
Full Information
NCT ID
NCT04222062
First Posted
January 6, 2020
Last Updated
August 28, 2023
Sponsor
University of Nebraska
Collaborators
Arbor Pharmaceuticals, Inc.
1. Study Identification
Unique Protocol Identification Number
NCT04222062
Brief Title
A Study Comparing GLIADEL to Stereotactic Radiosurgery in Metastatic Brain Disease
Official Title
A Randomized Trial Evaluating GLIADEL Compared to Stereotactic Radiosurgery in Subjects With Metastatic Brain Disease
Study Type
Interventional
2. Study Status
Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
November 6, 2020 (Actual)
Primary Completion Date
December 1, 2025 (Anticipated)
Study Completion Date
December 1, 2026 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Nebraska
Collaborators
Arbor Pharmaceuticals, Inc.
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This study is being done to see if adding GLIADEL to the site where the tumor was removed works as well as just having the tumor removed with radiation treatment done within six weeks after the surgery to keep the cancer from coming back.
Detailed Description
This study is being done to assess the efficacy of GLIADEL (a local chemotherapy) in preventing local recurrence of a metastatic brain tumor compared to stereotactic radiosurgery (SRS) after resection.
100 Adult subjects with one to four metastatic brain tumors with one tumor needing resection will be enrolled. Subjects with prior radiation, lymphoma, small cell, germ cell, unknown primary, or anaplastic thyroid diagnoses will be ineligible. Life expectancy should be greater than 3 months.
Subjects will be randomized at the time of surgery to 1) GLIADEL placement at the time of resection or 2) SRS post-operatively to the resection cavity. Any other tumors (up to three) will have SRS as their primary treatment after surgery. SRS will take place within 6 weeks from surgery.
Subjects will be evaluated pre-operatively with MRI brain and neuropsychological testing and will have immediate post-op MRI for extent of resection (EOR) determination. Subjects will have SRS to the resection cavity if no GLIADEL was placed and all will have SRS to any other lesions. They will be followed at set intervals to evaluate for local recurrence and neurocognitive changes. The genome of the metastatic brain tumor will be compared to their primary and germline for identification of alterations.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Brain Tumor - Metastatic
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Subjects will be randomized to either 1) the GLIADEL Arm or 2) the Standard of Care Arm (SRS post-op).
Masking
ParticipantCare ProviderOutcomes Assessor
Allocation
Randomized
Enrollment
100 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Standard of Care Arm
Arm Type
No Intervention
Arm Description
The tumor will be removed surgically. Within 6 weeks after surgery, the resection will be treated with stereotactic radiosurgery (SRS).
Arm Title
GLIADEL Arm
Arm Type
Experimental
Arm Description
Once the tumor has been removed, GLIADEL wafers will be applied to the resection cavity. The number of wafers used will be determined by the size of the cavity. Enough wafers should be used so that as much of the cavity is covered as possible.
Intervention Type
Drug
Intervention Name(s)
Carmustine 7.7Mg Wafer
Other Intervention Name(s)
GLIADEL
Intervention Description
GLIADEL wafers will be placed to cover tumor bed immediately after tumor removal.
Primary Outcome Measure Information:
Title
Efficacy of GLIADEL compared to Stereotactic Radiosurgery (SRS)
Description
The primary outcome is to evaluate the efficacy of GLIADEL local chemotherapy compared to Stereotactic Radiosurgery (SRS) in preventing local recurrence after resection of a metastatic brain tumor (local recurrence at surgical site).
Time Frame
12 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Age 18 years or older (Nebraska is 19 years or older)
Karnofsky Performance Score ≥ 70
RPA class I or II
Known or suspected primary solid cancer with metastatic brain tumor(s) - up to four in number and up to 4 cm in size with surgical resection planned for one or two tumors.
Adequate platelet count (≥ 100,000/mm3), transfusion permitted
Laboratory values adequate for patient to undergo surgery, including: (transfusion permitted to reach goals)
Women of childbearing potential must have a negative pregnancy test within 7 days of initiating study
INR ≤ 1.3
Estimated survival time of ≥ 3 months as determined by the patient's primary oncologist.
The subject is willing and able to consent to and abide by the protocol.
Exclusion Criteria:
Prior treatment to the area of planned resection (surgery, radiation).
Prior whole brain radiation therapy.
Diagnosis of lymphoma, germ cell cancer, small cell lung cancer, anaplastic thyroid cancer.
Leptomeningeal disease
Neurodegenerative disorder (e.g. dementia).
Tumor size > 4 cm.
RPA class III
Inability or unwillingness to co-operate with the requirements of the protocol
Any other clinically significant medical disease or condition laboratory abnormality or psychiatric illness that, in the Investigator's opinion, may interfere with protocol adherence or confound efficacy or safety assessment or a subject's ability to give informed consent.
Participation in other therapeutic clinical trials
Severe pulmonary, cardiac or other systemic disease, specifically:
New York Heart Association > Grade 2 congestive heart failure within 6 months prior to study entry, unless asymptomatic and well controlled with medication
Uncontrolled or significant cardiovascular disease, clinically significant ventricular arrhythmia, clinically significant pulmonary disease
Subjects who have any other disease, either metabolic or psychological, which as per the Investigator assessment may affect the subject's compliance or place the subject at higher risk of potential treatment complications.
The subject has a bleeding diathesis, or must take anticoagulants, or antiplatelet agents including NSAIDs (non-steroidal anti-inflammatory drugs), at the time of scheduled resection that cannot be stopped for surgery.
Inability to obtain MRI studies.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Erin E Rogers
Phone
402-559-0963
Email
errogers@unmc.edu
First Name & Middle Initial & Last Name or Official Title & Degree
Taylor A Johnson, BS, MA
Phone
402-559-4596
Email
taylora.johnson@unmc.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michele Aizenberg, MD
Organizational Affiliation
University of Nebraska
Official's Role
Principal Investigator
Facility Information:
Facility Name
Henry Ford
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48202
Country
United States
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ian Lee, MD
Facility Name
University of Nebraska Medical Center
City
Omaha
State/Province
Nebraska
ZIP/Postal Code
68198
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Michele R Aizenberg Ansari, MD
Phone
402-559-9614
Email
maizenberg@unmc.edu
Facility Name
Ohio State University
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43210
Country
United States
Individual Site Status
Not yet recruiting
12. IPD Sharing Statement
Plan to Share IPD
No
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A Study Comparing GLIADEL to Stereotactic Radiosurgery in Metastatic Brain Disease
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