Tumor Treating Fields for the Treatment of Leptomeningeal Metastases of the Spine in Patients With Breast Cancer
Anatomic Stage IV Breast Cancer AJCC v8, Metastatic Breast Carcinoma, Metastatic Malignant Neoplasm in the Leptomeninges
About this trial
This is an interventional treatment trial for Anatomic Stage IV Breast Cancer AJCC v8
Eligibility Criteria
Inclusion Criteria: Age >= 18 Prior tissue diagnosis of breast cancer Confirmed diagnosis of leptomeningeal metastases (LM) with positive cerebrospinal fluid (CSF) cytology for malignancy and meningeal enhancement (type 1A, 1B, and 1C) Radiographic evidence on MRI of leptomeningeal enhancement within the cervical, thoracic or lumbar spine on spinal MRI Life expectancy of at least 6 weeks Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, 2, or 3 Recovery from any neurotoxic effects of prior therapy Platelet count greater than 25,000/mm^3, and absolute neutrophil count (ANC) greater than 0.5 mm^3 Patients must have adequate liver function, total bilirubin < 2.5 mg%, unless elevated total bilirubin is due to elevated indirect bilirubin from known Gilbert's disease, aspartate aminotransferase (AST) =< 3.5 times upper limits of normal; adequate renal function (calculated estimated glomerular filtration rate [eGFR] >= 30%) Patients or legal medical representative must provide written informed consent Patients must have suitable body habitus for placement of transducer arrays Patients must be willing to wear the device for at least 18 hours a day (averaged over monthly) Patients must be willing to return for the scheduled evaluations and perform the required assessments Patients are without other disease or situation which would significantly compromise adequate assessment of safety and feasibility of the TTF Patient willing to start a study treatment with TTF =< 14 days from registration Exclusion Criteria: Concomitant therapy: Must not be receiving concurrent high-dose methotrexate (>= 3 g/m^2), high dose thiotepa, or high-dose cytarabine (>= 3 g/m^2). Any other systemic chemotherapy, targeted treatment, hormonal or immunotherapy directed at the primary systemic malignancy is permitted Must not have received radiation therapy (RT) to the brain or spinal cord within 2 weeks of initiation of TTF Must be at least 1 week from cessation of any prior intrathecal chemotherapy Women of childbearing age who are pregnant or lactating. (Male and female patients who are fertile must be willing to use an effective means of birth control to avoid pregnancy) Patients with uncontrolled or untreated infection including active hepatitis, and human immunodeficiency virus (HIV) Patients receiving any other investigational agents and must not have received any other investigational agent within 14 days prior to registration. The 14-day period should be extended if the investigational agent is known to have delayed toxicity Patients known to be allergic to the hydrophilic gel utilized for transducer attachment Patients with surgical hardware within the planned area of treatment in the spine (e.g., titanium rods, screws, fixation devices)
Sites / Locations
- Mayo Clinic in FloridaRecruiting
Arms of the Study
Arm 1
Experimental
Treatment (TTFields, digital photos)
Patients have transducer arrays applied and digital photographs taken of placement on study. Patients wear the NovoTTF-200T portable system on study. Patients also undergo MRI and may undergo LP during screening and on study.