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Surgical Tissue Flap to Bypass the Blood Brain Barrier in Glioblastoma

Primary Purpose

Glioma, Malignant, Glioblastoma, Glioblastoma Multiforme

Status
Recruiting
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Tissue autograft of pedicled temporoparietal fascial (TPF) or pericranial flap to bypass the blood brain barrier (BBB)
Sponsored by
Northwell Health
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Glioma, Malignant focused on measuring tissue autograft, blood brain barrier, pedicled temporoparietal fascial, pericranial flap

Eligibility Criteria

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

Inclusion Criteria: Subject is a male or female 18 years of age or older. Subject is undergoing planned resection of known or suspected GBM. Subject has a Karnofsky Performance Status (KPS) 70% or greater. Subject has a life expectancy of at least 6 months, in the opinion of the Investigator. Based on the pre-operative evaluation by neurosurgeon, the subject is a candidate for ≥ 80% resection of enhancing region. Subject must be able to undergo MRI evaluation. Subject meets the following laboratory criteria: White blood count ≥ 3,000/μL Absolute neutrophil count ≥ 1,500/μL Platelets ≥ 100,000/μL Hemoglobin > 10.0 g/dL (transfusion and/or ESA allowed) Total bilirubin and alkaline phosphatase ≤ 2x institutional upper limit of normal (ULN) Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) < 3 x ULN Blood urea nitrogen (BUN) and creatinine < 1.5 x ULN Females of reproductive potential must have a negative serum pregnancy test and be willing to use an acceptable method of birth control. Males of reproductive potential must be willing to use an acceptable method of birth control to ensure effective contraception with partner. Able to understand and willing to sign an institutional review board (IRB)- approved written informed consent document (legally authorized representative permitted). Inclusion criteria considered during surgery: Subject has a histologically confirmed (frozen section) diagnosis of WHO Grade IV glioblastoma multiforme (GBM). TPFF and/or pericranial flap is technically feasible. Exclusion Criteria: Subject, if female, is pregnant or is breast feeding. Subject has initiated chemotherapy or radiation treatment for diagnosis of or GBM. Subject intends to participate in another clinical trial Subject intends to undergo treatment with the Gliadel® wafer at the time of this surgery. Subject has an active infection requiring treatment. Subject has radiographic evidence of multi-focal disease or leptomeningeal dissemination. Subject has a history of other malignancy, unless the patient has been disease- free for at least 5 years. Adequately treated basal cell carcinoma or squamous cell skin cancer is acceptable regardless of time, as well as localized prostate carcinoma or cervical carcinoma in situ after curative treatment Subject has a known positive test for human immunodeficiency virus infection, or active hepatitis B or hepatitis C infection. Subject has a history or evidence of any other clinically significant disorder, condition or disease that would pose a risk to subject safety or interfere with the study evaluation, procedures or completion.

Sites / Locations

  • Lenox Hill Brain Tumor CenterRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Surgical tissue autograft: TPF flap/pericranial flap

Arm Description

Use of a pedicled autologous piece of tissue called the temporoparietal fascial (TPF) flap or pericranial flap into the resection cavity of newly diagnosed glioblastoma multiforme (GBM) patients

Outcomes

Primary Outcome Measures

Progression Free Survival (PFS)
PFS is defined as time from surgery until first known disease progression or death from any cause, whichever occurs first.

Secondary Outcome Measures

Overall Survival (OS)
OS will be calculated as the time from treatment initiation (TPF implantation) to the time of death.

Full Information

First Posted
July 13, 2023
Last Updated
August 1, 2023
Sponsor
Northwell Health
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1. Study Identification

Unique Protocol Identification Number
NCT05954858
Brief Title
Surgical Tissue Flap to Bypass the Blood Brain Barrier in Glioblastoma
Official Title
Tissue Autograft to Bypass the Blood Brain Barrier (BBB) in Human Glioblastoma Multiforme (GBM)
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
June 29, 2023 (Actual)
Primary Completion Date
June 30, 2025 (Anticipated)
Study Completion Date
June 30, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Northwell Health

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This single center, single arm, open-label, phase 2 study will assess the safety and efficacy of a pedicled temporoparietal fascial (TPF) or pericranial flap into the resection cavity of newly diagnosed glioblastoma multifome (GBM) patients. The objective of the Phase 2 study is to demonstrate that this surgical technique is safe and effective in a human cohort of patients with resected newly diagnosed AA or GBM and may improve progression-free survival (PFS) and overall survival (OS).
Detailed Description
Glioblastoma (GBM) is the most common primary central nervous system malignancy in adults, and accounts for over half of all malignant brain tumors. The prognosis for newly diagnosed GBM is extremely poor even with Stupp protocol consisting of surgery followed by temozolomide and radiotherapy. For newly diagnosed GBM the median overall survival (OS) is only 15 months, and the median progression-free survival (PFS) is a mere 5-6 months with only 53.9% of patients having 6 month PFS. This Phase 2 study is an extension of our recently completely enrolled Phase I trial which showed the initial safety of a TPF into the resection cavity of newly diagnosed GBM. All 36 subjects included in this Phase 2 study will initially undergo standard surgical resection for newly diagnosed GBM. Following the resection, the surgical cavity will be lined with a long pedicled, autologous piece of tissue called a temporoparietal fascial flap or pericranium. The patient's dura, bone and scalp will be closed as is customary. The subject will be followed for side effects at 72 hours, 7 days, 30 days, 60 days, 120 days and 180 days. The primary outcome measure will be progression free survival (PFS) and secondary outcome measures will include overall survival (OS). Risk assessment will include seizure, stroke, infection, tumor progression, and death.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Glioma, Malignant, Glioblastoma, Glioblastoma Multiforme, Glioblastoma Multiforme, Adult, High Grade Glioma, GBM, Brain Cancer
Keywords
tissue autograft, blood brain barrier, pedicled temporoparietal fascial, pericranial flap

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
32 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Surgical tissue autograft: TPF flap/pericranial flap
Arm Type
Experimental
Arm Description
Use of a pedicled autologous piece of tissue called the temporoparietal fascial (TPF) flap or pericranial flap into the resection cavity of newly diagnosed glioblastoma multiforme (GBM) patients
Intervention Type
Procedure
Intervention Name(s)
Tissue autograft of pedicled temporoparietal fascial (TPF) or pericranial flap to bypass the blood brain barrier (BBB)
Other Intervention Name(s)
surgical tissue flap, tissue autograft
Intervention Description
Surgical tissue autograft of pedicled temporoparietal fascial (TPF) or pericranial flap into the resection cavity of newly diagnosed glioblastoma multiforme (GBM) patients.
Primary Outcome Measure Information:
Title
Progression Free Survival (PFS)
Description
PFS is defined as time from surgery until first known disease progression or death from any cause, whichever occurs first.
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Overall Survival (OS)
Description
OS will be calculated as the time from treatment initiation (TPF implantation) to the time of death.
Time Frame
2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject is a male or female 18 years of age or older. Subject is undergoing planned resection of known or suspected GBM. Subject has a Karnofsky Performance Status (KPS) 70% or greater. Subject has a life expectancy of at least 6 months, in the opinion of the Investigator. Based on the pre-operative evaluation by neurosurgeon, the subject is a candidate for ≥ 80% resection of enhancing region. Subject must be able to undergo MRI evaluation. Subject meets the following laboratory criteria: White blood count ≥ 3,000/μL Absolute neutrophil count ≥ 1,500/μL Platelets ≥ 100,000/μL Hemoglobin > 10.0 g/dL (transfusion and/or ESA allowed) Total bilirubin and alkaline phosphatase ≤ 2x institutional upper limit of normal (ULN) Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) < 3 x ULN Blood urea nitrogen (BUN) and creatinine < 1.5 x ULN Females of reproductive potential must have a negative serum pregnancy test and be willing to use an acceptable method of birth control. Males of reproductive potential must be willing to use an acceptable method of birth control to ensure effective contraception with partner. Able to understand and willing to sign an institutional review board (IRB)- approved written informed consent document (legally authorized representative permitted). Inclusion criteria considered during surgery: Subject has a histologically confirmed (frozen section) diagnosis of WHO Grade IV glioblastoma multiforme (GBM). TPFF and/or pericranial flap is technically feasible. Exclusion Criteria: Subject, if female, is pregnant or is breast feeding. Subject has initiated chemotherapy or radiation treatment for diagnosis of or GBM. Subject intends to participate in another clinical trial Subject intends to undergo treatment with the Gliadel® wafer at the time of this surgery. Subject has an active infection requiring treatment. Subject has radiographic evidence of multi-focal disease or leptomeningeal dissemination. Subject has a history of other malignancy, unless the patient has been disease- free for at least 5 years. Adequately treated basal cell carcinoma or squamous cell skin cancer is acceptable regardless of time, as well as localized prostate carcinoma or cervical carcinoma in situ after curative treatment Subject has a known positive test for human immunodeficiency virus infection, or active hepatitis B or hepatitis C infection. Subject has a history or evidence of any other clinically significant disorder, condition or disease that would pose a risk to subject safety or interfere with the study evaluation, procedures or completion.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
John Boockvar, MD
Phone
212-434-3900
Email
jboockvar@northwell.edu
First Name & Middle Initial & Last Name or Official Title & Degree
Tamika Wong, MPH
Phone
212-434-4836
Email
twong4@northwell.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
John Boockvar, MD
Organizational Affiliation
Feinstein Institute for Medical Research/Lenox Hill Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Lenox Hill Brain Tumor Center
City
New York
State/Province
New York
ZIP/Postal Code
10075
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
John Boockvar, MD
Phone
212-434-3900
Email
twong4@northwell.edu
First Name & Middle Initial & Last Name & Degree
Tamika Wong, MPH
Phone
212-434-4836
Email
twong4@northwell.edu
First Name & Middle Initial & Last Name & Degree
David Langer, MD
First Name & Middle Initial & Last Name & Degree
Netanel Ben-Shalom, MD
First Name & Middle Initial & Last Name & Degree
Randy D'Amico, MD
First Name & Middle Initial & Last Name & Degree
Deborah Gruber, MD
First Name & Middle Initial & Last Name & Degree
Avraham Zlochower, MD
First Name & Middle Initial & Last Name & Degree
Vadim Zhigin, PA
First Name & Middle Initial & Last Name & Degree
Olivia Albers, NP
First Name & Middle Initial & Last Name & Degree
Amy McKewon, NP
First Name & Middle Initial & Last Name & Degree
Tamika Wong, MPH

12. IPD Sharing Statement

Plan to Share IPD
No

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Surgical Tissue Flap to Bypass the Blood Brain Barrier in Glioblastoma

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