search
Back to results

Expedited Laser Interstitial Thermal Therapy + Chemoradiation For Newly Diagnosed High Grade Gliomas

Primary Purpose

High Grade Glioma

Status
Recruiting
Phase
Early Phase 1
Locations
United States
Study Type
Interventional
Intervention
LITT
Radiation therapy
Temozolomide
Sponsored by
Case Comprehensive Cancer Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for High Grade Glioma focused on measuring LITT, Brain Tumor, Temozolomide

Eligibility Criteria

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

Inclusion Criteria:

  • Subjects must have suspected high grade glioma by MRI
  • Subjects must have received no prior therapies for this disease.
  • Patients must be considered appropriate candidates for LITT.
  • Karnofsky Performance status ≥ 60%
  • Subjects must have normal organ and marrow function as defined below. Measures of function must be within 14 days prior to registration.

    • Absolute neutrophil count (ANC) ≥ 1500 cells/mm3, platelets ≥ 100,000 cells/mm3, hemoglobin ≥ 10.0 g/dl. Use of transfusion or other intervention to achieve this hemoglobin level is acceptable.
    • Blood urea nitrogen ≤ 30mg/dl and creatinine ≤ 1.7 mg/dl
    • Bilirubin ≤ 2.0 mg/dl, Aspartate aminotransferase/ Alanine aminotransferase (AST/ALT) ≤ 3x upper limit of normal
    • Electrocardiogram without evidence of acute cardiac ischemia
    • Prothrombin time/international normalized ratio (PT INR) <1.4
  • Women of childbearing potential and male participants must practice adequate contraception.
  • For women of childbearing age, negative pregnancy test within 14 days prior to registration
  • Subjects must have the ability to understand and the willingness to sign a written informed consent document.

Exclusion Criteria:

  • Participants not eligible to obtain MRI with and without contrast
  • Recurrent High grade gliomas (HGG)
  • Cerebral edema, grade 3 or greater prior to surgery
  • Post-operative complications including significant neurological decline or hemorrhage that causes a drop in KPS to less than 60 or renders the patient not suitable for chemoradiation as determined by their treating physician
  • Severe co-morbidity that would confer excess risk of surgery, radiation or chemotherapy, as determined by the treating physician.

Any other major medical illnesses or psychiatric impairments that in the investigator's opinion will prevent administration of completion of protocol therapy

  • Any other major medical illnesses or psychiatric impairments that in the investigator's opinion will prevent administration or completion of protocol therapy.
  • Pregnancy or women of childbearing potential and men who are sexually active and not willing/able to use medically acceptable forms of contraception; this exclusion is necessary because the treatment involved in this study may be significantly teratogenic.
  • Participants receiving other investigational agents.

Sites / Locations

  • Cleveland Clinic Taussig Cancer institute, Case Comprehensive Cancer CenterRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

LITT with Radiation and Temozolomide

Arm Description

Laser interstitial thermal therapy (LITT) followed by Radiation therapy, three-dimensional conformal radiotherapy (3D-CRT) or intensity modulation radiation therapy (IMRT), 60 Gy/30 fractions. Radiation given with chemotherapy Temozolomide

Outcomes

Primary Outcome Measures

Study safety as determined by the number of patients who experience pre-specified adverse events
pre-specified adverse events include: Wound dehiscence, grade 3 (CTCAE v4.0), Grade 3 Seizures (CTCAE v4.0) in patients without a prior history of seizures and on adequate anti-seizure medications, Cerebral edema, grade 4 (CTCAE v4.0), Failure to complete of 60 Gy radiation

Secondary Outcome Measures

Number of patients with adjustments to radiation plan to account for post-LITT tissue distortion
The proportion of patients requiring a change in radiation plan after fusion of the plan with the post-operative MRI will be calculated, and a 95% confidence interval will be placed on this proportion.

Full Information

First Posted
November 18, 2016
Last Updated
July 24, 2023
Sponsor
Case Comprehensive Cancer Center
search

1. Study Identification

Unique Protocol Identification Number
NCT02970448
Brief Title
Expedited Laser Interstitial Thermal Therapy + Chemoradiation For Newly Diagnosed High Grade Gliomas
Official Title
Expedited Laser Interstitial Thermal Therapy and Chemoradiation for Patients With Newly Diagnosed High Grade Gliomas
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Recruiting
Study Start Date
August 24, 2017 (Actual)
Primary Completion Date
January 1, 2024 (Anticipated)
Study Completion Date
January 1, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Case Comprehensive Cancer Center

4. Oversight

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

5. Study Description

Brief Summary
The investigators of this study want to see if shortening the total treatment time for brain tumors is safe.The treatment for participant's brain tumors is laser surgery (Laser Interstitial Thermal Therapy (LITT)) followed by radiation with chemotherapy. For participants, the total time of treatment from surgery to the end of radiation and chemotherapy is about l 0 weeks long. This study asks whether it is safe to shorten the total treatment to 7 weeks. To shorten the total treatment time, investigators want to see if it is safe to start radiation with chemotherapy within 5 days after surgery. Usually patients start their radiation with chemotherapy about 21-28 days after the surgery. Shortening the total time of treatment may allow investigators to kill the cancer cells more effectively.
Detailed Description
Primary Objective To determine the safety and feasibility of reducing the time interval between LITT and the start of chemoradiation to ≤ 7 days. The primary endpoint (binary) for safety/feasibility will be defined as the occurrence of one or more of the following within each patient during a window of observation from the completion LITT to the end of radiation: Wound dehiscence, grade 3 {CTCAE v4.0) Seizures, grade 3 (CTCAE v4.0) in patients without a prior history of seizures and on adequate anti-seizure medications Cerebral edema, grade 4 (CTCAE v4.0) Failure to complete of 60 Grays (Gy) of radiation Secondary Objective(s) To estimate the proportion of patients requiring adjustments in radiation plans post-LITT. Secondary Endpoint: Requirement of an adjustment in the radiation plan to account for post-LITT tissue distortion. Study design This study will be a 2-stage, single-institution safety and feasibility trial. Patients will be evaluated by a neuro-oncology team consisting of a neurosurgeon trained in LITT, radiation oncologist and medical oncologist prior to surgery. Evaluable patients will have a histologic diagnosis of high-grade glioma, complete LITT, and are candidates for standard concurrent radiation (60 Gy) and temozolomide as determined by the treating physician. Concurrent chemoradiation will begin within 7 days of the LITT procedure.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
High Grade Glioma
Keywords
LITT, Brain Tumor, Temozolomide

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
LITT with Radiation and Temozolomide
Arm Type
Experimental
Arm Description
Laser interstitial thermal therapy (LITT) followed by Radiation therapy, three-dimensional conformal radiotherapy (3D-CRT) or intensity modulation radiation therapy (IMRT), 60 Gy/30 fractions. Radiation given with chemotherapy Temozolomide
Intervention Type
Procedure
Intervention Name(s)
LITT
Other Intervention Name(s)
Laser interstitial thermal therapy
Intervention Description
MRI-guided laser interstitial thermal therapy uses a gas cooled side-firing (directional) laser and a variety of procedure specific tools to thermally ablate target tissue in-situ.
Intervention Type
Radiation
Intervention Name(s)
Radiation therapy
Other Intervention Name(s)
3D-Conformal radiation therapy (RT), Intensity Modulated RT
Intervention Description
One treatment of 2 Gy will be given daily 5 days per week for a total of 60 Gy over 6 weeks. All portals shall be treated during each treatment session. Doses are specified such that at least 95% of the planning target volume (PTV) shall receive 100% of the prescribed dose.
Intervention Type
Drug
Intervention Name(s)
Temozolomide
Intervention Description
Temozolomide will be administered continuously from day 1 of radiotherapy to the last day of radiation at a daily oral dose of 75 mg/m2 for a maximum of 49 days
Primary Outcome Measure Information:
Title
Study safety as determined by the number of patients who experience pre-specified adverse events
Description
pre-specified adverse events include: Wound dehiscence, grade 3 (CTCAE v4.0), Grade 3 Seizures (CTCAE v4.0) in patients without a prior history of seizures and on adequate anti-seizure medications, Cerebral edema, grade 4 (CTCAE v4.0), Failure to complete of 60 Gy radiation
Time Frame
Up to 12 weeks after LITT therapy
Secondary Outcome Measure Information:
Title
Number of patients with adjustments to radiation plan to account for post-LITT tissue distortion
Description
The proportion of patients requiring a change in radiation plan after fusion of the plan with the post-operative MRI will be calculated, and a 95% confidence interval will be placed on this proportion.
Time Frame
Up to 12 weeks after LITT therapy

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects must have suspected high grade glioma by MRI Subjects must have received no prior therapies for this disease. Patients must be considered appropriate candidates for LITT. Karnofsky Performance status ≥ 60% Subjects must have normal organ and marrow function as defined below. Measures of function must be within 14 days prior to registration. Absolute neutrophil count (ANC) ≥ 1500 cells/mm3, platelets ≥ 100,000 cells/mm3, hemoglobin ≥ 10.0 g/dl. Use of transfusion or other intervention to achieve this hemoglobin level is acceptable. Blood urea nitrogen ≤ 30mg/dl and creatinine ≤ 1.7 mg/dl Bilirubin ≤ 2.0 mg/dl, Aspartate aminotransferase/ Alanine aminotransferase (AST/ALT) ≤ 3x upper limit of normal Electrocardiogram without evidence of acute cardiac ischemia Prothrombin time/international normalized ratio (PT INR) <1.4 Women of childbearing potential and male participants must practice adequate contraception. For women of childbearing age, negative pregnancy test within 14 days prior to registration Subjects must have the ability to understand and the willingness to sign a written informed consent document. Exclusion Criteria: Participants not eligible to obtain MRI with and without contrast Recurrent High grade gliomas (HGG) Cerebral edema, grade 3 or greater prior to surgery Post-operative complications including significant neurological decline or hemorrhage that causes a drop in KPS to less than 60 or renders the patient not suitable for chemoradiation as determined by their treating physician Severe co-morbidity that would confer excess risk of surgery, radiation or chemotherapy, as determined by the treating physician. Any other major medical illnesses or psychiatric impairments that in the investigator's opinion will prevent administration of completion of protocol therapy Any other major medical illnesses or psychiatric impairments that in the investigator's opinion will prevent administration or completion of protocol therapy. Pregnancy or women of childbearing potential and men who are sexually active and not willing/able to use medically acceptable forms of contraception; this exclusion is necessary because the treatment involved in this study may be significantly teratogenic. Participants receiving other investigational agents.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jennifer Yu, MD, PhD
Phone
1-866-223-8100
Email
TaussigResearch@ccf.org
First Name & Middle Initial & Last Name or Official Title & Degree
Teresa Allison
Phone
1-866-223-8100
Email
TaussigResearch@ccf.org
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jennifer Yu, MD, PhD
Organizational Affiliation
Cleveland Clinic Taussig Cancer institute, Case Comprehensive Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Cleveland Clinic Taussig Cancer institute, Case Comprehensive Cancer Center
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jennifer Yu, MD, PhD
Phone
866-223-8100
Email
TaussigResearch@ccf.org

12. IPD Sharing Statement

Learn more about this trial

Expedited Laser Interstitial Thermal Therapy + Chemoradiation For Newly Diagnosed High Grade Gliomas

We'll reach out to this number within 24 hrs