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Phase I Study of Fractionated Stereotactic Radiation Therapy

Primary Purpose

Brain Metastases

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Fractionated Stereotactic Radiation Therapy
Sponsored by
Albert Einstein College of Medicine
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Brain Metastases

Eligibility Criteria

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

Inclusion Criteria:

  • Pathologically proven diagnosis of a non-hematological malignancy other than small cell lung cancer within 5 years of registration.
  • Patients with measurable brain metastases who have a gadolinium contrast enhanced MRI obtained within 30 days prior to registration. Patients with CT based diagnostic imaging without MRI will not be allowed to enroll on this trial.
  • No surgical resection of the target lesion, defined as ≥3 cm but ≤6 cm in size on MRI of the Brain with contrast
  • Prior Whole Brain Radiation Therapy (WBRT) is allowed
  • Age ≥ 18 years
  • Karnofsky performance status ≥ 60 or ECOG ≤2
  • Women of childbearing potential and male participants must practice adequate contraception
  • History/Physical examination within 30 days prior to registration
  • Life expectancy>3 months
  • Patients are allowed to enroll if previously treated to other lesions with SRS
  • Patients with multiple lesions are allowed, as long there is one dominant lesion that will be treated with FSRT. Other lesions may be treated concurrently with SRS or FSRT at the discretion of the treating physician but will not contribute to the study endpoints.

Exclusion Criteria:

  • Patients with definitive leptomeningeal metastases, based on cerebrospinal fluid examination (CSF)
  • Plan for chemotherapy or targeted agents during treatment. All hormonal therapy and bone supportive therapy may be continued while patient is on study.
  • Contraindication to enhanced MRI imaging such as implanted metal devices. However, patients with implanted devices which are MRI compatible are allowed.
  • Patients with measurable brain metastasis resulting from small cell lung cancer and germ cell malignancy
  • Uncontrolled intercurrent illness such as congestive heart failure, unstable angina, cardiac arrhythmia, and uncontrolled seizure activity.
  • Previous treatment of the target lesions with radiotherapy.

Sites / Locations

  • Montefiore Medical CenterRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Fractionated Stereotactic Radiation Therapy

Arm Description

This study is unique in that it employs a continuous reassessment methodology (CRM) to determine the Maximum Tolerated Dose. Information for the proper dose level for each subsequent patient enrolled will be determined based on DLTs from previous patients enrolled in the trial.

Outcomes

Primary Outcome Measures

Maximum Tolerated Dose (MTD)
The primary endpoint of this study is to determine the maximum tolerated dose (MTD) associated with a 20% dose limiting toxicity (DLT).

Secondary Outcome Measures

Full Information

First Posted
October 30, 2018
Last Updated
June 7, 2023
Sponsor
Albert Einstein College of Medicine
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1. Study Identification

Unique Protocol Identification Number
NCT03726359
Brief Title
Phase I Study of Fractionated Stereotactic Radiation Therapy
Official Title
Phase I TITE-CREM Dose Escalation Study of Fractionated Stereotactic Radiation Therapy (FSRT) in Unresected Brain Metastases
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Recruiting
Study Start Date
December 25, 2017 (Actual)
Primary Completion Date
February 2024 (Anticipated)
Study Completion Date
February 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Albert Einstein College of Medicine

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
There is a lack of prospective trial data and consensus guidelines describing the use of Fractionated Stereotactic Radiation Therapy (FSRT) in the treatment of brain metastases. There has been no prospective dose escalation study performed to date to determine the maximum tolerated dose (MTD) in patients treated with FSRT. Prescription doses in the series described above ranged from 18 Gy to 42 Gy, delivered in 3 to 12 fractions. The results of this study will be used to plan future Phase II/III studies to determine the efficacy of different dose fractionation schedules of FSRT. We thus propose a phase I study to determine the feasibility and safety of FSRT in patients with brain metastases.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Brain Metastases

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Fractionated Stereotactic Radiation Therapy
Arm Type
Experimental
Arm Description
This study is unique in that it employs a continuous reassessment methodology (CRM) to determine the Maximum Tolerated Dose. Information for the proper dose level for each subsequent patient enrolled will be determined based on DLTs from previous patients enrolled in the trial.
Intervention Type
Radiation
Intervention Name(s)
Fractionated Stereotactic Radiation Therapy
Intervention Description
Initial starting dose will be 7 Gy x5= 35 Gy delivered to the planning target volume (PTV). Radiotherapy will be delivered every other day so that the SBRT schedule is completed within 1.5-2 weeks.
Primary Outcome Measure Information:
Title
Maximum Tolerated Dose (MTD)
Description
The primary endpoint of this study is to determine the maximum tolerated dose (MTD) associated with a 20% dose limiting toxicity (DLT).
Time Frame
1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Pathologically proven diagnosis of a non-hematological malignancy other than small cell lung cancer within 5 years of registration. Patients with measurable brain metastases who have a gadolinium contrast enhanced MRI obtained within 30 days prior to registration. Patients with CT based diagnostic imaging without MRI will not be allowed to enroll on this trial. No surgical resection of the target lesion, defined as ≥3 cm but ≤6 cm in size on MRI of the Brain with contrast Prior Whole Brain Radiation Therapy (WBRT) is allowed Age ≥ 18 years Karnofsky performance status ≥ 60 or ECOG ≤2 Women of childbearing potential and male participants must practice adequate contraception History/Physical examination within 30 days prior to registration Life expectancy>3 months Patients are allowed to enroll if previously treated to other lesions with SRS Patients with multiple lesions are allowed, as long there is one dominant lesion that will be treated with FSRT. Other lesions may be treated concurrently with SRS or FSRT at the discretion of the treating physician but will not contribute to the study endpoints. Exclusion Criteria: Patients with definitive leptomeningeal metastases, based on cerebrospinal fluid examination (CSF) Plan for chemotherapy or targeted agents during treatment. All hormonal therapy and bone supportive therapy may be continued while patient is on study. Contraindication to enhanced MRI imaging such as implanted metal devices. However, patients with implanted devices which are MRI compatible are allowed. Patients with measurable brain metastasis resulting from small cell lung cancer and germ cell malignancy Uncontrolled intercurrent illness such as congestive heart failure, unstable angina, cardiac arrhythmia, and uncontrolled seizure activity. Previous treatment of the target lesions with radiotherapy.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Alyssa Asaro, BA
Phone
718-920-5636
Email
aasaro@montefiore.org
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Madhur Garg, MD
Organizational Affiliation
Montefiore
Official's Role
Principal Investigator
Facility Information:
Facility Name
Montefiore Medical Center
City
Bronx
State/Province
New York
ZIP/Postal Code
10467
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Alyssa Asaro, BA
Phone
718-920-5636
Email
aasaro@montefiore.org

12. IPD Sharing Statement

Learn more about this trial

Phase I Study of Fractionated Stereotactic Radiation Therapy

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