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Serial MR Imaging and MR Spectroscopic Imaging for the Characterization of Lower Grade Glioma

Primary Purpose

Recurrent World Health Organization (WHO) Grade II Glioma, Recurrent WHO Grade III Glioma, WHO Grade II Glioma

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Hyperpolarized Carbon C 13 Pyruvate
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopic Imaging
Sponsored by
Susan Chang
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional diagnostic trial for Recurrent World Health Organization (WHO) Grade II Glioma focused on measuring Glioma, Hyperpolarized Pyruvate (13C)

Eligibility Criteria

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

Inclusion Criteria:

  • For patients in cohort 1: histologically proven lower grade glioma who are being followed with surveillance scans
  • For patients in cohort 2: histologically proven glioma who are scheduled for treatment due to suspected residual or recurrent tumor
  • Patients with a life expectancy > 12 weeks
  • Patients must have a Karnofsky performance status of > 60
  • Patients must have adequate renal function (creatinine < 1.5 mg/dL) before imaging. These tests must be performed within 60 days prior to the hyperpolarized imaging scan.
  • Patients must not have any significant medical illnesses that in the investigator's opinion cannot be adequately controlled with appropriate therapy, would compromise the patient's ability to participate in this study or any disease that will obscure toxicity or dangerously impact response to the imaging agent.
  • Patients must not have New York Heart Association (NYHA) grade II or greater congestive heart failure
  • Patients must not have history of myocardial infarction or unstable angina within 12 months prior to study enrollment
  • This study was designed to include women and minorities, but was not designed to measure differences of intervention effects. Males and females will be recruited with no preference to gender. Minorities will actively be recruited to participate. No exclusion to this study will be based on race
  • Patients must sign an informed consent indicating that they are aware of the investigational nature of this study. Patients must sign an authorization for the release of their protected health information
  • Patients may not be known to be human immunodeficiency virus (HIV)-positive. HIV testing is not required for study participation
  • Patients must not have a history of any other cancer (except non-melanoma skin cancer or carcinoma in-situ of the cervix), unless they are in complete remission and have been off all therapy for that disease for a minimum of 3 years
  • Patients must not be pregnant or breast-feeding. Women of childbearing potential are required to obtain a negative pregnancy test within 14 days of hyperpolarized imaging scan. Effective contraception (men and women) must be used in subjects of child-bearing potential

Exclusion Criteria:

  • Subjects will be excluded from participating in this study if they are unable to comply with study and/or follow-up procedures

Sites / Locations

  • University of California, San FranciscoRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Cohort 1 (MRI, MRSI) (CLOSED TO ENROLLMENT)

Cohort 2 (MRI, hyperpolarized carbon C 13 pyruvate, MRSI)

Arm Description

Patients undergo MRI and MRSI scans over 1 hour at baseline. Patients then continue to undergo MRSI scans that follow the clinical MRI schedule set by doctors to monitor patients' care. Participants enrolled in cohort 1 may later enroll in cohort 2 of study once eligibility has been reviewed and approved by neuro-oncologist

Patients undergo MRI scan at baseline. Patients then receive hyperpolarized carbon C 13 pyruvate IV over less than 1 minute and undergo MRSI scan at baseline. Patients then continue to undergo MRSI scans that follow the clinical MRI schedule set by doctors to monitor patients' care.

Outcomes

Primary Outcome Measures

Number of treatment-emergent adverse events (AEs)
Safety evaluation for endpoint will include monitoring for the occurrence of treatment-emergent adverse events (AEs). Reported toxicities will be graded using the National Cancer Institute (NCI) Common Terminology (Toxicity) Criteria for Adverse Events (CTCAE) version 4.0. All available safety data will be used and will be analyzed using descriptive statistics.
Peak lactate/pyruvate
The peak lactate/pyruvate in tumor and normal appearing brain tissue will be reported.
Peak bicarbonate/pyruvate
The peak bicarbonate/pyruvate in tumor and normal appearing brain tissue will be reported.
Change in peak lactate/pyruvate between scans
The change in peak lactate/pyruvate between scans will be reported.
Change in peak bicarbonate/pyruvate between scans
The change in peak bicarbonate/pyruvate between scans will be reported.

Secondary Outcome Measures

Full Information

First Posted
August 31, 2020
Last Updated
September 11, 2023
Sponsor
Susan Chang
Collaborators
GE Healthcare, Sigma-Aldrich, Phillips-Medisize
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1. Study Identification

Unique Protocol Identification Number
NCT04540107
Brief Title
Serial MR Imaging and MR Spectroscopic Imaging for the Characterization of Lower Grade Glioma
Official Title
Metabolic Imaging of Patients With Lower Grade Glioma Using Hyperpolarized 13C Pyruvate
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
January 11, 2017 (Actual)
Primary Completion Date
January 1, 2025 (Anticipated)
Study Completion Date
January 1, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Susan Chang
Collaborators
GE Healthcare, Sigma-Aldrich, Phillips-Medisize

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 trial studies how well serial magnetic resonance (MR) imaging and MR spectroscopic imaging work in characterizing lower grade glioma. Diagnostic procedures, such as MR imaging and MR spectroscopic imaging, may detect serial changes in lower grade glioma. This study may help researchers learn more about practical ways of evaluating and standardizing treatment in patients with brain tumors.
Detailed Description
PRIMARY OBJECTIVES: I. To assess the safety and feasibility of hyperpolarized 13C MR metabolic imaging as a new and unique tool for making an early assessment of progression and evaluation of response to therapy in patients with lower grade glioma II. To determine whether changes in levels of hyperpolarized 13C pyruvate, lactate and bicarbonate may provide early evidence of tumor progression in patients with lower grade glioma who are being followed with surveillance scans. III. To determine whether patients with lower grade glioma who are receiving treatment exhibit a reduction in levels of hyperpolarized 13C lactate/pyruvate at follow-up compared to their baseline scan. OUTLINE: Patients will be enrolled into Cohort 2. Participants previously enrolled in Cohort 1 may enroll in Cohort 2 of study upon re-review of eligibility. COHORT 1 (CLOSED TO ENROLLMENT): Patients undergo MR imaging (MRI) and MR spectroscopic imaging (MRSI) scans over 1 hour at baseline. Patients then continue to undergo MRSI scans that follow the clinical MRI schedule set by doctors to monitor patients' care. COHORT 2: Patients undergo MRI scan at baseline. Patients then receive hyperpolarized carbon C 13 pyruvate intravenously (IV) over less than 1 minute and undergo MRSI scan at baseline. Patients then continue to undergo MRSI scans that follow the clinical MRI schedule set by doctors to monitor patients' care.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Recurrent World Health Organization (WHO) Grade II Glioma, Recurrent WHO Grade III Glioma, WHO Grade II Glioma, WHO Grade III Glioma
Keywords
Glioma, Hyperpolarized Pyruvate (13C)

7. Study Design

Primary Purpose
Diagnostic
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
300 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Cohort 1 (MRI, MRSI) (CLOSED TO ENROLLMENT)
Arm Type
Experimental
Arm Description
Patients undergo MRI and MRSI scans over 1 hour at baseline. Patients then continue to undergo MRSI scans that follow the clinical MRI schedule set by doctors to monitor patients' care. Participants enrolled in cohort 1 may later enroll in cohort 2 of study once eligibility has been reviewed and approved by neuro-oncologist
Arm Title
Cohort 2 (MRI, hyperpolarized carbon C 13 pyruvate, MRSI)
Arm Type
Experimental
Arm Description
Patients undergo MRI scan at baseline. Patients then receive hyperpolarized carbon C 13 pyruvate IV over less than 1 minute and undergo MRSI scan at baseline. Patients then continue to undergo MRSI scans that follow the clinical MRI schedule set by doctors to monitor patients' care.
Intervention Type
Drug
Intervention Name(s)
Hyperpolarized Carbon C 13 Pyruvate
Other Intervention Name(s)
Hyperpolarized 13C-Pyruvate, Hyperpolarized Pyruvate (13C)
Intervention Description
Given IV
Intervention Type
Procedure
Intervention Name(s)
Magnetic Resonance Imaging
Other Intervention Name(s)
Magnetic Resonance Imaging Scan, Medical Imaging, Magnetic Resonance / Nuclear Magnetic Resonance, MR Imaging, MRI, MRI Scan, NMR Imaging, NMRI, Nuclear Magnetic Resonance Imaging
Intervention Description
Undergo MRI
Intervention Type
Procedure
Intervention Name(s)
Magnetic Resonance Spectroscopic Imaging
Other Intervention Name(s)
1H- Nuclear Magnetic Resonance Spectroscopic Imaging, 1H-nuclear magnetic resonance spectroscopic imaging, Magnetic Resonance Spectroscopy, MRS, MRS Imaging, MRSI, Proton Magnetic Resonance Spectroscopic Imaging
Intervention Description
Undergo MRSI
Primary Outcome Measure Information:
Title
Number of treatment-emergent adverse events (AEs)
Description
Safety evaluation for endpoint will include monitoring for the occurrence of treatment-emergent adverse events (AEs). Reported toxicities will be graded using the National Cancer Institute (NCI) Common Terminology (Toxicity) Criteria for Adverse Events (CTCAE) version 4.0. All available safety data will be used and will be analyzed using descriptive statistics.
Time Frame
Up to 4 years
Title
Peak lactate/pyruvate
Description
The peak lactate/pyruvate in tumor and normal appearing brain tissue will be reported.
Time Frame
Up to 4 years
Title
Peak bicarbonate/pyruvate
Description
The peak bicarbonate/pyruvate in tumor and normal appearing brain tissue will be reported.
Time Frame
Up to 4 years
Title
Change in peak lactate/pyruvate between scans
Description
The change in peak lactate/pyruvate between scans will be reported.
Time Frame
Baseline up to 4 years
Title
Change in peak bicarbonate/pyruvate between scans
Description
The change in peak bicarbonate/pyruvate between scans will be reported.
Time Frame
Baseline up to 4 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: For patients in cohort 1: histologically proven lower grade glioma who are being followed with surveillance scans For patients in cohort 2: histologically proven glioma who are scheduled for treatment due to suspected residual or recurrent tumor Patients with a life expectancy > 12 weeks Patients must have a Karnofsky performance status of >= 60 Patients must have adequate renal function (creatinine < 1.5 mg/dL) before imaging. These tests must be performed within 60 days prior to the hyperpolarized imaging scan. Patients must not have any significant medical illnesses that in the investigator's opinion cannot be adequately controlled with appropriate therapy, would compromise the patient's ability to participate in this study or any disease that will obscure toxicity or dangerously impact response to the imaging agent. Patients must not have New York Heart Association (NYHA) grade II or greater congestive heart failure Patients must not have history of myocardial infarction or unstable angina within 12 months prior to study enrollment This study was designed to include women and minorities, but was not designed to measure differences of intervention effects. Males and females will be recruited with no preference to gender. Minorities will actively be recruited to participate. No exclusion to this study will be based on race Patients must sign an informed consent indicating that they are aware of the investigational nature of this study. Patients must sign an authorization for the release of their protected health information Patients may not be known to be human immunodeficiency virus (HIV)-positive. HIV testing is not required for study participation Patients must not have a history of any other cancer (except non-melanoma skin cancer or carcinoma in-situ of the cervix), unless they are in complete remission and have been off all therapy for that disease for a minimum of 3 years Patients must not be pregnant or breast-feeding. Women of childbearing potential are required to obtain a negative pregnancy test within 14 days of hyperpolarized imaging scan. Effective contraception (men and women) must be used in subjects of child-bearing potential Exclusion Criteria: Subjects will be excluded from participating in this study if they are unable to comply with study and/or follow-up procedures
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Wendy Ma
Phone
877-827-3222
Email
cancertrials@ucsf.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Susan M Chang, MD
Organizational Affiliation
University of California, San Francisco
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of California, San Francisco
City
San Francisco
State/Province
California
ZIP/Postal Code
94143
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Wendy Ma
Phone
877-827-3222
Email
cancertrials@ucsf.edu
First Name & Middle Initial & Last Name & Degree
Susan M. Chang, MD

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Serial MR Imaging and MR Spectroscopic Imaging for the Characterization of Lower Grade Glioma

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