A Phase II Single-arm Study of Total Body Irradiation With Linac Based VMAT and IGRT
A Phase II Single-Arm Study of Total Body Irradiation With Linac Based Volumetric Modulated Arc Therapy (VMAT) and Image Guided Radiation Therapy (IGRT)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Total Body Irradiation (TBI) continues to play an important role in myeloablative and non-myeloablative conditioning regimens for Allogeneic Stem Cell Transplant (ASCT). When TBI is used as part of a myeloablative regimen, it is combined with chemotherapy to eradicate malignant cells, as well as to immunosuppress the host to prevent rejection of donor hematopoietic progenitor cells (HPC).
This study is a single-institution study to assess the safety of linac based VMAT TBI for myeablative sreatment in hematologic malignancies.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Rachel Joseph
- Phone Number: 646-754-7398
- Email: Rachel.Joseph@nyulangone.org
Study Locations
-
-
New York
-
New York, New York, United States, 10016
- NYU Langone Health
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age ≥ 18
Patients undergoing related, unrelated (including cord blood) hematopoietic progenitor cell (HPC) transplant, in which the protocol requires >12 Gray of TBI, as part of the conditioning regimen.
a. Conditioning regimens outlined per BMT SOP: CLNTX007: Selection of Conditioning Regimens for Blood and Marrow Transplantation - ADULTS.
Referral from the blood and marrow transplant (BMT) program for full-dose TBI, who meet inclusion and exclusion criterial per BMT SOPs.
- BMT program will initiate referral, utilizing Form: 170102, Radiation Oncology Consultation.
- Patients undergo pre-transplant testing, as defined in BMT SOPs:CLNAL002: Related (MRD, Haplo) Allogeneic Recipient Evaluation and Management or CLNAL011: Unrelated (MUD, MMUD, CBU) Allogeneic Recipient Evaluation and Management, per below.
i. BMT SOP's include baseline pulmonary function tests (PFTs). Patient with decreased FVC, FEV1 and or DLCO (adjusted for hemoglobin) or pulmonary history will have pulmonary consult, at the discretion of the BMT physician prior to undergoing myeloablative radiation.
ii. Medical history and physical by BMT provider.
iii. The following laboratory tests (additional testing may be required for positive results):
- ABO group and Rh type
- Red Blood Cell Antibody Screen.
- HLA typing and confirmatory typing
- HLA antibody screen, class I and II, performed within 30 days of transplant.
- Complete blood count (CBC) with differential.
- Basic metabolic panel, including glucose and to include at a minimum electrolyte evaluation of potassium, calcium, magnesium, and phosphorus.
- Blood urea nitrogen (BUN)
- Creatinine
- Liver Function Tests including: Total bilirubin, Alkaline phosphatase, Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Lactate dehydrogenase (LDH), Albumin, Total Protein, Urinalysis
Exclusion Criteria:
- Patient receiving less than 1200 cGy of TBI
- Previous history of thoracic radiation therapy including previous TBI
- All premenopausal women will require a urine qualitative pregnancy test to exclude pregnancy. Pregnant women will be excluded from the study.
- Prisoners
- Patient not meeting transplant criteria per BMT physician.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Patients with Hematologic Malgnancies
|
Use of linac based Volumetric Arc Therapy (VMAT) to deliver Total Body Irradiation (TBI).
The study intervention is a VMAT based delivery technique using a 6 MV photon beam from a Varian TrueBeam® (Palo Alto, CA) equipped with a Millennium multi-leaf collimation (MLC) system3.
TBI will be delivered using a Varian TrueBeam linear accelerator with photon beam VMAT capability.
VMAT is a radiation technique combining dynamic photon fluence modulation using multi-leaf collimation (MLC) with gantry rotation to deliver a highly conformal dose distribution with improved target coverage and sparing of organs at risk (OARs).
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Proportion of Patients Who Achieve Excellent Coverage While Sparing the Lung
Time Frame: Up to 1 year post-transplant
|
Excellent coverage while sparing the lung is quantified by meeting the following dosimetric parameters (all parameters must be met):
|
Up to 1 year post-transplant
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Event Free Survival (EFS)
Time Frame: Up to 1 year post-transplant
|
Interval from day of transplant to date of first objective disease progression or relapse or death from any cause.
Subjects without these failures will be censored at the last date that they were assessed and deemed failure free.
|
Up to 1 year post-transplant
|
|
Proportion of Patients Who Have Achieved a Maximum Dose to 2cc of the Entire Body (D2cc) < 130% of Rx Dose.
Time Frame: Up to 150 days post-transplant
|
Number of participants with Maximum dose to 2cc of the entire body (D2cc) <130% of Rx dose
|
Up to 150 days post-transplant
|
|
Cumulative Incidence Rate of Idiopathic Pneumonia Syndrome
Time Frame: Up to 100 Days Post-Transplant
|
Non-infectious pneumonia syndrome is defined by the American Thoracic Society as at least 1 of the following without concurrent infection detected on blood culture, broncoalveolar lavage, lung biopsy or sputum: There must also be the absence of cardiac dysfunction, acute renal failure, or iatrogenic fluid overload as etiology for pulmonary dysfunctionMultilobar infiltrates on chest radiograph or computed tomography (CT); Symptoms and signs of pneumonia including dyspnea, cough, cyanosis, hypoxia or pyrexia; New or increased restrictive patters on pulmonary function testing or increased alveolar to arterial oxygen difference |
Up to 100 Days Post-Transplant
|
|
Proportion of Patients Who Have Achieved a Maximum Dose to 0.03cc of OARs < 120% of Rx Dose.
Time Frame: Up to 150 days post-transplant
|
Number of participants with Maximum dose to 0.03cc of organs at risk <120% of Rx dose
|
Up to 150 days post-transplant
|
|
Occurrence of Acute GVHD, Transplant Related Mortality, or Mortality in the First 100 Days Following Transplant
Time Frame: 100 days post-transplant
|
Number of participants who experienced acute GVHD or all-cause mortality within 100 days following bone marrow transplant
|
100 days post-transplant
|
|
Proportion of Patients Who Achieved a Mean Dose to Each Kidney (Dmean) < 11Gy
Time Frame: Up to 150 days post-transplant
|
Number of participants with mean dose of <11Gy (1100 cGy) to either kidney
|
Up to 150 days post-transplant
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Naamit Gerber, MD, NYU Langone Health
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 19-00664
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Hematologic Malignancy
-
NCT06208878Enrolling by invitationHematologic Malignancy | Solid Malignancy
-
NCT05205252WithdrawnRefractory Hematologic Malignancy | Relapsed Hematologic Malignancy
-
NCT02412722Completed
-
NCT05713214RecruitingRefractory Hematologic Malignancy | Relapsed Hematologic Malignancy
-
NCT03625557CompletedNon-Hematologic Malignancy
-
NCT04285242RecruitingCancer | Non-Hematologic Malignancy
-
NCT05768269RecruitingHematological Malignancy | Solid Tumor Malignancy
-
NCT07511127RecruitingHematologic Malignancy
-
NCT05270096RecruitingRefractory Hematologic Malignancy | Relapsed Hematologic Malignancy
Clinical Trials on Linac Based VMAT TBI
-
NCT04946019CompletedNon-small Cell Lung Cancer
-
NCT05163509RecruitingMediastinal Tumor
-
NCT05182437Active, not recruiting
-
NCT05591547Active, not recruiting
-
NCT03972072Active, not recruitingHead and Neck Cancer | Xerostomia Due to Radiotherapy
-
NCT04288258Completed
-
NCT01214694Completed
-
NCT01056146Completed
-
NCT04281199Active, not recruitingAcute Leukemia | Myelodysplastic Syndrome