Study of Craniospinal Irradiation With Linac Based Volumetric Modulated Arc Therapy (VMAT) for Patients With Leptomeningeal Metastasis
A Phase II Single-Arm Study of Craniospinal Irradiation With Linac Based Volumetric Modulated Arc Therapy (VMAT) for Patients With Leptomeningeal Metastasis
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Benjamin Cooper, MD
- Phone Number: 212-731-5003
- Email: Benjamin.cooper@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
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Solid tumor cancer primary with leptomeningeal metastases established radiographically and/or by CSF cytology
- Candidate for radiation therapy for the treatment of leptomeningeal metastases
- If patient had prior radiation, a treatment plan can be generated that will not exceed normal tissue tolerances
- Patient must have reasonable systemic treatment options, as confirmed by their medical oncologist
- Age ≥ 18 years old
- Able to provide informed consent
- Karnofsky Performance Scale (KPS) ≥ 60
Adequate hematologic baseline
- Hemoglobin > 8g/dL
- Absolute neutrophil count >1,000/mm3
- Platelet count > 100,000/mm3
Female subjects must either be of
- Non-reproductive potential (over 60 years old, or without menses for at least 1 year without an alternative medical cause)
- Have history of hysterectomy, bilateral tubal ligation, or bilateral oophorectomy
- Must have negative serum/urine pregnancy test
- If of reproductive age, must practice effective contraceptive method
Exclusion Criteria:
- Patient has multiple severe neurologic deficits per physician assessment
- Patient has diffuse systemic disease without reasonable systemic therapy options
- Patient is unable to undergo MRI brain and spine with gadolinium contrast
- Prior radiation that would preclude development of a treatment plan that respects normal tissue constraints
- Pregnant or lactating women
- Prisoners
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: Linac based Volumetric Arc Therapy (VMAT) CSI
Radiation dose will be administered according to the physician's written directive.
Treatment will be administered once a day, Monday through Friday, for a total of ten fractions.
|
Varian TrueBeam linear accelerator with photon beam Volumetric Modulated Arc Therapy (VMAT) capability.
Subjects will receive 3000 centigray (cGy) in 10 fractions at 300 cGy per fraction.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Time to central nervous system (CNS) progression free survival
Time Frame: From baseline up to 1 year from end of treatment
|
Time to CNS progression free survival will be estimated using Kaplan Meier methods for censored data that includes CNS progressions.
CNS disease progression will be defined as new or worsening neurologic deficit unrelated to therapeutic intervention via neurological assessment using Neurologic Assessment in Neuro-Oncology (NANO) scale, cerebrospinal fluid (CSF) cytology being newly positive for malignancy after initially being negative, MRI brain with and without contrast or MRI total spine with and without contrast shows progression per the European Organization for Research and Treatment of Cancer (EORTC) Brain Tumor Group and the Response Assessment in Neuro-Oncology (RANO) scorecard.
|
From baseline up to 1 year from end of treatment
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Overall survival
Time Frame: From baseline up to 1 year from end of treatment
|
Overall survival will be estimated using Kaplan Meier methods for censored data that includes deaths as events.
|
From baseline up to 1 year from end of treatment
|
|
Time to CNS progression
Time Frame: From baseline up to 1 year from end of treatment
|
Time to CNS progression will be analyzed using competing risk methods, considering death and progression from other causes as competing risks.
|
From baseline up to 1 year from end of treatment
|
|
Rate of cessation of systemic therapy
Time Frame: 1 year post-treatment
|
1 year post-treatment
|
|
|
Number of treatment-related adverse events
Time Frame: End of study (up to 2 years)
|
End of study (up to 2 years)
|
|
|
M.D. Anderson Symptom Inventory - Brain Tumor (MDASI-BT) score
Time Frame: End of study (up to 2 years)
|
The MDASI-BT includes 22 items assessing severity of brain tumor symptoms and 6 items assessing interference.
Symptom severity and interference are assessed on a scale from 0-10 scale.
A score of 0 indicates "not present" or "did not interfere," while a score of 10 represents "as bad as you can imagine" or "interfered completely".
Scores range from 0-280.
Higher scores indicate the brain tumor significantly impairs daily functioning.
|
End of study (up to 2 years)
|
|
M. D. Anderson Symptom Inventory - Spine Tumor (MDASI-SP) score
Time Frame: End of study (up to 2 years)
|
The MDASI-SP includes 18 items assessing severity spinal tumor symptoms and 6 items assessing interference.
Symptom severity and interference are assessed on a scale from 0-10 scale.
A score of 0 indicates "not present" or "did not interfere," while a score of 10 represents "as bad as you can imagine" or "interfered completely".
Scores range from 0-240.
Higher scores indicate the brain tumor significantly impairs daily functioning.
|
End of study (up to 2 years)
|
|
Functional Assessment of Cancer Therapy - Brain (FACT-Br) score
Time Frame: End of study (up to 2 years)
|
The FACT-Brain (FACT-Br) is one such instrument that assesses brain-tumor related QOL issues.
The questionnaire consists of the FACT-G plus a brain-tumor specific scale.
A total of 50 items are included that cover the following domains of QOL: physical well-being, social/family well-being, emotional well-being, functional well-being, and disease specific concerns.
Patients are asked to indicate the presence/severity of certain issues/symptoms on a scale of 0 - 4 (a 5-point Likert Scale).
Higher scores indicate decreased health-related quality of life.
|
End of study (up to 2 years)
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Benjamin Cooper, MD, NYU Langone Health
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
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
- 24-01730
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
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