Lung Functional Avoidance Radiotherapy Using Hyperpolarized Xenon MRI (GuidedRT)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Customized 3D planning of radiation therapy for lung cancer delivers a lethal dose to the tumor region while avoiding important structures (spine) and organs (esophagus, heart, lungs). Since radiation dose to functioning lung is associated with acute radiation pneumonitis and chronic radiation fibrosis, researchers seek to shift dosage preferentially away from lung regions with highest function. Several lung functional imaging modalities have been investigated (ventilation-perfusion SPECT and PET, 4DCT, hyperpolarized 3He). These studies indicate that regional ventilation is not the optimal biometric. What is needed is a high-resolution imaging modality, tolerable to patients who have difficulty holding their breath, that delineates regions of full lung function warranting preservation, and also identifies regions whose function is irrevocably gone.
The investigators propose a translational study applying Hyperpolarized Xenon (HXe) MRI to improve lung-health outcomes for lung cancer patients treated with radiation therapy. This study will focus on a patient cohort with significant heterogeneity: new patients with lung cancer and GOLD stage 3+ emphysema as a comorbidity and patients receiving RT for their second (primary) lung cancer. Optimizing radiation therapy treatment plans could provide a statistically significant benefit within a manageably small patient cohort. Maps will delineate three regions of functionality: regions of full function, having both ventilation and gas exchange to blood (where radiation should be avoided or minimized), regions where function is irrevocably absent (where radiation dose can be increased/maximized), and regions where function may be present or recoverable (where radiation should remain below or at the normal dose limit). Regions of lungs with absent function will have highest priority for receiving radiation during the RT procedure, while healthy regions will be avoided. It is expected that following this functional avoidance procedure will result in a decrease in the radiation induced lung injury reported events and a better outcome of the radiation treatment.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 2
- Phase 1
Contacts and Locations
Study Contact
Study Contact
- Name: Karen Tang, B.S.
- Phone Number: 2672999618
- Email: karen.tang1@pennmedicine.upenn.edu
Study Contact Backup
- Name: Ching Lai, B.S.
- Phone Number: 215-614-1894
- Email: ching.lai@pennmedicine.upenn.edu
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patients over 18 years with a diagnosis of non-small lung cancer and planned for a definitive course of radiation therapy.
- Preferred patients will have had successful radiation therapy for a prior lung cancer and developed a secondary lung cancer for which are to be treated.
- Other de-nuovo lung cancer patients planned for radiation therapy with lung heterogeneity from natural co-morbidities (e.g., COPD stage 3+).
Exclusion Criteria:
- Patients less than 18 years old
- Patients known to be pregnant - a positive pregnancy test will be used to respectively exclude pregnant patients,
- Any known contraindication to MRI examination
- Anyone with an implanted metal device
- Inability to provide informed consent
- A language, communication, cognitive or behavioral impairment that might interfere with fully informed participation in the study.
- History of uncompensated organ failure (i.e. organ failure that is not stabilized through medical intervention), which will be assessed by the PI.
- Homelessness or other unstable living situation
- Active drug or alcohol dependence
- Claustrophobia
- Subjects weighting more than 300 pounds.
- Subjects with chest size larger than the bore of MRI machine can accommodate
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- 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: Guided Radiation Therapy for lung cancer using HXe MRI for functional lung avoidance and diagnosis.
Patients with non-small cell lung cancer scheduled for radiation therapy will be voluntarily enrolled in this study.
They will have their lung ventilation and function imaged with hyperpolarized xenon MRI.
The 3D HXe images will be used in determining a functional lung avoidance treatment map.
Patients will follow radiation therapy optimized for functional lung avoidance.
At 6-month follow up the subjects will be imaged again with HXe to assess lung ventilation and function post-RT compared to baseline (pre-RT).
Additionally, standard-of-care lung testing (DLCO, PFT) and quality-of-life questionnaires will be assessed at several time points during the study.
|
Patients with non-small cell lung cancer scheduled for radiation therapy willing to take part in this study will undergo hyperpolarized xenon MRI at several time points prior and post RT.
Images will be used to determine radiation treatment maps for functional lung avoidance.
Reported adverse events caused by radiation induced lung injury and post-RT changes in the lung function will be compared to standard-of-care.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Changes in DLCO at 6-month post RT treatment.
Time Frame: 1-year
|
Subjects will have measurements of DLCO at baseline (before RT) and at 6-month post RT.
An independent-sample t-test will be used to compare change in DLCO.
|
1-year
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change in Quality of Life questionnaires from baseline to 6-month post-RT.
Time Frame: 1-year
|
Quality of Life questionnaires ("MD Anderson Symptom Inventory - Lung Cancer" and "UCSD Shortness of Breath Questionnaire") will be assessed at baseline (prior to RT) and 6-month post RT.
A independent-sample t-test will be used to compare changes in the QoL.
|
1-year
|
|
Change in HXe lung MRI metrics from baseline to 6-month post-RT.
Time Frame: 1-year
|
HXe MRI metrics (including dynamic ventilation and dissolved phase - S/V and q-dot) will be assessed at baseline (prior to RT) and 6-month post RT.
A independent-sample t-test will be used to compare changes in the HXe metrics.
|
1-year
|
|
Change in FEV1 from baseline to 6-month post-RT.
Time Frame: 1-year
|
Other spirometry measurements (besides DLCO) such as FEV1, will be assessed at baseline (prior to RT) and 6-month post RT.
A independent-sample t-test will be used to compare changes in FEV1.
|
1-year
|
|
Incidence/severity of pneumonitis.
Time Frame: 1-year
|
Incidence/severity of pneumonitis will be graded using CTCAE at 6-month post RT.
This will be compared with known results from standard-of-care RT.
|
1-year
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Study record dates
Study Major Dates
Study Start (Estimated)
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
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- MagniXene-255434
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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.
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