- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04084067
Indocyanine Green (ICG) Guided Tumor Resection
This is a study to assess the ability of Indocyanine Green (ICG) to identify neoplastic disease. For many pediatric solid tumors, complete resection of the primary site and/or metastatic deposits is critical for achieving a cure. An optimal intra-operative tool to help visualize tumor and its margins would be of benefit. ICG real-time fluorescence imaging is a technique being used increasingly in adults for this purpose. We propose to use it during surgery for pediatric malignancies. All patients with tumors that require localization for resection or biopsy of the tumor and/or metastatic lesions will be eligible.
Primary Objective
To assess the feasibility of Indocyanine Green (ICG)-mediated near-infrared (NIR) imagery to identify neoplastic disease during the conduct of surgery to resect neoplastic lesions in children and adolescents. NIR imaging will be done at the start of surgery to assess NIR-positivity of the lesion(s) and at the end of surgery to assess completeness of resection. Separate assessments will be made for the following different histologic categories:
- Osteosarcoma
- Ewing Sarcoma
- Rhabdomyosarcoma (RMS)
- Non-Rhabdomyosarcoma Soft Tissue Sarcoma (NRSTS)
- Neuroblastoma
- Renal tumors (Only bilateral Wilms Tumor patients will be included.)
- Metastatic pulmonary deposits
- Liver tumors, lymphoma, other rare tumors, and nodules of unknown etiology
Exploratory Objectives
- To compare the ICG uptake by primary vs metastatic site and pre-treated (chemotherapy, radiation, or both) vs non-pre-treated.
- Assess the sensitivity and specificity of NIR imagery to find additional lesions not identified by standard of care intraoperative inspection and tactile feedback.
- Assess the sensitivity and specificity of NIR imagery to find additional lesions not identified on preoperative diagnostic imaging.
- Assess the sensitivity and specificity of NIR imagery for identifying residual disease at the conclusion of a tumor resection.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This trial is a single center open-label study. Patients with a solid tumor or lymphoma who require resection either for therapeutic or diagnostic intent will be included.
Indocyanine Green (ICG) is an FDA-approved drug. Prior to surgery, patients will receive a single dose of ICG intravenously.
During surgery, after the surgeon identifies the mass through visual (seen with the naked eye) and or tactile methods (palpated), the patient will have his/her tumor field imaged by Iridium system optimized for detection of ICG (Visionsense Corp, Philadelphia, PA). The entire procedure will be photo- documented and recorded.
The Visionsense system records images in real time, calculates percentages, and captures the data. At least three different areas of the tumor will be measured. If the tumor cannot be identified by visual inspection or palpation, NIR-imaging will be used in an attempt to locate the lesion. The surrounding area will be inspected and measured to screen for additional sites of metastatic disease. After tumor resection, residual fluorescence in the surgical resection bed will be measured.
Direct subject participation in the trial will last for the period of time from injection of the ICG the day before surgery and until 24 hours post-surgery.
Study Type
Enrollment (Estimated)
Phase
- Phase 1
Contacts and Locations
Study Contact
- Name: Abdelhafeez Abdelhafeez, MD
- Phone Number: 866-278-5833
- Email: referralinfo@stjude.org
Study Locations
-
-
Tennessee
-
Memphis, Tennessee, United States, 38105
- Recruiting
- St. Jude Children's Research Hospital
-
Contact:
- Abdelhafeez Abdelhafeez, MD
- Phone Number: 866-278-5833
- Email: referralinfo@stjude.org
-
Principal Investigator:
- Abdelhafeez Abdelhafeez, MD
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patients with a primary or relapsed solid tumor or lymphoma who require excision of the tumor or metastatic lesions.
Exclusion Criteria:
- Subjects with a history of iodide allergies, including positive allergic reaction to the screening iodine test.
- Inability or unwillingness of research participant or legal guardian/representative to give written informed consent.
- Patients with benign pathology.
- Patients with brain tumors.
- Pregnant female.
- Patients with unilateral Wilms Tumor.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Indocyanine green (ICG)
Participants will receive a single dose of 1.5 mg/kg of ICG intravenously over 15 minutes prior to surgery.
|
IV
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Sensitivity and specificity rates of the ICG guided neoplastic disease identification
Time Frame: up to 24 hours post-surgery
|
The 312 patients (39 patients in each of the 8 categories) will be evaluated for this objective.
|
up to 24 hours post-surgery
|
Collaborators and Investigators
Investigators
- Principal Investigator: Abdelhafeez Abdelhafeez, MD, St. Jude Children's Research Hospital
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- ICGLOW
- NCI-2019-06146 (Registry Identifier: NCI Clinical Trial Registration Program)
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
- ICF
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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