- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04503772
Preoperative Stereotactic Radiosurgery for Brain Metastases (STEP)
Phase II Study to Assess Preoperative Hypofractionated Stereotactic Radiotherapy of Brain Metastases
Study Overview
Study Type
Enrollment (Anticipated)
Phase
- Phase 2
Contacts and Locations
Study Contact
- Name: Angeline GINZAC COUVÉ, PhD
- Phone Number: +33 0463663337
- Email: angeline.ginzac@clermont.unicancer.fr
Study Locations
-
-
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Grenoble, France, 38700
- Recruiting
- CHU Grenoble Alpes
-
Contact:
- Andréa DESAGNEAUX, MD
-
Principal Investigator:
- Andréa DESAGNEAUX, MD
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Lyon, France, 69373
- Recruiting
- Centre Léon Bérard
-
Contact:
- Coralie MONCHARMONT, MD
-
Principal Investigator:
- Coralie MONCHARMONT, MD
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Lyon, France, 69002
- Recruiting
- Hospices Civils de Lyon
-
Contact:
- Anne d'Hombres, MD
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Principal Investigator:
- Anne d'Hombres, MD
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Metz-Tessy, France, 74370
- Recruiting
- Centre Hospitalier D'Annecy-Genevois
-
Contact:
- Alexandre TESSIER, MD
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Principal Investigator:
- ALEXANDRE TESSIER, MD
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Saint-Herblain, France
- Recruiting
- Institut de Cancérologie de l'Ouest
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Contact:
- François THYLLAYS, MD
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Principal Investigator:
- François THYLLAIS, MD
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Saint-Priest-en-Jarez, France, 42270
- Not yet recruiting
- Institut de Cancérologie de la Loire Lucien Neuwirth
-
Contact:
- Nicolas MAGNÉ, Pr
-
Principal Investigator:
- Nicolas MAGNÉ, Pr
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Strasbourg, France, 67000
- Recruiting
- Institut de cancerologie Strasbourg Europe (ICANS)
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Contact:
- Clara LEFEVRE, MD
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Principal Investigator:
- Clara LEFEVRE, MD
-
-
Puy-de-Dôme
-
Clermont-Ferrand, Puy-de-Dôme, France, 63800
- Recruiting
- Centre Jean Perrin
-
Contact:
- Lucie BRUN, MD
- Email: lucie.brun@clermont.unicancer.fr
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Contact:
- Julian BIAU, MD, PhD
- Email: julian.biau@clermont.unicancer.fr
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Principal Investigator:
- Julian BIAU, MD, PhD
-
Sub-Investigator:
- Lucie BRUN, MD
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Sub-Investigator:
- Juliette MOREAU, MD
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- ≤ 4 distinct brain metastases, one with surgical indication
- Diagnosis of primary histologically proven breast, digestive or non-small cells lung cancer
- ≤ 5 cm larger diameter
- Karnofsky performance status ≥ 70
- No contraindication for MRI
- Possibility for the patient to be treat with both surgery and stereotactic radiotherapy
- ≥ 18 years old
- Estimated overall survival ≥ 6 months according to diagnosis specific - graded prognostic assessment (DS GPA)
- Written inform consent signed
- Affiliation to the French social security system
- For women of childbearing age including those on luteinizing hormone-releasing hormone (LH-RH) agonists for ovarian suppression: inclusion negative serum pregnancy test (≤ 7 days prior to the start of preoperative stereotactic radiosurgery (SRS).
Exclusion Criteria:
- Lymphoma, leukaemia, multiple myeloma, germinal tumours or cerebral primary cancer
- Metastases from small-cells lung cancer, kidney cancer, melanoma or sarcoma
- Mass effect with deflection ≥ 5 mm from median line or hydrocephaly or compression 4th ventricle, patient neurologically unstable, need for emergency decompressive surgery
- > 4 brain metastases
- Contraindication to anaesthesia, MRI or gadolinium injection
- Proximity of the tumour with organs at risk which do not allow the prescribed dose to be reached in the envelope
- Pregnant or breastfeeding woman
- Anti vascular endothelial growth factor (VEGF) within 6 weeks before treatment
- Documented leptomeningeal injury
- History of irradiation of the encephalon in toto
- History of stereotactic radiotherapy on metastasis to be operated on
- Non-candidate patient for surgery
- Surgical delay > 3 days compared to stereotactic radiotherapy
- Estimated survival < 6 months by DS GPA
- Patient under guardianship or curators
- Psychological disorder (cognitive disorders, mental alertness, etc.) or social (deprivation of liberty by judicial or administrative decision) or geographical reasons that may compromise medical monitoring of the trial or compliance with treatment
- Woman of childbearing age without effective contraception
- Patient participating in another intervention study within 4 weeks prior to inclusion
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: NA
- Interventional Model: SINGLE_GROUP
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Experimental arm (all patients)
Patients will receive preoperative hypofractionated stereotactic radiosurgery (SRS). According to the association of french-speaking neuro-oncologists (ANOCEF) recommendations, total dose and fractionation will be 33 Gy in 3 fractions at the isocenter, 23.1 Gy in envelope (70% isodose), i.e. 30 Gy in growth tumor volume (GTV) envelope.) Surgery will take place within 3 days of the preoperative SRS. |
Patient will be treat with preoperative SRS and then surgery for brain metastases is realized within 3 days.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Evaluation of 6-months local control rate after preoperative SRS
Time Frame: 6 months after preoperative SRS (M6)
|
Local recurrence is defined as the onset or progression of nodular contrast grafting within the resection cavity according to the Response Assessment in Neuro-Oncology Brain Metastases (RANO-BM) criteria.
|
6 months after preoperative SRS (M6)
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Evaluation of 1-year local control rate after preoperative SRS
Time Frame: 12 months after preoperative SRS (M12)
|
Local recurrence is defined as the onset or progression of nodular contrast grafting within the resection cavity according to the RANO-BM criteria.
|
12 months after preoperative SRS (M12)
|
Evaluation of 1-year radionecrosis rate after preoperative SRS
Time Frame: 12 months after preoperative SRS (M12)
|
Radionecrosis is defined either histologically post-operatively according to the anatomopathological report or in the absence of salvage surgery by the appearance or increase of gadolinium contrast on T1 MRI sequences associated with an increase in the cerebral brain volume (CBV) ratio (brain blood volume of the tumour / brain blood volume of the non-tumour white matter) of less than 2 on perfusion MRI sequences and/or a standard uptake volume (SUV max) of less than 1, 59 on positron emission tomography (PET) scanners at 6-fluoro-[18 fluoro]-L-dihydroxyphenylalanine (F-DOPA)
|
12 months after preoperative SRS (M12)
|
Evaluation of overall survival
Time Frame: At each follow-up visits after preoperative SRS : +3 months (M3); +6 months (M6); +9 months (M9); +12 months (M12)
|
defined as the time interval between the date of preoperative radiosurgery and the date of death from any cause.
|
At each follow-up visits after preoperative SRS : +3 months (M3); +6 months (M6); +9 months (M9); +12 months (M12)
|
Evaluation of acute (less than 3 months post preoperative SRS) and delayed toxicities (more than 3 months after preoperative SRS)
Time Frame: At each follow-up visits after preoperative SRS : +3 months (M3); +6 months (M6); +9 months (M9); +12 months (M12)
|
They will be collected and graded according to the NCI-CTCAE v5.0 scale.
An adverse event of grade ≥ 3 will be considered "severe".
|
At each follow-up visits after preoperative SRS : +3 months (M3); +6 months (M6); +9 months (M9); +12 months (M12)
|
Rate of leptomeningeal relapses
Time Frame: At each follow-up visits after preoperative SRS : +3 months (M3); +6 months (M6); +9 months (M9); +12 months (M12)
|
According to cerebral MRI
|
At each follow-up visits after preoperative SRS : +3 months (M3); +6 months (M6); +9 months (M9); +12 months (M12)
|
Evaluation of cerebral distant control
Time Frame: At each follow-up visits after preoperative SRS : +3 months (M3); +6 months (M6); +9 months (M9); +12 months (M12)
|
Follow by MRI
|
At each follow-up visits after preoperative SRS : +3 months (M3); +6 months (M6); +9 months (M9); +12 months (M12)
|
Determination of predictive factors for local brain control, complication and prognosis factors for survival
Time Frame: At each follow-up visits after preoperative SRS : +3 months (M3); +6 months (M6); +9 months (M9); +12 months (M12)
|
At each follow-up visits after preoperative SRS : +3 months (M3); +6 months (M6); +9 months (M9); +12 months (M12)
|
|
Evaluation of cognitive function
Time Frame: At each follow-up visits after preoperative SRS : +3 months (M3); +6 months (M6); +9 months (M9); +12 months (M12)
|
Mini-mental state examination (MMSE)
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At each follow-up visits after preoperative SRS : +3 months (M3); +6 months (M6); +9 months (M9); +12 months (M12)
|
Evaluation of quality of life
Time Frame: At each follow-up visits after preoperative SRS : +3 months (M3); +6 months (M6); +9 months (M9); +12 months (M12)
|
European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-Core 30 (C30)
|
At each follow-up visits after preoperative SRS : +3 months (M3); +6 months (M6); +9 months (M9); +12 months (M12)
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Lucie BRUN, MD, Centre Jean Perrin
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ANTICIPATED)
Study Completion (ANTICIPATED)
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
- 2020-A00403-36
- 20.06.16-36701 (OTHER: Ethics committee Sud-Ouest et Outre-Mer IV)
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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