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MRI Study With Ferumoxytol in Assessing Early Response in Patients With Glioblastoma Multiforme Receiving Temozolomide and Radiation Therapy

19 de abril de 2017 actualizado por: Edward Neuwelt, OHSU Knight Cancer Institute

Early Assessment of Tumor Response to Therapy Using Ferumoxytol (Code 7228) as an MR Contrast Agent in Patients With Glioblastoma Multiforme (MedDRA Code 10018337)

This pilot clinical trial studies how a magnetic resonance imaging (MRI) study with ferumoxytol works as a contrasting agent in assessing early response in patients with glioblastoma multiforme receiving temozolomide and radiation therapy. Ferumoxytol is a very small form of iron particles that are injected into the body and taken up by certain tissues which may make these tissues easier to see during imaging. Diagnostic procedures, such as an MRI study with ferumoxytol, may help measure a patient's response to earlier treatment.

Descripción general del estudio

Descripción detallada

PRIMARY OBJECTIVES:

I. To characterize glioblastoma multiforme (GBM) tumor vascular properties using ferumoxytol (ferumoxytol non-stoichiometric magnetite) and compare to those obtained using gadolinium (Gd) based MRI contrast agent.

II. To characterize vascular changes in GBM tumors associated with standard radio/chemotherapy.

SECONDARY OBJECTIVES:

I. Cerebral blood flow (CBF), mean transit time (MTT), and time-to-peak (TTP) perfusion parameters will be measured for each contrast agent and evaluated in post-hoc analysis.

II. To obtain qualitative assessment of tumor vascularity using time-of-flight (TOF) magnetic resonance (MR) angiography techniques.

III. To characterize changes in the apparent diffusion coefficient (ADC) of tumor water associated with standard radio/chemotherapy in GBM.

OUTLINE:

Patients receive gadolinium intravenously (IV) on day 1 and ferumoxytol non-stoichiometric magnetite IV on day 2 then undergo dynamic susceptibility contrast enhanced (DSC) MRI, and dynamic contrast enhanced (DCE) MRI, diffusion-weighted imaging (DWI) (day 1 only), and TOF MR angiography on days 1-3 at 4 time points: before radiation, 3 weeks after initiation of radiation plus temozolomide, at the end of radiation (6 weeks post first dose) and 6 weeks after radiation (12 weeks post first dose). Ferumoxytol non-stoichiometric magnetite administration continues in the absence of unacceptable toxicity. Patients also receive temozolomide and undergo radiation therapy per standard of care.

After completion of ferumoxytol non-stoichiometric magnetite administration, patients are followed up for 4-6 weeks and then periodically until the resolution or stabilization of unacceptable toxicities.

Tipo de estudio

Intervencionista

Inscripción (Actual)

14

Fase

  • No aplica

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Ubicaciones de estudio

    • Oregon
      • Portland, Oregon, Estados Unidos, 97239
        • OHSU Knight Cancer Institute

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

18 años y mayores (Adulto, Adulto Mayor)

Acepta Voluntarios Saludables

No

Géneros elegibles para el estudio

Todos

Descripción

Inclusion Criteria:

  • Patients must have radiologically and histologically confirmed diagnosis of glioblastoma multiforme
  • Patients must have measurable disease, defined as evident tumors with gadolinium enhancement on MRI that is measurable in at least one diameter and visible on both axial and sagittal or coronal views
  • Life expectancy of greater than 6 months
  • Eastern Cooperative Oncology Group (ECOG) performance status =< 2 (Karnofsky >= 50%)
  • Patients scheduled for standard therapy (6 weeks radiation therapy (RT) ~ 60 Gy, plus temozolomide 75 mg/m^2 during 6 week [w] RT, and followed routine monthly temozolomide therapy)
  • Patients must be on a stable or decreasing dose (up to 8 mg daily) of dexamethasone throughout the study
  • After entry into the study, patients are expected to be followed for at least 1 month after the last infusion of ferumoxytol
  • Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation; should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately
  • Ability to understand and the willingness to sign a written informed consent document; all patients, or their legal guardians, must sign a written informed consent and Health Insurance Portability and Accountability Act (HIPAA) authorization in accordance with institutional guidelines

Exclusion Criteria:

  • Patients who have had chemotherapy or radiotherapy
  • Patients may not be receiving any other investigational agents
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to ferumoxytol: parenteral iron, parenteral dextran, parenteral iron-dextran, or parenteral iron-polysaccharide preparations (Ferumoxytol Investigator's Drug Brochure, 2005); patients with significant drug or other allergies or autoimmune diseases may be enrolled at the Investigator's discretion
  • Patients with clinically significant signs of uncal herniation, such as acute pupillary enlargement, rapidly developing motor changes (over hours), or rapidly decreasing level of consciousness, are not eligible
  • Patients who require monitored anesthesia for MRI scanning
  • Patients with history of hemochromatosis or iron overload
  • Patients with renal insufficiency (glomerular filtration rate (GFR) < 50)
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
  • Pregnant women are excluded from this study; breastfeeding should be discontinued if the mother is treated with ferumoxytol
  • Human immunodeficiency virus (HIV)-positive patients on combination antiretroviral therapy are ineligible

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Diagnóstico
  • Asignación: No aleatorizado
  • Modelo Intervencionista: Asignación de un solo grupo
  • Enmascaramiento: Ninguno (etiqueta abierta)

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Experimental: Ferumoxytol
Patients receive ferumoxytol non-stoichiometric magnetite IV on day 2 then undergo DSC MRI, and DCE MRI, DWI (day 1 only), and TOF MR angiography on days 1-3 at 4 time points: before radiation, 3 weeks after initiation of radiation plus temozolomide, at the end of radiation (6 weeks post first dose) and 6 weeks after radiation (12 weeks post first dose). Ferumoxytol non-stoichiometric magnetite administration continues in the absence of unacceptable toxicity.
Dado IV
Otros nombres:
  • Feraheme
  • Ferumoxitol
  • Fe3O4
Undergo DCE MRI
Otros nombres:
  • DCE-IRM
  • RM DCE
Undergo DSC MRI
Otros nombres:
  • DSC-IRM
  • RM con contraste de susceptibilidad dinámica
Undergo DWI
Otros nombres:
  • DWI
  • RM ponderada por difusión
  • RM DWI
  • DWI-IRM
Undergo TOF MR angiography
Otros nombres:
  • ARM
  • Angiografía por resonancia magnética
Comparador activo: Gadoteridol
Patients receive gadoteridol IV on day 1 then undergo DSC MRI, and DCE MRI, DWI (day 1 only), and TOF MR angiography on days 1-3 at 4 time points: before radiation, 3 weeks after initiation of radiation plus temozolomide, at the end of radiation (6 weeks post first dose) and 6 weeks after radiation (12 weeks post first dose).
Dado IV
Otros nombres:
  • Di-s
Undergo DCE MRI
Otros nombres:
  • DCE-IRM
  • RM DCE
Undergo DSC MRI
Otros nombres:
  • DSC-IRM
  • RM con contraste de susceptibilidad dinámica
Undergo DWI
Otros nombres:
  • DWI
  • RM ponderada por difusión
  • RM DWI
  • DWI-IRM
Undergo TOF MR angiography
Otros nombres:
  • ARM
  • Angiografía por resonancia magnética
Comparador activo: Gadoteridol Leakage Corrected
Patients receive gadoteridol IV on day 1 then undergo DSC MRI, and DCE MRI, DWI (day 1 only), and TOF MR angiography on days 1-3 at 4 time points: before radiation, 3 weeks after initiation of radiation plus temozolomide, at the end of radiation (6 weeks post first dose) and 6 weeks after radiation (12 weeks post first dose).
Dado IV
Otros nombres:
  • Di-s
Undergo DCE MRI
Otros nombres:
  • DCE-IRM
  • RM DCE
Undergo DSC MRI
Otros nombres:
  • DSC-IRM
  • RM con contraste de susceptibilidad dinámica
Undergo DWI
Otros nombres:
  • DWI
  • RM ponderada por difusión
  • RM DWI
  • DWI-IRM
Undergo TOF MR angiography
Otros nombres:
  • ARM
  • Angiografía por resonancia magnética

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Mean Cerebral Blood Volume (CBV)
Periodo de tiempo: At radiographical progression (between 6 and 12 weeks post first dose of chemoradiation)
Radiographical progression is determined based on RANO criteria.
At radiographical progression (between 6 and 12 weeks post first dose of chemoradiation)
Tumor Progression on Conventional MR
Periodo de tiempo: Anytime between baseline and 12 weeks post treatment initiation: average 6 weeks post treatment initiation.
Tumor progression was assessed by RANO criteria (Wen, 2010).
Anytime between baseline and 12 weeks post treatment initiation: average 6 weeks post treatment initiation.

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Investigadores

  • Investigador principal: Edward Neuwelt, OHSU Knight Cancer Institute

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio

1 de diciembre de 2006

Finalización primaria (Actual)

1 de junio de 2014

Finalización del estudio (Actual)

1 de junio de 2014

Fechas de registro del estudio

Enviado por primera vez

10 de abril de 2008

Primero enviado que cumplió con los criterios de control de calidad

11 de abril de 2008

Publicado por primera vez (Estimar)

17 de abril de 2008

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

16 de mayo de 2017

Última actualización enviada que cumplió con los criterios de control de calidad

19 de abril de 2017

Última verificación

1 de abril de 2017

Más información

Términos relacionados con este estudio

Otros números de identificación del estudio

  • IRB00002753
  • P30CA069533 (Subvención/contrato del NIH de EE. UU.)
  • 2753 (OHSU Knight Cancer Institute)
  • 813
  • NCI-2015-00224 (Identificador de registro: CTRP (Clinical Trial Reporting Program))
  • SOL-06062-LX
  • NCI-2015-00204
  • 8097

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