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A Study of Aminolevulinic Acid (ALA) to Enhance Visualization and Resection of Malignant Glial Tumors of the Brain (ALA)

The recruitment status of this study is unknown. The completion date has passed and the status has not been verified in more than two years.
Verified March 2014 by Jefferson W Chen, MD, Legacy Health System.
Recruitment status was:  Active, not recruiting
DUSA Pharmaceuticals, Inc.
Information provided by (Responsible Party):
Jefferson W Chen, MD, Legacy Health System Identifier:
First received: July 25, 2011
Last updated: March 24, 2014
Last verified: March 2014
This study aims to determine the safety and utility of using 5-Aminolevulinic Acid (ALA) in removing malignant brain tumors during surgery.

Condition Intervention Phase
Drug: 5-Aminolevuline Acid
Phase 2

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Phase 2 Study of Aminolevulinic Acid (ALA) to Enhance Visualization and Resection of Malignant Glial Tumors of the Brain

Resource links provided by NLM:

Further study details as provided by Jefferson W Chen, MD, Legacy Health System:

Primary Outcome Measures:
  • Establish a safe dose to provide optimal discrimination between normal and malignant tissue for oral ALA administration intraoperatively [ Time Frame: participants will be followed while in the hospital and for 12 weeks after surgery ]

Secondary Outcome Measures:
  • Compare time-to-progression and survival to that in comparable cases performed without the aid of ALA [ Time Frame: participants will be followed for 24 months ]

Estimated Enrollment: 18
Study Start Date: October 2010
Estimated Study Completion Date: March 2015
Primary Completion Date: December 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: ALA
5-Aminolevuline Acid (ALA)
Drug: 5-Aminolevuline Acid
5-Aminolevuline Acid (ALA) at 30 mg/kg given orally 4 hours before surgery

Detailed Description:

This study aims to determine the safety and utility of using 5-Aminolevulinic Acid (ALA) in removing brain tumors during surgery. When ALA is provided at an increased concentration, protoporphorin concentration in the malignant cell increases and renders the cell fluorescent under long ultraviolet light. This study looks at using oral ALA to help identify the tumor cells intraoperatively and facilitate complete resection.

Oral ALA will be given prior to image-guided microsurgical resection of the tumor. Following tumor resection under light microscopy, the tumor bed will be illuminated and any residual fluorescent tissue in cavity will be surgically removed leading to a more complete resection of tumor. Pathologic confirmation of tumor type will be made by neuropathology. Photosensitizer concentration in malignant and normal tissue will be estimated by fluorescence microscopy.


Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Patients must have clinically documented primary brain tumor for which resection is clinically indicated. The anticipated histology at resection should include: Anaplastic astrocytoma, Astrocytoma, Brain stem glioma, Ependymoma, Glioblastoma, Glioblastoma multiforme, Gliosarcoma, oligodendroglioma, Medulloblastoma, Mixed astrocytoma-ependymoma
  • Patients may have prior therapy
  • 18 years of age
  • Male or Female
  • Life expectancy is not a consideration for protocol entry
  • Patients must have normal organ and marrow function as defined below: Leukocytes >3,000/mL, Absolute neutrophil count >1,500/mL, Platelets >100,000/mL, Total bilirubin within normal institutional limits AST (SGOT)/ALT (SGPT)<2.5 X institutional upper limit of normal, Creatinine within normal institutional limits or Creatinine clearance >60 mL/min/1.73 m2 for patients with creatinine levels above institutional normal
  • Confirmation of Glial Tumor
  • Gross total resection is the aim of surgery
  • Ability to understand and the willingness to sign a written informed consent document or have a parent or guardian with the ability to understand and the willingness to sign a written informed consent.

Exclusion Criteria:

  • Non-Glial tumor i.e. tumor abscess, metastasis, lymphoma, vasculitis
  • Tumor with perforating vessels
  • Tumor involves critical fiber tracks
  • Use of the microsurgical tool monopolar loop
  • Subject has preexisting severe deficits concerning language or motor function not resolved with steroids
  • Performance Status of less than 60
  • Prior therapy is not an exclusion criterion
  • Patients may not be receiving any other investigational agents
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition to aminolevulinic acid (ALA)
  • Personal or family history of porphorias
  • 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
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Please refer to this study by its identifier: NCT01403311

United States, Oregon
Legacy Health System
Portland, Oregon, United States, 97210
Sponsors and Collaborators
Legacy Health System
DUSA Pharmaceuticals, Inc.
Principal Investigator: Jefferson Chen, MD, PhD Legacy Health System
  More Information

Responsible Party: Jefferson W Chen, MD, Principal Investigator, Legacy Health System Identifier: NCT01403311     History of Changes
Other Study ID Numbers: 5-ALA-01
Study First Received: July 25, 2011
Last Updated: March 24, 2014

Keywords provided by Jefferson W Chen, MD, Legacy Health System:
Anaplastic astrocytoma
Brain stem glioma
Glioblastoma multiforme
Mixed astrocytoma-ependymoma

Additional relevant MeSH terms:
Brain Neoplasms
Neoplasms, Neuroepithelial
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neoplasms by Histologic Type
Neoplasms, Glandular and Epithelial
Neoplasms, Nerve Tissue
Central Nervous System Neoplasms
Nervous System Neoplasms
Neoplasms by Site
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Aminolevulinic Acid
Photosensitizing Agents
Dermatologic Agents processed this record on May 25, 2017