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Trial record 6 of 120 for:    focused ultrasound | Recruiting, Not yet recruiting, Available Studies

MR-guided High Intensity Focused Ultrasound (HIFU) on Pediatric Solid Tumors

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ClinicalTrials.gov Identifier: NCT02076906
Recruitment Status : Recruiting
First Posted : March 4, 2014
Last Update Posted : April 3, 2018
Sponsor:
Information provided by (Responsible Party):
AeRang Kim, Children's Research Institute

Brief Summary:
The purpose of this study is to determine if Magnetic Resonance guided High Intensity Focused Ultrasound ablative therapy is safe and feasible for children, adolescents, and young adults with refractory or relapsed solid tumors.

Condition or disease Intervention/treatment Phase
Relapsed Pediatric Solid Tumors Refractory Pediatric Solid Tumors Tumors Located in Bone or Soft Tissue in Close Proximity to Bone Rhabdomyosarcoma Ewing Sarcoma Osteosarcoma Neuroblastoma Wilms Tumor Hepatic Tumor Germ Cell Tumor Desmoid Tumor Device: Magnetic Resonance High Intensity Focused Ultrasound Phase 1

Detailed Description:
Magnetic Resonance (MR)-guided high intensity focused ultrasound (HIFU) is an innovative technique that allows for non-invasive thermal ablation of tissue. Advantages over conventional local tumor control such as surgery, radiation, or radiofrequency are that MR-HIFU is completely non-invasive, non-ionizing, and enables ablation of large tumor volumes with avoidance of adjacent tissue injury. This study will evaluate the safety and feasibility of MR-HIFU ablative therapy in children, adolescents, and young adults with refractory or relapsed solid tumors that are located in bone or soft tissue in close proximity to bone. Patients ≤ 30 years of age with refractory or relapsed solid tumors with measurable target lesions that are located in bone or soft tissue in close proximity to bone are eligible. Tolerability will be defined during the 14 days following MR-HIFU ablation. Patients will continue to be followed for tumor response and secondary outcomes for up to one year post ablation treatment.

Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 14 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Safety and Feasibility Study of Using MR-guided High Intensity Focused Ultrasound (HIFU) for the Ablation of Relapsed or Refractory Pediatric Solid Tumors
Study Start Date : April 2014
Estimated Primary Completion Date : January 2019
Estimated Study Completion Date : January 2019


Arm Intervention/treatment
Experimental: MR-HIFU
Magnetic Resonance High Intensity Focused Ultrasound (MR-HIFU) ablative therapy for children with recurrent or relapsed solid tumors.
Device: Magnetic Resonance High Intensity Focused Ultrasound
MR-High intensity focused ultrasound (HIFU) is an ultrasound based technology which allows for non-invasive thermal ablation of tumors under the guidance of MR thermography.
Other Names:
  • MR-HIFU
  • HIFU
  • Philips Sonalleve




Primary Outcome Measures :
  1. Toxicity [ Time Frame: 28 days following ablative therapy ]
    Toxicity will be evaluated using CTCAEv4. Adverse events will be summarized descriptively with tabulations of adverse event type, severity, and relationship to study treatment.


Secondary Outcome Measures :
  1. Disease response [ Time Frame: Up to 1 year ]
    We will preliminarily define tumor response from MR-HIFU ablative therapy assessed according to a modified Response Evaluation Criteria in Solid Tumors (RECIST). We will also evaluate functional tumor response using FDG-PET post MR-HIFU ablative treatment for patients with PET avid target lesions.

  2. Patient reported outcomes and quality of life measurements [ Time Frame: Up to 1 year ]
    We will use a validated symptom distress scale and quality of life metrics pre- and post-therapy at scheduled intervals.

  3. Immune Markers [ Time Frame: Pre-treatment, 1 day post treatment, 7 days post treatment ]
    Changes in immune markers from baseline and post therapy will be evaluated.



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Ages Eligible for Study:   up to 30 Years   (Child, Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

AGE: ≤ 30 years of age.

DIAGNOSIS:

Histologically confirmed malignant solid tumors, which may include but are not limited to rhabdomyosarcoma and other soft tissue sarcomas, Ewing's sarcoma family of tumors, osteosarcoma, neuroblastoma, Wilms' tumor, hepatic tumors, germ cell tumors, and desmoid tumors.

TUMOR LOCATION: Target lesion(s) must be located in bone or soft tissue in close proximity to bone. Target lesions must be reachable within the normal safety margins of HIFU as specified in the instructions for use.

TARGET LESION(S): Radiographically evaluable or measurable solid tumor target lesion(s).

THERAPEUTIC OPTIONS:

Malignant Tumor: The patient's cancer must have relapsed after or failed to respond to frontline curative therapy and there must not be other potentially curative treatment options available. Curative therapy may include surgery, radiation therapy, chemotherapy, or any combination of these modalities.

PRIOR THERAPY:

Patients must have fully recovered from the acute toxic effects of all prior chemotherapy, immunotherapy, or radiotherapy prior to entering on this study.

No limitation on the number of prior chemotherapy regimens that the patient may have received prior to study entry.

Myelosuppressive chemotherapy: The last dose of all myelosuppressive anticancer drugs must be at least 3 weeks prior to study entry.

Immunotherapy: The last dose of immunotherapy (monoclonal antibody or vaccine) must be at least 4 weeks prior to study entry.

Biologic (anti-cancer agent): The last dose of all biologic agents for the treatment of the patient's cancer (such as retinoids or tyrosine kinase inhibitors) must be at least 7 days prior to study entry.

Radiation therapy: The last dose of radiation to more than 25 % of marrow containing bones (pelvis, spine, skull) must be at least 4 weeks prior to study entry. The last dose of all other local palliative (limited port) radiation must be at least 2 weeks prior to study entry.

Stem Cell Transplantation. At least 2 months post-autologous stem cell transplant or at least 3 months post-allogeneic transplant and recovered from toxicities without evidence of graft versus host disease and on stable doses of immunosuppressive medications if required.

Growth Factors. The last dose of colony stimulating factors, such as filgrastim, sargramostim, and erythropoietin, must be at least 1 week prior to study entry, the last dose of long-acting colony stimulating factors, such as pegfilgrastim, must be at least 2 weeks prior to study entry.

CONCURRENT THERAPIES:

No other anti-cancer therapy (chemotherapy, biological therapy, radiation therapy) is permitted during HIFU treatment and post treatment follow up for tolerability (see section 3.3).

PERFORMANCE STATUS:

Patients > 10 years old must have a Karnofsky performance level ≥ 50%, and children ≤ 10 years old must have a Lansky performance level ≥ 50% (See Appendix I).

Patients who are unable to walk because of paralysis or motor weakness, but who are up in a wheelchair will be considered ambulatory for the purpose of calculating the performance score.

  • HEMATOLOGIC FUNCTION:

    1. Peripheral absolute neutrophil count (ANC) of ≥750/µL
    2. Platelet count ≥75,000/µL (may receive transfusions)
  • RENAL FUNCTION: Age-adjusted normal serum creatinine OR a creatinine clearance ≥60 mL/min/1.73 m2.
  • ADEQUATE PULMONARY FUNCTION: Defined as no dyspnea at rest, and a pulse oximetry >94% on room air if there is clinical indication for determination.
  • Normal PT, PTT and INR < 1.5 x ULN (including patients on prophylactic anticoagulation)

Exclusion Criteria:

Clinically significant unrelated systemic illness, such as serious infections, hepatic, renal or other organ dysfunction, which in the judgment of the Principal or Associate Investigator would compromise the patient's ability to tolerate the general anesthetic required for the procedure.

Target lesions that are pulmonary primary tumors or metastases.

Implant or prosthesis or scar tissue within the path of the HIFU beam.

Target <1 cm from nerve plexus, spinal canal, bladder, bowel

Target in contact with hollow viscera

Lesion in the skull

Inability to undergo MRI and/or contraindication for MRI

Inability to tolerate stationary position during HIFU

Patients currently receiving other anticancer agents.

Patients currently receiving other investigational agents.


Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02076906


Contacts
Contact: Stephanie Forlenza, MA 202-476-6841 saforlenza@childrensnational.org

Locations
United States, District of Columbia
Children's National Medical Center Recruiting
Washington, District of Columbia, United States, 20010
Contact: Emily Stern, RN, BSN    202-476-2802    estern@childrensnational.org   
Contact: Stephanie A Forlenza       saforlenza@childrensnational.com   
Principal Investigator: AeRang Kim, MD, PhD         
United States, Ohio
Cincinnati Children's Hospital Medical Center Recruiting
Cincinnati, Ohio, United States, 45229
Contact: Laura Fossett    513-636-2799    cancer@cchmc.org   
Principal Investigator: James Geller, MD         
Sponsors and Collaborators
AeRang Kim
Investigators
Principal Investigator: AeRang Kim, MD, PhD Children's Research Institute

Responsible Party: AeRang Kim, MD, PhD, Children's Research Institute
ClinicalTrials.gov Identifier: NCT02076906     History of Changes
Other Study ID Numbers: HIFU3917
First Posted: March 4, 2014    Key Record Dates
Last Update Posted: April 3, 2018
Last Verified: March 2018

Keywords provided by AeRang Kim, Children's Research Institute:
high intensity focused ultrasound
relapsed pediatric solid tumors
refractory pediatric solid tumors
rhabdomyosarcoma
Ewing's sarcoma
osteosarcoma
neuroblastoma
Wilms' tumor
hepatic tumors
germ cell tumors
desmoid tumor

Additional relevant MeSH terms:
Neoplasms
Sarcoma
Neuroblastoma
Neoplasms, Germ Cell and Embryonal
Osteosarcoma
Rhabdomyosarcoma
Sarcoma, Ewing
Wilms Tumor
Fibromatosis, Aggressive
Liver Neoplasms
Neoplasms, Connective and Soft Tissue
Neoplasms by Histologic Type
Neuroectodermal Tumors, Primitive, Peripheral
Neuroectodermal Tumors, Primitive
Neoplasms, Neuroepithelial
Neuroectodermal Tumors
Neoplasms, Glandular and Epithelial
Neoplasms, Nerve Tissue
Neoplasms, Bone Tissue
Neoplasms, Connective Tissue
Myosarcoma
Neoplasms, Muscle Tissue
Neoplasms, Complex and Mixed
Kidney Neoplasms
Urologic Neoplasms
Urogenital Neoplasms
Neoplasms by Site
Neoplastic Syndromes, Hereditary
Kidney Diseases
Urologic Diseases