Indocyanine Green (ICG) Guided Tumor Resection
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|ClinicalTrials.gov Identifier: NCT04084067|
Recruitment Status : Recruiting
First Posted : September 10, 2019
Last Update Posted : February 11, 2020
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.
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:
- Ewing Sarcoma
- Rhabdomyosarcoma (RMS)
- Non-Rhabdomyosarcoma Soft Tissue Sarcoma (NRSTS)
- Renal tumors
- Metastatic pulmonary deposits
- Liver tumors, lymphoma, other rare tumors, and nodules of unknown etiology
- 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.
|Condition or disease||Intervention/treatment||Phase|
|Neoplastic Disease Solid Tumor||Drug: Indocyanine Green||Phase 1|
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. The day before the surgery, patients will receive a single dose of ICG intravenously. Surgery will be performed the following day.
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 :||Interventional (Clinical Trial)|
|Estimated Enrollment :||312 participants|
|Intervention Model:||Single Group Assignment|
|Masking:||None (Open Label)|
|Official Title:||Indocyanine Green (ICG) Guided Tumor Resection|
|Actual Study Start Date :||February 7, 2020|
|Estimated Primary Completion Date :||December 31, 2022|
|Estimated Study Completion Date :||December 31, 2022|
Experimental: Indocyanine green (ICG)
Participants will receive a single dose of 1.5 mg/kg of ICG intravenously over 15 minutes the day before surgery.
Drug: Indocyanine Green
- 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.
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): NCT04084067
|Contact: Abdelhafeez Abdelhafeez, MDfirstname.lastname@example.org|
|United States, Tennessee|
|St. Jude Children's Research Hospital||Recruiting|
|Memphis, Tennessee, United States, 38105|
|Contact: Abdelhafeez Abdelhafeez, MD 866-278-5833 email@example.com|
|Principal Investigator: Abdelhafeez Abdelhafeez, MD|
|Principal Investigator:||Abdelhafeez Abdelhafeez, MD||St. Jude Children's Research Hospital|