Working…
ClinicalTrials.gov
ClinicalTrials.gov Menu

Study of Sonodynamic Therapy in Participants With Recurrent High-Grade Glioma

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT04559685
Recruitment Status : Recruiting
First Posted : September 23, 2020
Last Update Posted : March 22, 2021
Sponsor:
Collaborators:
Barrow Neurological Institute
Ivy Brain Tumor Center
SonALAsense
InSightec
Information provided by (Responsible Party):
Nader Sanai, St. Joseph's Hospital and Medical Center, Phoenix

Brief Summary:
A Phase 0 single center, first in human, open-label study of ascending energy doses of sonodynamic therapy (SDT) utilizing the MRgFUS combined with intravenous ALA to assess safety and efficacy in up to 30 participants with recurrent HGG. Eligible participants who are scheduled for resection will be administered intravenous (IV) aminolevulinic acid HCl (ALA) approximately six to seven (6-7) hours prior to receiving sonodynamic therapy (SDT).

Condition or disease Intervention/treatment Phase
High Grade Glioma Combination Product: SONALA-001(ALA) and MR-Guided Focused Ultrasound device (MRgFUS) Early Phase 1

Layout table for study information
Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 30 participants
Allocation: Non-Randomized
Intervention Model: Sequential Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase 0, First in Human, Open-label Study of Intravenous Aminolevulinic Acid HCl (ALA) and MR-Guided Focused Ultrasound Device (MRgFUS) in Participants With Recurrent High Grade Glioma (HGG)
Actual Study Start Date : March 15, 2021
Estimated Primary Completion Date : December 31, 2021
Estimated Study Completion Date : March 31, 2022

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: Arm A Dose-escalation
In Arm A, the dose-escalation cohort, there will be 3 cohorts of ascending MRgFUS power/energy dose combinations with a fixed SONALA-001 dose and fixed surgical time. Arm A will determine the power/energy dose combination for Arm B.
Combination Product: SONALA-001(ALA) and MR-Guided Focused Ultrasound device (MRgFUS)
SONALA-001(ALA) given 6-7 hours prior to receiving the MRgFUS.

Experimental: Arm B Time-escalation
In Arm B, the time-escalation cohort, the SONALA-001 and power/energy dose combination will be fixed. Participants will be enrolled into two time cohorts (2 days and 6 days post-SDT).
Combination Product: SONALA-001(ALA) and MR-Guided Focused Ultrasound device (MRgFUS)
SONALA-001(ALA) given 6-7 hours prior to receiving the MRgFUS.




Primary Outcome Measures :
  1. Biological changes associated with the sonodynamic therapy [ Time Frame: Intraoperatively 2, 4, or 6 days post sonodynamic therapy ]
    The percentage (%) of Cleaved Caspase-3, MIB-1 level, GammaH2Ax of the surgical tissue will be quantified and compared to intra-patient control specimens.


Secondary Outcome Measures :
  1. Radiographic evidence of tumor physiological imaging changes associated with sonodynamic therapy [ Time Frame: Pre and 14 Days Post-operative scan ]
    Dynamic Contrast Enhanced (DCE)-MRI data to quantify permeability

  2. Radiographic evidence of tumor physiological imaging changes associated with sonodynamic therapy [ Time Frame: Pre and 14 Days Post-operative scan ]
    Dynamic Susceptibility Contrast (DSC)-MRI data to quantify perfusion

  3. Radiographic evidence of tumor physiological imaging changes associated with sonodynamic therapy [ Time Frame: Pre and 14 Days Post-operative scan ]
    Diffusion Weighted Imaging (DWI) data to evaluate cellularity

  4. To identify oxidative stress in tissue exposed to sonodynamic therapy in recurrent high-grade glioma patients. [ Time Frame: Intraoperatively 2, 4, or 6 days post sonodynamic therapy ]
    To quantify markers for oxidative stress (Protein oxidation (Protein Carbonyl Content), Lipid peroxidation (4-hydroxynonenal and MDA), DNA damage (8-hydroxyguanosine),General (GSH, GSSG, Cys, CySS) in the brain tumor tissue (2-, 4- and 6-days post SDT) (both in SDT and control fractions)

  5. Performance of MRgFUS [ Time Frame: Day 1 ]
    Percentage of SDT treatments in which the MRgFUS system works as planned

  6. Performance of MRgFUS [ Time Frame: Day 1 ]
    Percentage of treatments in which procedure deviations were noted

  7. Safety and Tolerability [ Time Frame: up to 30 days after the last study dose ]
    Number and incidence of drug-related toxicity

  8. Safety and Tolerability [ Time Frame: up to 30 days after the last study dose ]
    Adverse device effects



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


Layout table for eligibility information
Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Prior resection of histologically diagnosed high-grade gliomas (III and IV) defined as participants who have progressed on or following standard (Stupp regimen) therapy, which includes maximal surgical resection, temozolomide, and fractionated radiotherapy.
  2. Recurrence must be confirmed by diagnostic biopsy with local pathology review or contrast-enhanced MRI with positive perfusion.
  3. Have measurable disease preoperatively, defined as at least 1 contrast-enhancing lesion, with a volume of at least 6 cm3 and ≤ 20cm3 of targeted treatment area.
  4. Age ≥18 at time of consent.
  5. Have a performance status (PS) of ≤2 on the Eastern Cooperative Oncology (Group (ECOG) scale (Oken et al. 1982).
  6. Ability to swallow oral medications.
  7. Has adequate bone marrow and organ function as defined by the following laboratory values (as assessed by the local laboratory for eligibility)

    Adequate bone marrow function:

    • absolute neutrophil count ≥1,000/mcL
    • Platelets (at time of surgery) ≥100,000/mcL
    • hemoglobin ≥8.0 g/dL Participants may receive erythrocyte transfusions to achieve this hemoglobin level at the discretion of the investigator.

    Adequate hepatic and renal function:

    • total bilirubin ≤1.5 X ULN. Participants with Gilbert's syndrome with a total bilirubin ≤2.0 times ULN and direct bilirubin within normal limits are permitted.
    • AST(SGOT) ≤3 X institutional ULN
    • ALT(SGPT) ≤3 X institutional ULN
    • GGT ≤3 X institutional ULN
    • Serum creatinine ≤1.5 X institutional ULN
  8. Confirmed negative serum pregnancy test (β-hCG) before starting study treatment or participant has had a hysterectomy.
  9. For females of reproductive potential: use of highly effective contraception for at least 1 month prior to screening and agreement to use such a method during study participation and for an additional 3 months after the end of treatment administration.
  10. For males of reproductive potential: use of condoms or other methods to ensure effective contraception with partner and for an additional 1 month after the end of treatment administration. A condom is required to be used also by vasectomized men as well as during intercourse with a male partner to prevent delivery of the drug via seminal fluid.
  11. Participants who received chemotherapy must have recovered (Common Terminology Criteria for Adverse Events [CTCAE] Grade ≤1) from the acute effects of chemotherapy except for residual alopecia or Grade 2 peripheral neuropathy prior to Day 1. A washout period of at least 21 days is required between last chemotherapy dose and Day 1 (provided the patient did not receive radiotherapy).
  12. Participants who received radiotherapy must have completed and fully recovered from the acute effects of radiotherapy. A washout period of at least 14 days is required between end of radiotherapy and Day 1.
  13. Ability to understand and the willingness to sign a written informed consent document (personally or by the legally authorized representative, if applicable).
  14. Has voluntarily agreed to participate by giving written informed consent (personally or via legally authorized representative(s), and assent if applicable). Written informed consent for the protocol must be obtained prior to any screening procedures. If consent cannot be expressed in writing, it must be formally documented and witnessed, ideally via an independent trusted witness.
  15. Willingness and ability to comply with scheduled visits, treatment plans, Lifestyle Considerations, laboratory tests and other procedures.

Exclusion Criteria:

  1. Known active systemic bacterial infection (requiring intravenous [IV] antibiotics at time of initiating study treatment), fungal infection, or detectable viral infection (such as known human immunodeficiency virus positivity or with known active hepatitis B or C [for example, hepatitis B surface antigen positive]. Screening is not required for enrollment.
  2. Have had a recent (≤3 months prior to first dose of study drug) transient ischemic attack or stroke.
  3. Significant vascular disease (e.g. aortic aneurysm)
  4. Evidence of bleeding diathesis or coagulopathy
  5. Diagnosis of porphyria
  6. Unstable angina and/or congestive heart failure within the last 6 months
  7. Transmural myocardial infarction within the last 6 months
  8. Serious and inadequately controlled cardiac arrhythmia
  9. Acute exacerbation of chronic obstructive pulmonary disease
  10. Inability to undergo MRI (e.g., presence of a pacemaker)
  11. Pregnancy or breastfeeding
  12. Has serious and/or uncontrolled preexisting medical condition(s) that, in the judgment of the investigator, would preclude participation in this study.
  13. Simultaneous use of other potentially phototoxic substances (e.g. tetracyclines, sulfonamides, fluoroquinolones, hypericin extracts)
  14. Hypersensitivity against porphyrins
  15. Treatment with another investigational drug within 30 days prior to enrollment or within 5 half-lives of the investigational product, whichever is longer.
  16. Has an Overall Skull Density Ratio of 0.45 (±0.05) or less as calculated from the screening CT.

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): NCT04559685


Contacts
Layout table for location contacts
Contact: Phase 0 Navigator 602-406-8605 research@ivybraintumorcenter.org

Locations
Layout table for location information
United States, Arizona
St. Joseph's Hospital and Medical Center Recruiting
Phoenix, Arizona, United States, 85013
Contact: Phase 0 Navigator    602-406-8605    research@ivybraintumorcenter.org   
Sponsors and Collaborators
Nader Sanai
Barrow Neurological Institute
Ivy Brain Tumor Center
SonALAsense
InSightec
Investigators
Layout table for investigator information
Principal Investigator: Nader Sanai, MD St. Joseph's Hospital and Medical Center, Phoenix
Layout table for additonal information
Responsible Party: Nader Sanai, Deputy Director, Ivy Brain Tumor Center, St. Joseph's Hospital and Medical Center, Phoenix
ClinicalTrials.gov Identifier: NCT04559685    
Other Study ID Numbers: 2020-11
21-500-032-34-38 ( Other Identifier: St. Joseph's Hospital and Medical Center )
First Posted: September 23, 2020    Key Record Dates
Last Update Posted: March 22, 2021
Last Verified: March 2021
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

Layout table for additional information
Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: Yes
Device Product Not Approved or Cleared by U.S. FDA: Yes
Additional relevant MeSH terms:
Layout table for MeSH terms
Glioma
Neoplasms, Neuroepithelial
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neoplasms by Histologic Type
Neoplasms
Neoplasms, Glandular and Epithelial
Neoplasms, Nerve Tissue