Status:

WITHDRAWN

Single vs Multi-fraction SRS Patients on Immunotherapy

Lead Sponsor:

University of Chicago

Conditions:

Brain Cancer

Brain Metastases

Eligibility:

All Genders

18+ years

Phase:

PHASE2

Brief Summary

This study is meant to compare different surgical approaches to brain cancer.

Eligibility Criteria

Inclusion

  • i. Adult patients (≥ 18 years old) with an ECOG Performance Status 0-2 and a life expectancy of 3 months or more.
  • ii. Histologically confirmed systemic malignancy with gadolinium contrast-enhanced MRI scan demonstrating 1-10 newly diagnosed intraparenchymal brain metastases.
  • iii. Well-circumscribed, measureable intraparenchymal brain metastasis(s) with maximum tumor diameter ≤3.0 cm. If multiple metastases are present, the other(s) must not exceed 3.0 cm in maximum diameter. At least one metastasis must be ≥ 0.5 cm in maximum diameter to be considered measurable disease.
  • iv. Negative urine or serum pregnancy test done ≤ 21 days prior to CT simulation, for women of child bearing potential only.
  • v. Ability to understand and willingness to sign a written informed consent document.
  • vi. Must have received immunotherapy (PD-1/PD-L1 and/or CTLA-4 inhibitor(s)) within the past 6 months or plan on receiving immunotherapy within the next 1 month.
  • vii. Must have a Gustave Roussy Immune Score (GRIm-Score) of 0 or 1 (neutrophil-to-lymphocyte ratio \> 6 = 1 point, LDH \> Upper Limit of Normal = 1 point, and Albumin \< 3.5 g/dL = 1 point).

Exclusion

  • i. Diagnosis of germ cell tumor or hematologic malignancy. ii. Metastases in the brain stem, midbrain, pons, medulla, or within 7 mm of the optic apparatus (optic nerves, chiasm and optic tracts).
  • iii. Diagnosis of leptomeningeal disease. iv. Prior SRS to an immediately adjacent lesion(s) of interest or to the current lesion(s) of interest.
  • v. Prior history of pseudoprogression or radionecrosis from cranial radiotherapy.
  • vi. A neurosurgical resection cavity deemed too large by the radiation oncologist to be treated with a single fraction of stereotactic radiosurgery.
  • vii. Contraindications to gadolinium contrast-enhanced MRI (eg, non-compatible pacemaker, eGFR \<30, gadolinium allergy).
  • viii. A Gustave Roussy Immune Score (GRIm-Score) \> 1 (neutrophil-to-lymphocyte ratio \> 6 = 1 point, LDH \> Upper Limit of Normal = 1 point, and Albumin \< 3.5 g/dL = 1 point).

Key Trial Info

Start Date :

June 29 2020

Trial Type :

INTERVENTIONAL

Allocation :

ACTUAL

End Date :

December 12 2022

Estimated Enrollment :

Patients enrolled

Trial Details

Trial ID

NCT04427228

Start Date

June 29 2020

End Date

December 12 2022

Last Update

August 28 2023

Active Locations (1)

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1

University Of Chicago

Chicago, Illinois, United States, 60637