Lymphangioleiomyomatosis (LAM)

Researchers are evaluating new imaging techniques in adults aged 18 to 85 with lung diseases such as asthma, emphysema, COPD, bronchiectasis, sarcoidosis, pulmonary fibrosis, alpha 1-anti-trypsin deficiency, and lymphangioleiomyomatosis (LAM). The study aims to develop tools for analyzing lung function and structure using hyperpolarized Xenon 129 MRI alongside pulmonary function tests. This research is supported by Western University, Canada. Participants will undergo a series of tests during a one to two-hour visit, including medical history review, vital signs measurement, full pulmonary function testing following American Thoracic Society guidelines, proton MRI, specialized 129-Xe MRI scans using chest coils, and a low-dose thoracic CT scan. The MRI procedure includes monitoring heart rate and oxygen levels, providing hearing protection, and offering supplemental oxygen as needed. These imaging and testing methods help assess lung ventilation, diffusion, and gas exchange. During the study visit, participants will complete pulmonary function tests such as spirometry, plethysmography, and diffusing capacity tests. They will undergo magnetic resonance imaging with hyperpolarized Xenon gas to visualize lung airways and anatomy, along with CT scans matched to MRI breathing maneuvers. Researchers will measure ventilation defect percent (VDP), apparent diffusion coefficients (ADC), and dissolved phase spectroscopy over five years. Participant safety is monitored throughout the visit, and the total study duration includes these assessments and follow-up measures.

Researchers are evaluating a new 10-minute cardiovascular magnetic resonance (CMR) imaging protocol designed to improve current CMR procedures for patients with various heart conditions, including coronary artery disease, cardiomyopathies, and other cardiac diseases. The study aims to develop a standardized, contrast-free imaging method that can be applied to about 70% of cardiac patients. The goal is to assess whether this shorter protocol enhances diagnostic decision-making and reduces healthcare costs. The study involves two groups: healthy volunteers over 18 years old without significant cardiovascular or respiratory conditions, and patients over 18 years who require a clinically indicated CMR exam. The new protocol focuses on heart function and tissue characterization without using contrast agents. Researchers will compare the new 10-minute protocol to standard CMR imaging, evaluating its clinical feasibility, performance, and cost-effectiveness in different patient populations. Participants will undergo CMR scans using both the new and standard protocols. Researchers will monitor diagnostic results, scan completion rates, scan sequence times, adverse events, and cost differences between methods. Various heart tissue measurements and reproducibility between different readers and scanners will also be assessed. The study spans from 2019 to 2025, with ongoing safety monitoring during imaging sequences and a focus on improving the efficiency and quality of cardiac imaging.

Researchers are investigating targeted drug therapies for patients with vascular malformations that are resistant to standard treatments or for whom standard treatments are unsuitable. These vascular malformations are classified as either slow-flow or fast-flow types, driven by genetic changes in two specific signalling pathways. This phase II open-label trial aims to evaluate the effects of 48 weeks of treatment using either alpelisib for slow-flow vascular malformations with PI3K pathway mutations or mirdametinib for fast-flow vascular malformations with MAPK pathway mutations. Participants are divided into two treatment groups based on their vascular malformation type and genetic mutation. Those with slow-flow malformations and PI3K pathway mutations will receive alpelisib, an oral PI3-kinase inhibitor, for 48 weeks followed by a 24-week follow-up. Those with fast-flow malformations and MAPK pathway mutations will receive mirdametinib, an investigational oral MEK inhibitor, also for 48 weeks followed by 24 weeks of follow-up. Both treatments are given as monotherapy and involve genetic testing before enrollment to confirm mutations. Throughout the study, participants will undergo various assessments including symptom evaluations using the Vascular Malformation Patient Specific Outcome Measure (VM-PSOM) and OVAMA questionnaires, MRI scans to measure lesion size, and monitoring for adverse events. The primary outcome is the improvement in the most significant symptom after 48 weeks of treatment. Follow-up visits continue for 24 weeks after treatment ends to monitor ongoing effects and safety. The total participation duration for each patient is approximately 72 weeks.

Researchers are investigating how lung cancer and its treatments may affect thinking and memory in patients with both small-cell lung cancer (SCLC) and non-small-cell lung cancer (NSCLC). This observational study aims to understand the occurrence of cognitive impairment during the first year after patients join the study. The European Institute of Oncology is leading this research to better understand cognitive changes in lung cancer patients. The study includes patients diagnosed with lung cancer across all stages (I to IV). There are no drug treatments or interventions involved since this is an observational study, meaning researchers will monitor and assess participants without giving any new treatments. Participants will be observed and evaluated during the first year after enrollment to track cognitive changes. Participants will undergo comprehensive neuropsychological assessments to measure thinking and memory abilities at different times over one year. Researchers will also look for risk factors that might affect cognitive function in lung cancer patients. The study excludes patients with brain metastases, brain radiotherapy, or other neurological or psychiatric disorders. The total time of involvement is up to 12 months, during which participants will complete cognitive tests and other assessments.

Researchers are evaluating the effects of a manual vibration technique applied to the chest wall on the duration of chest tube placement, secretion clearance, and hemodynamic parameters in patients who have chest tubes after thoracic surgery. Thoracic surgery treats diseases of the lungs, pleura, chest wall, and mediastinum. Postoperative problems include pain, ineffective coughing, reduced lung volume, pulmonary complications, and chest wall tension, which may delay recovery and increase hospital stays. Tube thoracostomy helps drain fluid and air to allow lung expansion. The manual vibration technique is being studied as a cost-effective, adaptable alternative to mechanical vibration for helping these patients.

Researchers are evaluating the effect of a high-dose nicotine patch on pain sensitivity in male tobacco smokers who stop smoking before thoracic surgery. Smoking is a major risk factor for complications after surgery and is linked to higher mortality and more postoperative problems. Nicotine withdrawal symptoms and increased opioid use after surgery make pain management challenging, prompting this study to explore nicotine patches as a potential aid during surgery recovery. Participants receive either a nicotine patch or a placebo patch starting 24 hours before surgery and continuing for 48 hours after. The nicotine patch dose depends on the number of cigarettes smoked daily, with one 21 mg patch per 20 cigarettes or a 42 mg patch for those smoking 40 or more cigarettes. Patches are applied to the arm, chest, or back with cleaned skin. The control group receives a placebo patch matching the nicotine patch's appearance and placement. During the study, participants undergo thoracoscopic lung surgery under general anesthesia. Researchers monitor pain by measuring analgesic pump dosage used within 48 hours post-surgery. Other assessments include clinical evaluations and monitoring for any postoperative complications or adverse reactions. The study aims to observe differences in opioid use and pain management between the nicotine patch group and placebo group over the immediate postoperative period.

Researchers are evaluating the effects of Ciprofol, a new intravenous anesthetic drug, on myocardial injury occurring after non-cardiac thoracic surgery. Myocardial injury after noncardiac surgery (MINS) is identified by elevated cardiac troponin levels due to ischemic causes and is a common complication after thoracic surgery, linked to increased risks of mortality and vascular problems. This study aims to see if Ciprofol can reduce the incidence of MINS compared to propofol, focusing on patients undergoing video-assisted thoracoscopic surgery (VATS) for lung cancer treatment. Participants will be randomly assigned to receive either Ciprofol or propofol as sedative agents during general anesthesia for VATS. Both groups will also receive sufentanil and cis-atracurium intravenously. The doses and administration times for study drugs are carefully controlled. The trial is double-blind and multicenter, comparing the circulatory stability and sedative effects of Ciprofol with those of propofol in thoracic surgery patients. During the study, patients will be monitored for myocardial injury within 30 days post-surgery, as well as for new heart rhythm problems, episodes of low blood pressure, and mortality rates. Data on anesthesia induction, maintenance, and perioperative hemodynamics will be collected. The study includes baseline assessments and safety monitoring, with follow-up visits lasting at least three days postoperatively. Researchers will analyze the incidence of myocardial injury and other cardiovascular outcomes to assess the impact of Ciprofol on patient safety and recovery.

This research aims to evaluate whether erector spinae blocks (ESB) with bolus infusions of local anesthetic can reduce postsurgical pain and the need for opioid pain medications in patients undergoing pulmonary resection surgery. The study focuses on patients having surgery on the side of the chest, where nerve disruption often causes significant pain. ESB may be especially helpful for patients who need anticoagulation and cannot receive more invasive nerve blocks. Participants will be randomly assigned to one of two groups: one group will receive the erector spinae block with bupivacaine alongside standard care, while the other group will receive only standard care without the block. The ESB involves a local anesthetic infusion targeting nerves in the thoracic area. This approach is being studied for its potential to improve pain control while minimizing opioid use after surgery. During the study, patients will be monitored for pain levels and opioid consumption at 6, 12, and 24 hours after surgery. Researchers will assess pain using visual analogue scores and track medication use to understand the impact of the block. The study will help determine if ESB offers a safer alternative to traditional nerve blocks, especially for those on blood thinners, with the total participation time covering the immediate postoperative period.

Lymphangioleiomyomatosis (LAM) is a rare lung disease that behaves like a slow-growing cancer caused by unregulated activity of the mTOR pathway. Researchers are studying the long-term safety and tolerability of imatinib mesylate, a drug approved for leukemia that may induce death of LAM cells. This Phase 1 trial follows a previous short-term pilot study and aims to provide more information on imatinib's effects in patients with LAM. Participants will be randomly assigned to receive either imatinib mesylate or a placebo over a six-month period. Imatinib is taken orally at a dose of 400 mg twice daily. The trial includes five office visits and check-up phone calls every two weeks to monitor participants. The study is designed as a double-blinded, placebo-controlled trial to compare safety and tolerability between the two groups. During the study, participants will undergo assessments including lung function tests such as Forced Vital Capacity (FVC) and Forced Expiratory Volume in One Second (FEV1), as well as measurement of the biomarker VEGF-D. Quality of life will be evaluated using the St. George Respiratory Questionnaire. The main outcome measured is the incidence of adverse events over one year. Participants will be monitored regularly for safety and adherence throughout the trial duration.

Researchers are studying Birt-Hogg-Dube (BHD) syndrome, a rare inherited condition that causes benign skin tumors and increases the risk of kidney cancer. The study aims to understand the types and characteristics of kidney tumors linked to BHD, the risk of kidney cancer in affected individuals, whether more than one gene causes BHD, and the genetic mutations responsible for the disorder. The research also explores connections between genetic changes and disease symptoms.