Lapeer

Researchers are evaluating if adding a special device called the TheraBionic P1, which uses amplitude-modulated radiofrequency electromagnetic fields, can impact the treatment response in women with early-stage, operable breast cancer that is hormone receptor positive and HER2-negative. This pilot study focuses on patients scheduled for surgery and aims to understand how this device affects the cancer before removal. Participants will use the TheraBionic P1 device by self-administering three 60-minute treatments each day—morning, midday, and evening—continuously for about two weeks before their planned surgery to remove the tumor. The device delivers specific electromagnetic fields targeting the cancer during this pre-surgical period. During the study, participants will be closely monitored, and their pathological response to the treatment will be assessed at the time of surgery, approximately two weeks after starting the device therapy. Researchers will review tissue samples and track safety measures while ensuring participants follow the treatment and study protocols. This involvement lasts from treatment initiation through surgery and includes follow-up monitoring for adherence and safety.

Researchers are evaluating if adding amplitude-modulated radiofrequency electromagnetic fields (AM RF EMF) to the drug Fruquintinib can improve survival and be safe for patients with metastatic colorectal cancer that no longer responds to standard treatments. This phase 2 study focuses on people with confirmed metastatic colorectal adenocarcinoma who have previously received specific chemotherapy and targeted therapies but whose cancer has progressed or who cannot tolerate those treatments. Participants receive Fruquintinib, a drug that targets certain blood vessel receptors involved in cancer growth, combined with the TheraBionic P1 device, which delivers AM RF EMF. The study tests this combination's effects on survival and tolerance. Treatment monitoring includes regular imaging scans such as CT, MRI, or PET to evaluate disease status. During the study, participants are closely monitored for overall survival up to five years after treatment ends or until death. Researchers assess safety, organ function, and cancer progression through scans and clinical evaluations. Participants must be able to take oral medication and use the device, and they are followed according to the study protocol for the entire duration of the trial.

This research aims to collect ongoing safety and effectiveness data for the C-Brace System, a microprocessor-controlled knee ankle foot orthosis used by patients with lower extremity pareses. The study follows patients who have been casted for a C-Brace fitting and consent to participate, focusing on documenting their progress and experiences over time with this device. The C-Brace device includes custom thigh, calf, and foot components connected by an ankle joint and sensor system that continuously monitors knee joint movement. This allows the device to adjust resistance and control knee flexion and extension during walking. Participants will receive standard care including baseline evaluation, fitting, training or therapy sessions, and follow-up visits at 6, 12, 24, and 36 months after final fitting. Participants will undergo assessments such as walking speed tests, mobility and balance evaluations, and balance confidence questionnaires to measure changes from baseline. The study also tracks device-related adverse events, especially falls, to monitor safety over 12 months and beyond. The total follow-up period extends up to 36 months to provide comprehensive data on long-term use.

Researchers are evaluating how well proton beam radiation therapy compares with intensity modulated photon radiotherapy in treating patients with stage I to IVA esophageal cancer. This phase III trial aims to determine if proton beam therapy can improve overall survival and reduce serious heart and lung side effects compared to photon therapy. The study also looks at symptom impact, quality of life, treatment costs, response rates, and hospitalization length between the two treatments. Participants are randomly assigned to receive either proton beam therapy or intensity modulated photon therapy, both given in 28 sessions over 5.5 weeks alongside chemotherapy. Chemotherapy options include carboplatin/paclitaxel, FOLFOX/CAPOX, or docetaxel/fluorouracil regimens, selected by the patient and physician. After completing chemoradiation, patients may have surgery to remove the tumor if it is safe and feasible. During the study, blood samples and imaging scans such as PET/CT or CT are collected to monitor progress. Patients are followed every 3 to 6 months for three years and then yearly to track survival, side effects, and disease status. Researchers also assess patient-reported symptoms and quality of life. The main outcomes measured are overall survival and the occurrence of serious heart and lung side effects related to treatment over up to eight years. Additional assessments include immune cell levels, disease recurrence, and treatment toxicity.

Researchers are evaluating comprehensive genomic analysis in tissue samples from patients with recurrent or stage IV non-small cell lung cancer. This analysis aims to identify specific gene mutations in the cancer's DNA, which may help doctors tailor treatments to target these mutations more precisely. The study seeks to determine how often therapy can be started based on these genomic test results and to understand the outcomes for patients who receive such targeted therapy. Patients provide tumor tissue samples for genomic analysis using techniques like mass spectrometry, polymerase chain reaction (PCR), and microarray. Those whose genomic results indicate suitable targets may begin therapy tailored to their tumor's specific mutations. The study involves collecting and analyzing existing tumor samples or performing new biopsies if needed. During the study, patients undergo laboratory tests and tissue collection, followed by therapy initiation when appropriate. After treatment, patients are monitored every 3 months for 2 years, then every 6 months for 3 years, and annually thereafter to track progression-free survival and response to therapy. The main outcome measured is the proportion of patients who start treatment based on genomic analysis within 21 days. Safety and long-term outcomes are also followed.

Researchers are evaluating whether breast conservation surgery combined with endocrine therapy can achieve a similar rate of invasive or non-invasive ipsilateral breast tumor recurrence (IBTR) compared to breast conservation surgery followed by breast radiation and endocrine therapy in patients with Stage I, hormone sensitive, HER2-negative breast cancer with an Oncotype recurrence score of 18 or less. This Phase III trial builds on the established role of radiation after lumpectomy, aiming to identify if radiation can be safely omitted in certain low-risk patients to reduce treatment burden and side effects. Participants receive either breast radiation plus endocrine therapy or endocrine therapy alone. Radiation therapy involves external beam radiation to the whole breast with or without a boost, partial breast irradiation, or accelerated partial breast irradiation, starting within 12 weeks after the last breast surgery. Endocrine therapy is given for a minimum of 5 years, with the specific drug choice and schedule determined by the treating physician. Endocrine therapy may begin before, during, or after radiation therapy, depending on the treatment group. Throughout the study, participants undergo regular assessments including imaging such as mammograms or MRI within six months before enrollment, and clinical evaluations to monitor tumor recurrence. The main outcome measured is the time to invasive or non-invasive ipsilateral breast tumor recurrence over five years. Safety, adherence to therapy, and recovery from surgery are also monitored. The total participation period includes at least five years to evaluate long-term recurrence rates.

Researchers are evaluating if adding adjuvant chemotherapy (ACT) to ovarian function suppression (OFS) plus endocrine therapy (ET) improves invasive breast cancer-free survival (IBCFS) compared to OFS plus ET alone. This Phase III trial focuses on premenopausal women with early-stage breast cancer that is estrogen receptor (ER)-positive, HER2-negative, and has a 21-gene recurrence score between 16-25 for node-negative patients or 0-25 for patients with 1-3 positive nodes. The study addresses the need for better treatment options for younger women diagnosed with this type of breast cancer, as younger age is linked to worse outcomes despite standard therapies. Participants receive one of two treatments: either OFS combined with an aromatase inhibitor (AI) for five years or adjuvant chemotherapy followed by the same OFS plus AI regimen. The specific AI and GnRH agonist used, along with their dosing schedules, are chosen by the investigator, commonly including goserelin, leuprolide, or triptorelin administered monthly or every three months. Bilateral oophorectomy may be used instead of ovarian suppression if preferred. Endocrine therapy beyond five years is at the investigator's discretion. During the trial, participants will be closely monitored for invasive breast cancer-free survival over an 11-year period from randomization. Assessments include clinical evaluations, hormone receptor testing, tumor staging, and genetic recurrence scoring prior to enrollment. Safety and effectiveness data will be collected throughout the study, with particular attention to treatment side effects and long-term outcomes. The trial involves detailed eligibility screening and ongoing follow-up to ensure accurate measurement of the study's primary outcome.

Researchers are evaluating the safety and effectiveness of a combination treatment for patients with metastatic pancreatic adenocarcinoma. This Phase 2 study investigates the use of gemcitabine, nab-paclitaxel, and the TheraBionic P1 device, which delivers amplitude-modulated radiofrequency electromagnetic fields, to see if this approach can help control the disease. The treatment involves giving patients nab-paclitaxel as a 30-40 minute infusion weekly on days 1, 8, and 15 or on days 1 and 15. Following this, gemcitabine is administered over 30 minutes on the same schedule. In addition, patients use the TheraBionic P1 device, which applies low-level radio waves through an antenna placed in the mouth three times daily for one hour each time. Participants will be closely monitored throughout the study. This includes imaging scans like CT, MRI, or PET to measure tumor response, laboratory tests to check blood counts and organ function, and assessments of overall health and side effects. The main outcome measured is the progression-free survival rate at six months. Patients are followed to assess safety, treatment effects, and to understand how well they tolerate the combination therapy.

Researchers are evaluating two chemotherapy treatments, mFOLFIRINOX and mFOLFOX, with or without the immunotherapy drug nivolumab, for advanced, unresectable, or metastatic HER2 negative adenocarcinoma of the esophagus, gastroesophageal junction, and stomach. This phase III trial aims to determine whether adding irinotecan to the usual FOLFOX regimen improves overall survival and other outcomes such as progression-free survival, response rates, and treatment tolerability. The study also explores biomarkers like PD-L1 combined positive score and cell free DNA to understand treatment effects better. Participants are randomly assigned to one of two treatment groups. One group receives fluorouracil, leucovorin calcium, oxaliplatin, and irinotecan (mFOLFIRINOX) with nivolumab as needed, while the other group receives fluorouracil, leucovorin calcium, and oxaliplatin (mFOLFOX) with nivolumab as needed. All drugs are given intravenously. Throughout the trial, patients undergo MRI and CT scans and may provide blood samples for additional testing. During the study, participants are closely monitored for overall survival for up to two years after randomization. Researchers assess safety, side effects, and patient-reported outcomes to evaluate treatment tolerability. The trial also tracks progression of disease and response to therapy using imaging and other clinical evaluations. Participation includes regular imaging, blood collection, and completing questionnaires to help understand the impact of these treatments.

Researchers are evaluating surgical and minimally invasive treatments for lumbar spinal stenosis (LSS) by comparing Medicare patients who received the MILD procedure against those who had interspinous process decompression (IPD). The study focuses on outcomes such as the rate of harms related to the initial procedure and the frequency of additional surgical or minimally invasive interventions within 24 months after treatment. Enrollment includes patients treated from January 1, 2017, onward, with continuation until the sponsor decides to stop. The MILD procedure involves percutaneous image-guided lumbar decompression, performed under fluoroscopy through a dorsal approach to partially remove tissue and bone at the affected spinal level. The control group receives the IPD procedure for LSS. Both groups are monitored for a 24-month period post-index procedure using Medicare claims data to track reoperations and any harms. Participants contribute data through Medicare claims without needing prior enrollment or consent, as the study is exempt from IRB oversight. Researchers collect and analyze information on procedure-related harms and subsequent interventions over two years. This approach allows evaluation of long-term safety and effectiveness outcomes for patients treated with either MILD or IPD.