WBSI Guided Personalized Delivery of TTFields

Abramson Cancer Center at Penn Medicine

Status: Enrolling

Conditions: Glioma Glioblastoma Multiforme; Tumor, Brain; GBM

Treatments: Diagnostic Test: Whole Brain Spectroscopy Imaging Array Mapping Layout

Study type: Interventional

Funder types: Other; Industry; NIH

Identifiers

NCT05086497

848715 (Other Identifier)

1R01CA262584-01 (U.S. NIH Grant/Contract)

09321

Details and patient eligibility

About

This research study is for Glioblastoma (GBM) patients who will be beginning Optune as part of their clinical care, which is a novel treatment that utilizes - tumor treating fields (TTFields), (aka, electrical therapy), which has shown to improve overall survival in large multi-center trials. As a part of this study, participants will either receive Optune with "standard array mapping" (based on regular contrast enhanced MRI) or an "alternative (more precise) array mapping" based on sophisticated state of the art MRI techniques including "whole brain spectroscopy". Whole brain MRI spectroscopy provides additional metabolic information to map out the full extent of tumor spreading within the brain (far beyond from what is seen on regular MRI), by identifying certain metabolites that are present in cancer cells versus healthy tissue. This study is being performed to show whether alternative array mapping improves treatment outcomes, as opposed to the standard array mapping, by maximizing delivery of TTFields dose, thereby achieving more effective tumor cell killing, decreasing the rate of local recurrence, and improving the overall survival as well as quality of life measures.

Enrollment: 155 estimated patients

Sex: All

Ages: 22+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adult population ≥ 22 years
• Histologically confirmed diagnosis of GBM or molecular GBM according to c-IMPACT NOW criteria
• Have undergone maximal safe surgical resection followed by either standard full course radiation of 6000 cGy in 6 weeks or a hypofractionated course of 4000 cGy in 3 weeks
• 3 Harboring any genotype profiles (MGMT promoter methylation or unmethylation and/or isocitrate dehydrogenase (IDH) mutant or IDH wild-type)
• Possessing adequate hematological, hepatic and renal functions
• Willingness to receive TTFields

Exclusion criteria

• Presence of infra-tentorial GBM
• Pregnancy
• Significant co-morbidities at baseline which would prevent maintenance TMZ treatment
• Active implanted medical device, a skull defect (such as missing bone with no replacement) or bullet fragments. Examples of active electronic devices include deep brain stimulators, spinal cord stimulators, vagus nerve stimulators,pacemakers, defibrillators and programmable shunts. , other implanted electronic devices in the brain.
• Sensitivity to conductive hydrogels like the gel used on electrocardiogram (ECG) stickers or transcutaneous electrical nerve stimulation (TENS) electrodes.
• Presence of significant hemorrhage in and around the tumor bed that may potentially degrade the image quality.

Trial design

Primary purpose: Diagnostic

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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155 participants in 2 patient groups

Conventional Array Mapping Layout

No Intervention group

Description:

Participants in this study arm will still receive Optune array layout mapping based on standard MR imaging sequences.

Advanced MR Imaging Array Mapping Layout

Experimental group

Description:

Participants in this study arm will receive Optune array layout mapping created from advanced MR imaging sequences obtained through trial enrollment.

Treatment:

Diagnostic Test: Whole Brain Spectroscopy Imaging Array Mapping Layout