MedPath

Integrated Analysis of Therapy Response and Resistence in Embryonal Tumors and Gliomas

Not yet recruiting
Conditions
Embryonal Tumor
Glioma, Malignant
Medulloblastoma
Ependymoma
Interventions
Diagnostic Test: Tissue, blood, cerebrospinal-spinal fluid
Registration Number
NCT06323408
Lead Sponsor
University Hospital Regensburg
Brief Summary

The treatment of adolescents and young adults (AYA, 15 to 39 years) with malignant intra-axial CNS parenchymal tumors such as IDH-mutated gliomas, medulloblastomas and ependymomas is still not curative in all cases. The tumor biology and clinical needs to diagnose and treat these tumors are comparable across all age groups, so an integrated treatment environment overseen by adult and pediatric neuro-oncology specialists seems promising to leverage synergisms and advance diagnostic and therapeutic development in these tumors. A comprehensive, prospective and integrated biomaterial and imaging-based pipeline for the multi-faceted evaluation of AYAs has not yet been established for AYA patients with brain tumors in Germany. Current diagnostic platforms neglect the integrative processing of data from MRI and FET-PET imaging, radiotherapy plans, tumor tissue, liquid biopsies and clinical data as well as prognostic markers. A prospective AYA pipeline can therefore enable a better understanding of the aforementioned high-risk CNS malignancies and promises clinical advances for AYA patients and the clinical and scientific research landscape.

Detailed Description

Objectives: We are conducting a non-interventional study for AYAs with malignant intraaxial CNS parenchymal tumors. All 6 Bavarian BZKF sites are involved in the study. We will collect data on diagnostic and prognostic MRI and FET-PET imaging, quality assurance in radiotherapy and radiotherapy treatment patterns, diagnostic and predictive liquid biopsies from CSF and blood and targeted therapy approaches and integrate them bioinformatically with clinical data.

Work packages: WP01 Prediction of diagnosis by artificial intelligence (AI)-assisted processing of MRI and FET-PET; WP02 Analysis of response and relapse patterns by AI-assisted processing of MRI and FET-PET; WP03 Quality control of radiotherapy planning and patterns-of-care analysis; WP04 Prediction of response, relapse and treatment density using markers identified in liquid biopsies from CSF and blood; WP05 Identification of targets for targeted therapy from paraffin-embedded tissue (FFPE), CSF and blood; WP06 Investigation of clinical patterns and progression (PFS) or WP07 Bioinformatic integration of data to predict PFS, OS and patterns of response, relapse, treatment density and potential molecular targets.

Inclusion criteria: (1) first diagnosis of high-risk CNS tumors including IDHmutated gliomas, medulloblastomas, ependymomas, and other intra-axial primary brain tumors; (2) adolescents and young adults (AYA; 15 to 39 years); (3) Karnofsky status of 60 or higher; (4) multimodality therapy planned at the discretion of the medical professional; (5) expected survival min. 6 months; (6) informed consent by patient and (for patients under 18 years) legal representative; (7) complete material collection expected.

Exclusion criteria: (1) synchronous independent tumor disease, except basal cell carcinoma and carcinoma in situ; (2) participation in interventional clinical trial, except in standard arms of interventional clinical trials.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
72
Inclusion Criteria
  1. first diagnosis of high-risk CNS tumors including glioma IDHmutated, medulloblastoma, ependymoma and other intra-axial primary brain tumors
  2. adolescents and young adults (AYA; 15 to 39 years)
  3. Karnofsky status of 60 or higher
  4. resection, extended biopsy or stereotactic biopsy with sufficient tissue volume
  5. multimodal therapy planned at the discretion of the treating specialist
  6. expected survival time of at least 6 months
  7. informed consent from the patient or the patient's legal guardian prior to the first study procedure
  8. complete material collection expected.
Exclusion Criteria
  1. synchronous independent tumor disease other than basal cell carcinoma and carcinoma in situ
  2. participation in interventional clinical trial except in standard arms of interventional clinical trials.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Glioma, IDH-mutatedTissue, blood, cerebrospinal-spinal fluidIDH-mutated gliomas, including WHO grades 2, 3 and 4
EmbryonalTissue, blood, cerebrospinal-spinal fluidEmbryonal tumors, including medulloblastoma and ATRT
Primary Outcome Measures
NameTimeMethod
Analysis of response in liquid biopsiesMarch 2026

Prediction of response using markers detected in liquid biopsies from cerebrospinal fluid and blood

AI processing of MRI fand PET or diagnosisMarch 2026

Prediction of diagnosis by artificial intelligence (AI)-assisted processing of magnetic resonance imaging (MRI) and Fluorethyltyrosin-Positron Emission Tomography (FET-PET)

Target molecules in tissue and liquid biopsiesMarch 2026

Identification of target molecules for targeted therapy from paraffin-embedded tissue (FFPE), cerebrospinal fluid and blood

AI processing of MRI and PET for evaluation of response and relapseMarch 2026

Analysis of response and relapse patterns by artificial intelligence (AI)-assisted processing of magnetic resonance imaging (MRI) and Fluorethyltyrosin-Positron Emission Tomography (FET-PET)

Evaluation of progression free survivalMarch 2026

Investigation of clinical patterns of response in view of progression free survival (PFS)

Quality control analysis in radiotherapyMarch 2026

Quality control of radiotherapy planning and patterns-of-care analysis

Secondary Outcome Measures
NameTimeMethod
© Copyright 2025. All Rights Reserved by MedPath