Intravital Microscopy (IVM) in Human Solid Tumors
Overview
- Phase
- Not Applicable
- Intervention
- Diagnostic Microscopy
- Conditions
- Not specified
- Sponsor
- Mayo Clinic
- Enrollment
- 85
- Locations
- 1
- Primary Endpoint
- 1. Tumor vessel identification (# tumor vessels visualized per high power field)
- Status
- Recruiting
- Last Updated
- 4 months ago
Overview
Brief Summary
This study will investigate the tumor-associated vasculature of patients with solid tumors. The investigators will use a technology known as intravital microscopy (IVM) in order to visualize in real-time the vessels associated with solid tumors. The IVM observations may determine if an individual patient's tumor vessels would be amenable to receiving systemic therapy, based on the functionality of the vessels.
Detailed Description
PRIMARY OBJECTIVE: I. To determine the feasibility of performing human intravital microscopy (HIVM) in patients with deep space solid tumors during standard course of surgical resection. SECONDARY OBJECTIVES: I. Compare the microscopic observation of the tumor-associated vessels with normal tissue (e.g. peritoneal surface or normal brain tissue) in each individual subject. II. Correlate the microscopic observations of the tumor-associated vessels with pathologic grade of tumor. III. To correlate the microscopic observation of the microvasculature with tumor-specific and overall survival. OUTLINE: Patients receive fluorescein intravenously (IV) and undergo HIVM over 1-2 minutes per field. After completion of study, patients are followed up at 2-3 weeks after surgery.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Age ≥ 18 years of age
- •Eastern Cooperative Oncology Group (ECOG)Performance Status of ≤ 2
- •Measurable tumor by direct visualization requiring surgical resection in the operating room (OR)
- •Tumor types of origin include gastric, pancreatic, hepatobiliary, colorectal, sarcoma, brain, or breast cancer that may involve the axillary lymph nodes cancers. Tumors may be primary or metastatic
- •Subject must understand the investigational nature of this study and sign an Independent Ethics Committee/Institutional Review Board approved written informed consent
- •Subject must have a skin prick test pre-operatively (at the time of the preoperative visit and after signed informed consent for entry into this clinical trial is given) to determine any sensitivity to fluorescein
Exclusion Criteria
- •Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations
- •Renal dysfunction as defined as a glomerular filtration rate (GFR) \< 45
- •Liver dysfunction as defined by Child-Pugh score \> 5, or liver function test (LFT)'s 1.5 x above normal range
- •Any known allergy or prior reaction to fluorescein or a positive skin prick test to fluorescein
- •Pregnant or nursing female subjects, determined preoperatively with a urine pregnancy test
- •Unwilling or unable to follow protocol requirements
- •Any condition which in the investigators' opinion deems the patient unsuitable (e.g., abnormal electrocardiography \[EKG\], including T wave inversion, elevated T waves, prolonged QRS interval, or conduction blocks) or that requires further work-up (including cardiac echo or stress test)
- •Any condition that excludes surgical resection as the standard of care for the patient
Arms & Interventions
Arm 1
Determine the feasibility and clinical utility of performing Human Intravital Microscopy (HIVM) in patients with solid tumors during surgical resection.
Intervention: Diagnostic Microscopy
Arm 1
Determine the feasibility and clinical utility of performing Human Intravital Microscopy (HIVM) in patients with solid tumors during surgical resection.
Intervention: Fluorescein Sodium Injection
Outcomes
Primary Outcomes
1. Tumor vessel identification (# tumor vessels visualized per high power field)
Time Frame: 12-15 minutes
Identify and measure vessels associated with solid tumors
2. Tumor vessel density (# tumor vessels per square cm area observed)
Time Frame: 12-15 minutes
Determine vessel density per 10x field
3. Fluorescent dye uptake (# tumor vessels with fluorescent dye uptake and # tumor vessels without dye uptake)
Time Frame: 12-15 minutes
Visualize vital dye within the vessels (fluorescein)
4. Tumor blood flow (velocity, mm/sec)
Time Frame: 12-15 minutes
Calculate the blood flow velocity of the vessels and tissue penetration of fluorescent dye as a marker of vessel permeability.
Secondary Outcomes
- 5. Post-operative comparison of the microvasculature of tumor with normal tissue(15-20 minutes)
- 6. Post-operative correlation of the microvasculature with pathologic features of the tumor implants (i.e. tumor grade) at the time of the final pathology report (5-7 days after surgery).(5-7 days)
- Post-operative correlation of the microscopic observation of the tumor microvasculature tumor-specific and overall survival.(5 years)