Surveillance for Malignant Transformation of Neurofibromatosis Type 1 (NF1) Related Peripheral Nerve Sheath Tumors (PNST)
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 225
- 试验地点
- 1
- 主要终点
- Assess feasibility of the study algorithm in identifying atypical neurofibromas (ANs), atypical neurofibromatous neoplasms of unknown biologic potential (ANNUBPs), CDKN2A/B mutated lesions, and/or malignant peripheral nervous sheath tumors (MPNS...
研究概览
简要总结
Background:
Neurofibromatosis type 1 (NF1) is a genetic disease that can cause many symptoms. About half of people with NF1 will develop benign (noncancerous) tumors along nerves in the skin, brain, and other parts of the body. Sometimes, though, these tumors can become cancerous. Researchers do not yet know how to predict which tumors will become cancerous.
Objective:
To test a new method for predicting which benign NF1 tumors will become cancerous.
Eligibility:
People aged 3 years and older with a clinical or genetic diagnosis of NF1.
Design:
- Participants will be screened with a review of their medical history. All participants will have a baseline visit. They will have bood tests and imaging scans. They will have a physical exam. They will answer questions about their family history. Participants aged 8 years and older will take tests of their thinking skills and their emotional health.
- Some participants may be asked to undergo more tests. These may include another type of imaging scan and a biopsy: A small sample of tissue may be removed from the tumor.
- Participants will be divided into two groups: those believed to be at low risk and those believed to be at high risk of developing cancer.
- Participants in the high-risk group will be asked to return for their next visit in 1 month to 3 years.
- Participants in the low-risk group will be asked to return for their next visit in 6 months to 5 years.
- Participants may also have follow-up visits by phone throughout the study. They will be in the study for 10 years.
详细描述
Background
- Patients with NF1 are at risk for the development of both benign and malignant peripheral nerve sheath tumors (MPNST). Some factors that increase risk for malignant tumors are known, such as large benign plexiform neurofibroma (PN) tumor burden, germline NF1 microdeletion, and history of radiation therapy. However, there is not currently a consensus in the field about the most appropriate clinical surveillance or management strategy for these patients at increased risk of malignancy.
- In the past decade, data from the existing NCI POB NF1 Natural History study (08-C-0079, NCT00924196) and others have identified atypical neurofibromas (AN) and atypical neurofibromatous neoplasms of uncertainly biologic potential (ANNUBP) as premalignant lesions characterized by heterozygous loss of CDKN2A/B in addition to the homozygous loss of NF1 found in all PN.
- On Magnetic Resonance Imaging (MRI), distinct nodular lesions (DNL) have been identified as having unique characteristics, including increased fluorodeoxyglucose (FDG)-positron emission tomography (PET) avidity and growth rate compared to surrounding PN, and are often, though not always, found to be AN on histologic evaluation.
Objective
- To assess the feasibility of the study algorithm in identifying ANs, ANNUBPs, CDKN2A/B mutated lesions, and/or MPNST
Eligibility
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 3 Years 至 120 Years（Child, Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •INCLUSION CRITERIA:
- •High-Risk and Low-Risk NF1 Cohorts
- •Age >= 3 years old
- •Participants with clinical or genetic diagnosis of NF
- •Participants with a diagnosis of mosaic or segmental NF1 are also eligible.
- •Individuals may have (High-Risk Cohort) or not have (Low-Risk Cohort) at least one of the following characteristics:
- •Microdeletion or 844-848 missense variants or other variants associated with increased risk of malignant peripheral nervous sheath tumor (MPNST)
- •Family history of MPNST / atypical neurofibromatous neoplasm of unknown biologic potential (ANNUBP) / atypical neurofibromas (ANF)
- •Personal history of MPNST/ANNUBP/ANF or neurofibroma with CDKN2A/B loss
- •Prior radiation therapy at any site
- •Large plexiform neurofibroma (PN) burden (>= 350 mL)
- •Presence >= 1 DNL at baseline
- •The ability of the individual, parent/guardian or Legally Authorized Representative (LAR) to understand and the willingness to sign a written consent document for participation.
排除标准
- •High-Risk and Low-Risk NF1 Cohorts
- •- Inability or unwillingness to undergo MRI imaging
- •INCLUSION CRITERIA:
- •Parent Cohort
- •Parent or guardian of pediatric individuals (8-17 years old) in High-Risk or Low-Risk Cohorts.
- •The ability of the parent/guardian or LAR to understand and the willingness to sign a written consent document for parent/guardian participation in this study.
- •EXCLUSION CRITERIA:
- •Parent Cohort
研究组 & 干预措施
1 - High-Risk
Participants with clinical or genetic diagnosis of NF1 AND at least one of the eligibility-required high-risk characteristics
3 - Caregiver
Parents or guardians of participants 8-17 years old in High-Risk or Low-Risk Cohorts
2 - Low-Risk
Participants with clinical or genetic diagnosis of NF1 AND none of the eligibility-required high-risk characteristic
结局指标
主要结局
Assess feasibility of the study algorithm in identifying atypical neurofibromas (ANs), atypical neurofibromatous neoplasms of unknown biologic potential (ANNUBPs), CDKN2A/B mutated lesions, and/or malignant peripheral nervous sheath tumors (MPNS...
时间窗: Throughout the study
Proportion of lesions that undergo surgical intervention (biopsy or resection) that are ANs, ANNUBPs, CDKN2A/B mutated lesions and/or MPNST
次要结局
- Assess whether the proposed surveillance and management approach for participants with NF1 at high risk and low risk of MPNST is feasible(Throughout the study)