A Dose Finding Study of MiniBeam RadioTherapy for Skin and Superficial Soft Tissue Tumors (MBRT1)
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 发起方
- Mayo Clinic
- 入组人数
- 60
- 试验地点
- 2
- 主要终点
- Maximum tolerated dose
研究概览
简要总结
This clinical trial tests the safety and best dose of minibeam radiation therapy (MBRT) with a tungsten slit collimator for treating patients with skin or soft tissue tumors that have come back after a period of improvement (recurrent) or that spread from where they first started (primary site) to other places in the body (metastatic). Radiation therapy uses high energy x-rays, particles, or radioactive seeds to kill tumor cells and shrink tumors. Tungsten is an extremely dense metal and is commonly used for blocking x-rays for minimum radiation exposure. A tungsten slit collimator is a device that separates an initially wide beam of x-rays into several very narrow individual beams of radiation. As radiation passes through the collimator, the radiation hits regions of solid tungsten and is blocked. In the open slit regions, radiation passes through to the intended target/tumor area defined by the physician. The tungsten slit collimator then selectively blocks portions of the radiation to create an alternating pattern of higher "peak" and lower "valley" radiation dose regions. These narrow beams of radiation are referred to as "minibeams" and the general approach referred to as MBRT.
详细描述
PRIMARY OBJECTIVE:
I. To determine the maximum tolerated dose (MTD) of MBRT and describe the adverse events of treatment.
SECONDARY OBJECTIVE:
I. To assess the ability to maintain a distinct differential between peak and valley doses using film dosimetry.
EXPLORATORY OBJECTIVES:
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age ≥ 18 years
- •Histologically confirmed malignancy
- •Primary, recurrent, or metastatic skin or superficial soft tissue tumor amenable to palliative orthovoltage radiotherapy
- •Anticipated life expectancy ≥ 30 days and anticipated capacity for follow up for ≥ 30 days
- •Negative pregnancy test done ≤ 28 days prior to registration, for biological women of childbearing potential only
- •Willing to provide written informed consent
- •Willing to allow baseline and follow up photograph acquisition for response and toxicity assessment
- •Willing and able to return to enrolling institution for follow-up during the active monitoring phase of the study
- •Willing to provide blood and tissue samples for correlative research purposes (this does not apply to the optional Riskguard or OncoExtra samples)
排除标准
- •Hematologic, germ cell, or any other tumor that the investigational team would deem to have a high likelihood of clinical complete response with standard palliative radiotherapy (8 Gy in 1, 30 Gy in 10, etc.)
- •COHORT A (INTACT SKIN) ONLY: Prior radiotherapy targeting the lesion presenting for treatment or prior adjacent radiotherapy if > 10 Gy overlaps with a portion of the planned target
- •Treatment with a B-Raf proto-oncogene, serine/threonine kinase (BRAF) inhibitor, monoclonal antibodies targeting vascular endothelial growth factor (VEGF) (bevacizumab or ramucirumab) or small molecule inhibitors inhibiting VEGF within the last 2 weeks or planned treatment with BRAF inhibitor within 4 weeks after radiation
- •Treatment with an investigational drug therapy within 2 weeks prior to or 4 weeks (the DLT monitoring period) after MBRT
- •Any tumor with direct extension into the spine such that targeting the spine/spinal cord could not be avoided
研究组 & 干预措施
Device feasibility (MBRT with tungsten slit collimator)
Patients undergo MBRT with a tungsten slit collimator over 2-3 fractions on study. Patients also undergo standard of care CT simulation on study and undergo collection of blood samples and punch or core biopsy throughout the study.
干预措施: Minibeam Radiation Therapy (Radiation)
Device feasibility (MBRT with tungsten slit collimator)
Patients undergo MBRT with a tungsten slit collimator over 2-3 fractions on study. Patients also undergo standard of care CT simulation on study and undergo collection of blood samples and punch or core biopsy throughout the study.
干预措施: Biopsy Procedure (Procedure)
Device feasibility (MBRT with tungsten slit collimator)
Patients undergo MBRT with a tungsten slit collimator over 2-3 fractions on study. Patients also undergo standard of care CT simulation on study and undergo collection of blood samples and punch or core biopsy throughout the study.
干预措施: Biospecimen Collection (Procedure)
Device feasibility (MBRT with tungsten slit collimator)
Patients undergo MBRT with a tungsten slit collimator over 2-3 fractions on study. Patients also undergo standard of care CT simulation on study and undergo collection of blood samples and punch or core biopsy throughout the study.
干预措施: Computed Tomography (Procedure)
Device feasibility (MBRT with tungsten slit collimator)
Patients undergo MBRT with a tungsten slit collimator over 2-3 fractions on study. Patients also undergo standard of care CT simulation on study and undergo collection of blood samples and punch or core biopsy throughout the study.
干预措施: Medical Device Usage and Evaluation (Other)
结局指标
主要结局
Maximum tolerated dose
时间窗: Up to 28 days
The maximum tolerated dose is defined as the dose level associated with a dose limiting toxicity (DLT) probability closest to the target toxicity rate (30%), which will be determined based on the time-to-event Bayesian optimal interval procedures. The incidence and proportion of patients experiencing DLTs will be summarized for each dose level and across all dose levels.
Maximum tolerated dose
时间窗: Up to 28 days
The maximum tolerated dose is defined as the dose level associated with a dose limiting toxicity (DLT) probability closest to the target toxicity rate (30%), which will be determined based on the time-to-event Bayesian optimal interval procedures. The incidence and proportion of patients experiencing DLTs will be summarized for each dose level and across all dose levels.
Incidence of adverse events
时间窗: Up to 12 months
Safety will be assessed based on reported adverse events (AEs). The severity of AEs will be graded as mild, moderate, severe, or life-threatening according to Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.
次要结局
- Ability to maintain a distinct differential between peak and valley doses using film dosimetry(Up to 12 months)
- Incidence of adverse events(At months 6, 9, and 12)
