Neoplasms

All Conditions

Ear, Nose, and Throat Diseases

Nervous System Diseases

Diseases and Abnormalities at or Before Birth

Symptoms and General Pathology

Skin and Connective Tissue Diseases

Rare Diseases

Neurilemmoma

Vestibular Diseases

Neurofibromatoses

Neurofibromatosis 1

Neurofibroma

Neuroma, Acoustic

Neurofibromatosis 2

Nerve Sheath Neoplasms

Neoplasms, Nerve Tissue

Neoplasms by Histologic Type

Syndrome

Neoplastic Syndromes, Hereditary

Neurocutaneous Syndromes

Heredodegenerative Disorders, Nervous System

Neurodegenerative Diseases

Genetic Diseases, Inborn

Peripheral Nervous System Diseases

Neuromuscular Diseases

Nervous System Neoplasms

Peripheral Nervous System Neoplasms

Labyrinth Diseases

Labyrinthitis

Ear Diseases

Otorhinolaryngologic Diseases

Neuroma

Neuroendocrine Tumors

Neuroectodermal Tumors

Neuroectodermal Tumors, Primitive

Neoplasms, Germ Cell and Embryonal

Vestibulocochlear Nerve Diseases

Retrocochlear Diseases

Otorhinolaryngologic Neoplasms

Cranial Nerve Diseases

Schwannoma

Neurofibromatosis

Neurofibromatosis Type 1

Acoustic Neuroma

Neurofibromatosis Type 2

Neuroendocrine Tumor

Neuroepithelioma

John D Heiss, M.D.

Background:

* Neurofibromatosis type II (NF2) is associated with tumors of the nerves, brain, and spinal cord. Most people with NF2 develop vestibular schwannomas, or tumors on the hearing and balance nerves. As they grow, vestibular schwannomas can cause hearing loss and balance problems. If they grow very large they can cause more serious problems, such as seizures, loss of eyesight, weakness, speech problems, and problems with the sense of touch. More research is needed into NF2 because researchers do not completely understand why these tumors occur or what makes them grow over time.
* Currently, tumor size is measured with magnetic resonance imaging (MRI) scans. However, MRI scans cannot predict how fast a tumor will grow. By using positron emission tomography (PET) scanning, researchers hope to be able to predict sudden growth spurts of tumors associated with NF2 and develop better treatment methods for this type of cancer.

Objectives:

- To use magnetic resonance imaging and positron emission tomography to better understand the growth of brain tumors in people with neurofibromatosis type II.

Eligibility:

- Individuals between 18 and 50 years of age who have been diagnosed with NF2 and have at least three untreated intracranial tumors.

Design:

* This study requires an initial set of outpatient visits to the NIH Clinical Center that will last 7 to 10 days.
* Participants will have a physical and neurological examination and blood tests at the first visit. Participants will then have the following imaging studies to examine the tumors:
* MRI scans of the brain
* PET scans of the brain, combined with a computed tomography (CT) scan. The PET scans will be performed on separate days. Different contrast agents will be used for both scans, so researchers will inform participants if they need to fast or follow other procedures before having the scan.
* After the initial imaging studies, participants will have additional MRI scans every 6 months for 2 years to track tumor growth.

OBJECTIVE:

The objective of this prospective observational study of intracranial tumors in patients with neurofibromatosis type 2 (NF2) is to gain insight into the use of 18F-fluoro-deoxyglucose (FDG) and 3 -deoxy-3 -18F-fluorothymidine (FLT) positron emission tomography (PET)/computed tomography (CT) as a predictive measure of future tumor growth patterns.

STUDY POPULATION: \<TAB\>

Twelve patients, ages 18-50, with a clinical or genetic diagnosis of NF2 and harboring at least 3 unoperated intracranial tumors (meningiomas and/or vestibular schwannomas) will participate in this study.

DESIGN:

Study participants will be evaluated with a thorough physical and neurologic examination upon enrollment. This initial outpatient evaluation will include contrast-enhanced magnetic resonance imaging (MRI) of the brain, FDG-PET/CT and FLT-PET/CT scans.

Subjects will be followed as outpatients for two years, during which time MRI evaluation will be performed every six months.

OUTCOME MEASURES:

Based on data derived from this study, we hope to correlate FDG-PET/CT and FLT-PET/CT scans with metabolic activity and cellular proliferation within tumors. These findings will help us better forecast tumor growth and senescence. These findings should permit the safer treatment of the subset of tumors that will grow and cause symptoms and avoid the unnecessary treatment of lesions that will remain stable (not requiring treatment) in these patients.

Using Positron Emission Tomography to Predict Intracranial Tumor Growth in Neurofibromatosis Type II Patients

Using Positron Emission Tomography (PET) to Predict Intracranial Tumor Growth in Neurofibromatosis Type II (NF2) Patients

National Institute of Neurological Disorders and Stroke (NINDS)

Meningioma

Neoplasms, Vascular Tissue

Meningeal Neoplasms

Central Nervous System Neoplasms

All Drugs and Chemicals

Histone Deacetylase Inhibitors

AR-42 will be administered three times per week beginning 3 weeks prior to surgery.

AR-42 will be administered in a total of ten oral doses, +/- 1 dose, at 40 mg/dose, will be self-administered by study participants at approximately 8:00pm (+/- 1 hour) for 3 weeks pre-operatively, with the last dose being administered the night before surgery. The treating surgeon will perform the clinically indicated surgical procedure 3 weeks post-initial dose of medication as well as the specimen collection.

AR-42

Brad Welling, MD, PhD

This will be a multi-center, proof of concept phase 0 study to assess the suppression of p-AKT in Vestibular Schwannoma (VS) and meningiomas by AR-42 in adult patients undergoing tumor resection. AR-42 is a small molecule which crosses the blood brain barrier (BBB) in rodents, but the investigators are not certain yet if it will penetrate human VS. Meningiomas are outside the BBB, but seem to be unusually resistant to all current medical treatments. The primary endpoint of the bioactivity of suppression of p-AKT by AR-42 was selected as drug activity seems more informative than bioavailability. Our preclinical data and others have shown dose dependent suppression of p-AKT by AR-42 in both VS and meningiomas.

This is a multi-center, proof of concept phase 0 study to assess the suppression of p-AKT in VS and meningiomas by AR-42 in adult patients undergoing NF2-tumor resection. AR-42 will be administered three times per week beginning 3 weeks prior to surgery. A total of ten doses, +/- 1 dose at 40 mg/dose, will be self-administered orally by study participants at approximately the same time every day (+/- 1 hour, preferably in the evening) 3 times per week for 3 weeks pre-operatively, with the last dose taken the night before surgery. Patients will be evaluated within the context of their standard post-operative follow up which includes within 2 days of surgery and again at 2 weeks (+/- 10 days) after surgery. Samples will be shipped to the participating laboratories (OSU Comprehensive Cancer Center (CCC) Pharmacoanalytical Shared Resource (PhASR) and Nationwide Children's Research Institute) for assessment of intratumoral drug concentration and assessment of intratumoral disease markers. During surgery, four blood samples will also be obtained and sent to the cooperating laboratory (PhASR) for determination of drug concentration and molecular analysis.

Exploratory Evaluation of AR-42 Histone Deacetylase Inhibitor in the Treatment of Vestibular Schwannoma and Meningioma

We report the average total number of doses of AR-42 taken per participant during this study.

The phospho-AKT/AKT ratio was used to estimate the activity of AKT, a kinase, at the core of resected tumors. Quantitation of the normalized p-AKT/AKT ratio is depicted as a percentage relative to the untreated VS2 set as 100%. For example, a value under 100% indicates a lower level of AKT activity relative to untreated VS2 tumors. Phosphorylated AKT, or phospho-AKT, is the activated form of AKT. These measurements were derived from the core of the resected tumors.

The phospho-AKT/AKT ratio was used to estimate the activity of AKT, a kinase, at the core of resected tumors. Quantitation of the normalized p-AKT/AKT ratio is depicted as a percentage relative to the untreated VS2 set as 100%. For example, a value under 100% indicates a lower level of AKT activity relative to untreated patients. Phosphorylated AKT, or phospho-AKT, is the activated form of AKT. These measurements were derived from the periphery of the resected tumors.

Steady-state plasma concentrations of AR-42 at the time of tumor resection are provided.

Concentrations of AR-42 at the tumor capsule are provided.

Intra-tumor concentrations of AR-42 at the tumor center are reported.

Capsule/plasma intra-tumor AR-42 concentrations are provided as a ratio.

Center/plasma intra-tumoral AR-42 concentrations are provided as a ratio.

Johns Hopkins University

Mayo Clinic

Stanford University

Ohio State University

Nationwide Children's Hospital

Massachusetts Eye and Ear Infirmary

Chief Otolaryngology Massachusetts Eye and Ear

Adverse events were graded according to Common Terminology Criteria for Adverse Events (CTCAE) and were also recorded according to severity, expectedness, and relatedness to the investigational treatment. Participants were encouraged throughout the study to spontaneously report all adverse events promptly to their physician-investigator.

AR-42 was administered three times per week beginning 3 weeks prior to surgery. AR-42 was administered in a total of ten oral doses, +/- 1 dose, at 40 mg/dose, and was self-administered by study participants at approximately 8:00pm (+/- 1 hour) for 3 weeks pre-operatively, with the last dose being administered the night before surgery. A study investigator performed the clinically indicated surgical procedure 3 weeks post-initial dose of medication as well as the specimen collection.

AR-42 Administration

Age, Categorical

Age, Continuous

Sex: Female, Male

Ethnicity (NIH/OMB)

Race (NIH/OMB)

United States

Region of Enrollment

Two participants were withdrawn from the study prior to baseline weight measurement.

Weight

Prior tumor biopsy or debulking

Sporadic vestibular schwannoma

Sporadic meningioma

Relevant diagnosis

ECOG = 0

ECOG not assessed at baseline

The ECOG Scale of Performance Status grades a patient's level of functioning in terms of their ability to care for themselves and other activities of daily living. Grading is done from 0 (zero) to 5 (five). An ECOG grade of 0 (zero) is defined as "fully active, able to carry on all pre-disease performance without restriction." An ECOG grade of 4 (four) is defined as "completely disabled; cannot carry on any selfcare; totally confined to bed or chair." An ECOG grade of 5 (five) is defined as death.

ECOG Grade

Plasma concentrations of AR-42 at baseline (before tumor resection) are reported individually for each of the 5 participants.

Baseline plasma concentration of AR-42

Two participants were withdrawn from the study prior to the administration of the study drug: one was deemed ineligible, and one chose not to participate.

The supplier of AR-42 was unable to continue to supply drugs after 2017. We elected to present the data on five of the originally planned 20 patients. Accrual was also limited by patient willingness to accept potential additional peri-operative risk without a reasonable likelihood of benefit from only 3 weeks of therapy with AR-42. Other limitations include possible selection bias, lack of control subjects, and the inability to perform meaningful statistical analysis.

Matthew E Stenerson, MSc, Clinical Research Project Manager

There was no randomization in this trial and all participants completed study procedures uniformly. AR-42 was administered three times per week beginning 3 weeks prior to surgery. AR-42 was administered in a total of ten oral doses, +/- 1 dose, at 40 mg/dose, which was self-administered by study participants at approximately 8:00pm (+/- 1 hour) for 3 weeks pre-operatively, with the last dose being administered the night before surgery. All participants were instructed to take the study medication at least 1 hour before, or 2 hours after, a meal. The principal investigator performed the clinically indicated surgical procedure 3 weeks post-initial dose of medication as well as the specimen collection.

Ratio of Phospho-AKT (p-AKT) to AKT After 3 Weeks of Oral AR-42

Peripheral Phospho-AKT (p-AKT) to AKT Ratio After 3 Weeks of Oral AR-42

AR-42 Plasma Concentration

AR-42 Tumor Concentration (Capsule)

AR-42 Tumor Concentration (Center)

AR-42 Tumor Concentration (Capsule/Plasma)

AR-42 Tumor Concentration (Center/Plasma)

Number of Doses of AR-42 Received

Overall Study

Schwannomatosis

Patients meeting clinical and/or genetic criteria for Neurofibromatosis 1

Patients meeting clinical and/or genetic criteria for Neurofibromatosis 2

Patients meeting clinical and/or genetic criteria for Schwannomatosis

Kate Kelts, B.S.N.

Annette Bakker, Ph.D.

The NF Registry is a database of patient-reported symptoms, treatments, and experiences with their neurofibromatosis disease. It is a contact registry to relay clinical trial opportunities to targeted patient subgroups, and to supply de-identified disease data to researchers. It has the potential to become a natural history resource.

Patients and parents of patients will be made aware of the Neurofibromatosis (NF) Registry through various non-commercial information sources such as the Children's Tumor Foundation (CTF) website, CTF-affiliated NF clinics, social media, CTF educational and fundraising events, and other nonprofit organizations and foundations such as the National Organization for Rare Diseases (NORD) and social media.

The NF Registry will be accessed by individual adult (over age 18) subjects via a web-based patient portal. The portal contains an IRB-approved informed consent form. Following consent, the registrant creates an account which is activated after email confirmation. An account can be created by an adult patient with the disorder, or by the parent or guardian of a child with the disorder. Account creators are required to enter identifiable contact and demographic data.

After the account is created, the account owner enrolls themselves or a minor family member (or both) and completes an on-line survey. There are separate surveys for NF1, NF2, and Schwannomatosis. The surveys ask about about the affected individual's medical and family history of the disease, testing and diagnosis, clinical manifestations (e.g., tumor types and locations) interventions and therapies, and quality of life. The account holder chooses whether to receive emails from the Registry with information about relevant clinical trials and studies for which they may be eligible.

Participant's responses are used to compile charts and graphics of de-identified aggregate data. Registered patients may view this data. Researchers may apply to our Data Use Committee for access to de-identified data or for subject recruitment emails to be sent to specific patient subgroups. Data capture and security for the NF Registry is done under contract by OpenApp (Dublin, Ireland), a web-based patient opt-in registry provider.Participants will be asked to update their information at least once a year. Their information will be stored in the NF Registry for an indefinite period of time. This longitudinal study is intended as a resource for patients and researchers. There is no specific outcome measure or anticipated endpoint.

Neurofibromatosis (NF) Registry Portal

Neurofibromatosis (NF) Registry Portal Funded by Children's Tumor Foundation

patients will input medical information and treatment information about their NF and update at least yearly in an ongoing natural history study

The Children's Tumor Foundation

Antineoplastic Agents

Amino Acids

Lapatinib

Tyrosine Kinase Inhibitors

Protein Kinase Inhibitors

Enzyme Inhibitors

Tyrosine

Subjects will receive lapatinib for 10 days prior to surgery for vestibular schwannoma resection.

Control subjects will not receive any intervention prior to surgery for vestibular schwannoma resection.

1500 mg lapatinib by mouth per day for 10 days

lapatinib

Jaishri O Blakeley, MD

Tumors can grow on the auditory nerves and can cause hearing loss. A common type of tumor that does this is a vestibular schwannoma (VS), or acoustic neuroma. These tumors are not cancerous. Most often, people have only one VS. Occasionally, people have more than one VS and may have a condition called neurofibromatosis type 2 (NF2).

Because VS can cause hearing loss, many people with VS will have treatment to preserve their hearing. This treatment usually involves surgery or radiation therapy. There are risks to these procedures, and sometimes they do not work to prevent hearing loss. Because surgery and radiation have risks and are not able to help everyone with VS, other methods of treatment are being explored. One area of exploration is looking to see if there is a drug that can be taken that might prevent the VS from growing larger and causing hearing loss, and might possibly even cause the VS to shrink in size.

This study is exploring whether a drug that is approved by the FDA and is currently used to treat breast cancer might also work to treat VS. This study will measure the amount of drug that travels from the bloodstream and arrives at the tumor. This drug is safe and has few side effects. If this drug is shown to reach the tumor, it might be used in the future to treat VS without needing surgery or radiation.

This study is recruiting people who are having surgery for VS. If you are going to have surgery to treat a VS, you may be eligible to participate.

Neurofibromatosis type 2 (NF2) is a rare autosomal dominant genetic disorder with an incidence of approximately 1/40,000. The most common tumor type in NF2 is vestibular schwannoma and the majority of NF2 patients develop progressive hearing loss in adolescence or young adulthood due to bilateral vestibular schwannoma (VS). In addition to hearing loss, VS can cause significant morbidity, and in some cases mortality, due to brain stem compression.

Currently, the only accepted modality for treatment of VS in patients with NF2 is surgical resection. Although surgical resection is effective at tumor reduction, it is often associated with morbid complications such as hearing loss, facial palsy, CSF leaks, chronic headache and infection. In addition, the tumors often recur after surgery. Radiation therapy (RT) has been proposed as an alternative, however, its safety in the NF2 population has not been established and there is concern about long term efficacy. For a distinct population of NF2 patients, surgery and RT at not feasible and no additional therapy is currently available. Hence, a systemic therapy is needed.

Sporadic VS are common with roughly 3,000 new cases per year in the United States and a growing incidence in recent years. These tumors cause unilateral hearing loss, tinnitus, and vertigo. The primary treatment modality for these tumors is surgical resection or radiosurgery. Surgery is associated with the same complications listed above for NF2-related VS. Hence, RT is often offered in place of surgery. Although considered safe in sporadic VS, it may not have good long term efficacy and may complicate future procedures. Again, a systemic therapy that could control tumor progression obviating the need for an invasive procedure is needed.

As the understanding of tumor molecular biology continues to advance, there are an increasing number of attractive targets for VS growth inhibition. EGFR and ErbB2 have been identified as important targets for VS. In a study of 21 sporadic and 17 NF2-related VS samples, both EGFR and ErbB2 were found to be upregulated in the majority of tumors. In addition, an anti-ErbB2 monoclonal antibody reduced schwannoma cell proliferation in vitro. Collectively, this data suggests that abnormal signaling via EGFR and ErbB2 is a major contributor to tumor growth and progression in both sporadic and NF2-related VS, and that inhibition of this signaling pathway can result in decreased tumor growth. Although agents targeting these pathways are commercially available, there is little pre-clinical data to assist in prioritizing which agents to advance to clinical trials. Given the relative rarity of the disorder and the enormous patient, financial and time commitments an efficacy study requires, there is a need to carefully select agents for testing that have the best chance of success.

In this trial, we propose to assess the delivery of lapatinib, a commercially available inhibitor of ErbB2 and EGFR, to VS via tissue sampling at the time of clinically indicated surgery. Demonstrating that lapatinib reaches meaningful intratumoral concentrations is important data to recommend this drug above other small molecule inhibitors for efficacy trials for VS. The primary objective is to determine the steady state concentration of lapatinib in VS in patients with NF2 and in patients with sporadic VS. Patient who are planning to have surgical resection of their tumor for clinical indications will be given lapatinib for 15 days prior to resection. At the time of resection, VS tissue will be assessed for drug concentration and molecular markers of drug activity.

Demonstrating that lapatinib reaches meaningful concentrations within VS would support selecting this agent for investigation in efficacy studies for VS, and tissue-based molecular studies will provide corollary information about the behavior of VS in general and about lapatinib specifically in VS tissue. This may further our understanding of the pathophysiology of VS, the similarities and differences between NF2-related and sporadic VS, and inform the design of subsequent efficacy trials.

Concentration and Activity of Lapatinib in Vestibular Schwannomas

Exploration and Estimation of Intratumoral Concentration and Activity of Lapatinib in Vivo in Vestibular Schwannomas

Steady-state plasma concentrations of lapatinib (ng/mL) at time of surgery, 10-13 days from starting drug.

Count of tissue samples with lapatinib concentration \>3uM

Assessed number of samples with high expression of phospho-ErbB2 in tissue at time of surgery

A comparison in the median lapatinib concentration (ng/g) in vestibular schwannomas associated with neurofibromatosis type 2 and sporadic vestibular schwannomas

Due to the sample sizes, a comparison between sporadic and NF2-related vestibular schwannomas could not be made. Instead we report the mutational status.

GlaxoSmithKline

New York University

House Research Institute

Washington University School of Medicine

Weill Medical College of Cornell University

Massachusetts General Hospital

Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

Zero participants were At Risk from the Control arm since they did not receive any intervention.

Subjects received lapatinib 1500 mg by mouth for 10 days prior to surgery for vestibular schwannoma resection.

Control subjects will not receive any intervention prior to surgery for vestibular schwannoma resection. Control subjects donate tissue at the time of surgery. AEs were not collected in this group as there was no study intervention (i.e. they did not take the drug).

Control

Subjects received lapatinib for 1500 mg by mouth daily for 10 days prior to surgery for vestibular schwannoma resection

Control subjects did not receive any intervention prior to surgery for vestibular schwannoma resection

Total

KPS is a physician-reported outcome measuring an individual's functional impairment. Scores range from 0% (death) to 100% (normal no complaints; no evidence of disease).

Specific to these results, 70% represents an ability to care for self; unable to carry on normal activity or to do active work, and 90% represents an ability to carry on normal activity; minor signs or symptoms of disease.

Per protocol, KPS was not recorded for control participants. Control participants agreed to donate tissue only. No clinical data was collected.

Karnofsky Performance Status (KPS)

Patients with a diagnosis of NF2

A total of 10 tissue and 11 plasma samples donated by participants receiving lapatinib and 2 tissue samples from control participants were lost from analysis due to freezer failure denaturing the samples. This substantially reduced the sample size.

Jaishri Blakeley

Subjects received lapatinib 1500 mg by mouth for 10 days prior to surgery for vestibular schwannoma resection

In the lapatinib group, 10 tissue and plasma samples were lost from analysis due to a freezer failure during a natural disaster denaturing the samples. 1 blood sample was contaminated, but tissue was available. Control group did not get any drug. A total of 8 participants of 19 given drug had data for analysis.

Median Steady-state Lapatinib Plasma Concentrations at the Time of Surgical Resection

Subjects will receive lapatinib for 10 days prior to surgery for vestibular schwannoma resection.

lapatinib: 1500 mg lapatinib by mouth per day for 10 days

In the lapatinib group, 10 tissue and plasma samples were lost from analysis due to a freezer failure during a natural disaster denaturing the samples. Nine samples were available for tissue concentration assessment.

To Assess Whether Lapatinib Can Reach a Minimum Tumor Concentration Level of >3uM in VS After Oral Dosing.

Control subjects will not receive any intervention prior to surgery for vestibular schwannoma resection. Control subjects donate tissue at the time of surgery.

10 lapatinib participants and 3 control participants did not have adequate tissue for analysis.

Assess the Level of ErbB2 Phosphorylation in VS.

The experiment to assess this outcome measure failed and no interpretable data could be collected.

Assess Markers of Tumor Proliferation and Cell Death in VS After Exposure to Lapatinib.

Participants with vestibular schwannomas associated with a diagnosis of neurofibromatosis type 2

NF2 Associated VS

Participants with sporadic vestibular schwannomas (i.e. not associated with a diagnosis of neurofibromatosis type 2)

Sporadic VS

Of the nine participants in the lapatinib who had tumor available for analysis, four had a vestibular schwnannoma associated with a diagnosis of neurofibromatosis type 2 (NF2); five had sporadic vestibular schwannomas.

Explore the Difference in the Concentration of Lapatinib Achieved in NF2-related Versus Idiopathic VS.

Hemizygous deletion in NF2 gene

Homozygous deletion in NF2 gene

No deletion in NF2 gene

Seven participants had successful NF2 gene mutation analysis via exon scanning and MLPA.

Participants With Tissue Available for Gene Mutation Analysis

6 of the 7 participants had sporadic VS; 1 of 7 had NF2-associated VS. As such, we were unable to explore differences between the groups.

Perform NF2 Gene Mutation Analysis Via Exon Scanning and MLPA as Well as Protein Expression in All VS and Explore Differences Between Sporadic and NF2 Related VS.

Control subjects did not receive any intervention prior to surgery for vestibular schwannoma resection.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Using Positron Emission Tomography to Predict Intracranial Tumor Growth in Neurofibromatosis Type II Patients	NCT01222728	Neoplasms Nervous System ... Vestibular Dise...		18 Years - 50 Years	National Institutes of Health Clinical Center (CC)
Exploratory Evaluation of AR-42 Histone Deacetylase Inhibitor in the Treatment of Vestibular Schwannoma and Meningioma	NCT02282917	Vestibular Schw... Meningioma Acoustic Neurom... Neurofibromatos...	AR-42	18 Years -	Massachusetts Eye and Ear Infirmary
Neurofibromatosis (NF) Registry Portal	NCT01885767	Neurofibromatos... Neurofibromatos... Schwannomatosis		-	The Children's Tumor Foundation
Concentration and Activity of Lapatinib in Vestibular Schwannomas	NCT00863122	Vestibular Schw... NF2 Neurofibromatos... Acoustic Neurom... Auditory Tumor	lapatinib	18 Years -	Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Concentration and Activity of Lapatinib in Vestibular Schwannomas	NCT00863122	Vestibular Schw... NF2 Neurofibromatos... Acoustic Neurom... Auditory Tumor	lapatinib	18 Years -	Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
Concentration and Activity of Lapatinib in Vestibular Schwannomas	NCT00863122	Vestibular Schw... NF2 Neurofibromatos... Acoustic Neurom... Auditory Tumor	lapatinib	18 Years -	Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins

Spots Global Cancer Trial Database for nf2

Every month we try and update this database with for nf2 cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Spots Global Cancer Trial Database for nf2

Every month we try and update this database with for nf2 cancer trials from around the world to help patients and their families find trials that might be right for them. We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Every month we try and update this database with for nf2 cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.