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Brief Title: 5-Aminolevulinic Acid (5-ALA) to Enhance Visualization of Malignant Tumor
Official Title: A Multicenter Study of 5-Aminolevulinic Acid (5-ALA) to Enhance Visualization of Malignant Tumor in Patients With Newly Diagnosed or Recurrent Malignant Gliomas: A Safety, Histopathology, and Correlative Biomarker Study
Study ID: NCT02632370
Brief Summary: In support of the US marketing application for 5-ALA, this single arm trial is being conducted to establish the efficacy and safety of Gliolan® (5-ALA) in patients with newly diagnosed or recurrent malignant gliomas. The hypothesis of the study is Gliolan® (5-ALA), as an adjunct to tumor resection, is safe and that real-time tissue fluorescence correlates with malignant histopathology. The primary objective in this single arm study is to define the positive predictive value (PPV) of Gliolan®-induced PPIX fluorescence for malignant tumor at the time of initial resection and first use of FGS by taking a biopsy of tissue presenting with red fluorescence when observed during the course of resection of new or recurrent malignant gliomas. The functionality and performance reliability of the blue light excitation microscope platforms will be assessed.
Detailed Description: Primary Objectives * To determine whether Gliolan® (5-ALA)-induced PPIX fluorescence correlates with malignant tumor histopathology (in a minimum of 3-5 serial biopsies taken from the red fluorescent region of tissue resection). * To determine the patient safety profile of both oral Gliolan® (5-ALA), as well as use of the fluorescence operative microscope. These will include use of commonly accepted toxicity measures as well as recording surgically-related neurological deficits within the six weeks after surgery. * To determine functionality and performance reliability of the blue light excitation microscope platforms (Zeiss Pentero, Leica OH4, Leica OH6 and others). Secondary Objectives * To correlate PPIX-containing extracellular microvesicles recovered from blood (at multiple time points prior to and following tumor resection) with the pre-operative MRI tumor volume. * To characterize the presence and longitudinal changes in microvesicle biomarkers recovered from blood evaluating EGFRvIII, IDH1/2 wt and mutations and others. These microvesicular blood genes will be identified and correlated with the same microvesicular genes identified in tissue at the time of surgery.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
George Washington University, Washington, District of Columbia, United States
Delray Medical Center, Delray Beach, Florida, United States
Winship Cancer Institute of Emory University, Atlanta, Georgia, United States
Saint Alphonsus Regional Medical Center, Boise, Idaho, United States
University of Kansas Medical Center, Kansas City, Kansas, United States
Massachusetts General Hospital, Boston, Massachusetts, United States
Henry Ford Hospital, Detroit, Michigan, United States
CentraCare St. Cloud Hospital, Saint Cloud, Minnesota, United States
St. Luke's Marion Bloch Neuroscience Institute, Kansas City, Missouri, United States
Washington University School of Medicine, Saint Louis, Missouri, United States
University of New Mexico School of Medicine, Department of Neurosurgery, Albuquerque, New Mexico, United States
Mount Sinai Beth Israel, New York, New York, United States
Icahn School of Medicine at Mount Sinai, New York, New York, United States
St. Luke's University Health Network, Bethlehem, Pennsylvania, United States
Penn State- Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States
Allegheny General Hospital, Pittsburgh, Pennsylvania, United States
Huntsman Cancer Institute, Salt Lake City, Utah, United States
Name: Bob Carter, MD, PhD
Affiliation: Massachusetts General Hospital
Role: PRINCIPAL_INVESTIGATOR