Neoplasms

Symptoms and General Pathology

All Conditions

Digestive System Diseases

Gland and Hormone Related Diseases

Rare Diseases

Neoplasm Metastasis

Pancreatic Neoplasms

Liver Neoplasms

Neoplastic Processes

Gastrointestinal Neoplasms

Digestive System Neoplasms

Endocrine Gland Neoplasms

Gastrointestinal Diseases

Pancreatic Diseases

Endocrine System Diseases

Liver Diseases

Pancreatic Cancer

Hematinics

All Drugs and Chemicals

Anti-Infective Agents

Liver Extracts

Carbamide Peroxide

Neesha Dhani, M.D.

This is a feasibility study to perform image-guided liver biopsies in 25 patients who have pancreatic cancer with liver metastasis (cancer in the pancreas that has spread to the liver). This will contribute with samples for the bio-bank (bank of tumors) and develop xenografts (human tumors growing in mice) for further analysis of genes.

This study might bring a better understanding of the metastatic pancreatic cancer and evaluate the differences between the metastatic and the primary pancreatic cancer (the type that does not have metastasis).

A Study of Pancreatic Cancer in Xenografts From Liver Metastases

A Feasibility Study Of Developing Murine Primary Xenografts From Biopsies Of Liver Metastases In Patients With Advanced Pancreatic Cancer

Monitoring adverse events during trial related to biopsies

determine the "take rate" or success of establishing xenografts

complete histological and molecular comparison of original patient sample with murine xenograft

determine the correlation between engraftment rate and clinical data (response to treatment, disease-free survival, overall survival).

University Health Network, Toronto

Pheochromocytoma

Adrenal Gland Neoplasms

Adrenal Gland Diseases

Adrenal Cancer

Vasoconstrictor Agents

Respiratory System Agents

Hormones

Epinephrine

Racepinephrine

Epinephryl borate

To collect adrenal tumor tissue biopsy samples in order to study and evaluate new methods that may help identify cancerous or precancerous cells. Participants who have a large tumor or one that secretes hormones will have standard surgery to remove the tumor.

Participants whose tumor does not secrete hormones will have a tumor biopsy to collect tissue for the study.

Tumor tissue biopsy

Participants who have a large tumor or one that secretes hormones will have standard surgery to remove the tumor. Tissue will be collected for study.

Surgery

Naris Nilubol, M.D.

Background:

- Tumors of the adrenal gland are common. Most of them are not cancerous. However, there are no tests that can accurately tell which adrenal tumors are cancerous and which are not. The only way to tell is to remove the tumor with surgery and then examine it. Researchers have been using new methods to study samples of adrenal tissue. These methods may help identify whether the cells are or may become cancerous without an operation. This information will help doctors determine which tumors will need to be removed.

Objectives:

- To collect adrenal tumor tissue biopsy samples in order to study and evaluate new methods that may help identify cancerous or precancerous cells.

Eligibility:

- Individuals at least 18 years of age who have an adrenal tumor that may or may not be cancerous.

Design:

* Participants will be screened with a physical examination, medical history, blood and urine tests, and imaging studies.
* Participants will be examined to determine whether they have a specific type of adrenal tumor

(pheochromocytoma).

* Participants whose tumor does not secrete hormones will have a tumor biopsy to collect tissue for study.
* Participants who have a large tumor or one that secretes hormones will have standard surgery to remove the tumor. Tissue will be collected for study.
* Researchers will examine the collected tissue. They will try to determine whether the cells are cancerous or may become cancerous.
* Participants will be asked to return to the National Institutes of Health Clinical Center every year for about 5 years. During these visits they will have imaging studies, lab tests, and a physical examination.

Background:

* Adrenal neoplasms are common and are incidentally discovered in 4-10% of abdominal imaging studies.
* The majority of adrenal incidentalomas are cortical adenoma.
* Many patients with nonfunctioning adrenal incidentalomas undergo adrenalectomy to exclude a cancer diagnosis.
* There are no reliable clinical, radiographic or laboratory studies that accurately distinguish between localized benign and malignant adrenal neoplasm.
* This protocol is designed to determine the feasibility and accuracy of using novel molecular markers of malignant adrenal neoplasm in fine needle aspiration (FNA) biopsy and surgically resected samples.

Objectives:

* Primary Objectives:

  * To evaluate the feasibility of molecular testing in adrenal neoplasm FNA biopsy samples.
  * To determine the accuracy of novel diagnostic molecular markers in clinical adrenal FNA biopsy and surgically resected samples.
* Secondary Objectives:

  * To analyze the gene expression level relative to disease-free survival and overall survival in patients with adrenocortical carcinoma

Eligibility:

* An individual with an adrenal neoplasm greater than 2cm in size
* Age greater than or equal to 18 years
* Adults must be able to understand and sign the informed consent document

Design:

* Prospective observational study.
* Demographic, clinical, laboratory and pathologic data will be collected for each patient participant. Data will be securely stored in a computerized database.
* Patients will have biochemical testing to determine if their adrenal neoplasm is functioning or nonfunctioning.
* After their initial on-study evaluation, patients who are found to have a nonfunctioning adrenal tumor with a low risk of malignancy will be re-screened every year for 5 years with non-invasive imaging studies.
* Treatment of patients with an adrenal neoplasm will be performed based on standard clinical practice.
* Projected accrual will be 50 patients per year for a total of 10 years. Thus, we anticipate accruing 500 patients on this protocol.

Evaluation of Molecular Markers in Adrenal Tumors

Evaluation of Diagnostic and Prognostic Molecular Markers in Adrenal Neoplasm

Feasibility of molecular testing in adrenal neoplasm fine needle aspiration (FNA) samples was determined by immunohistochemistry. Ribonucleic acid and deoxyribonucleic acid was extracted from fine needle aspiration and tumor tissue samples to differentiate between normal and abnormal tissue.

Tumor tissue obtained via FNA and surgical resection were to be analyzed for molecular markers to help determine if cells were cancerous or may become cancerous.

Gene expression levels were to be analyzed relative to disease free and overall survival in patients with adrenocortical carcinoma.

Here is the count of participants with serious and non-serious adverse events assessed by the Common Terminology Criteria in Adverse Events (CTCAE v4.0). A non-serious adverse event is any untoward medical occurrence. A serious adverse event is an adverse event or suspected adverse reaction that results in death, a life threatening adverse drug experience, hospitalization, disruption of the ability to conduct normal life functions, congenital anomaly/birth defect or important medical events that jeopardize the patient or subject and may require medical or surgical intervention to prevent one of the previous outcomes mentioned.

National Cancer Institute (NCI)

Principal Investigator

Adrenal neoplasms are common and are incidentally discovered in 4-10% of abdominal imaging studies. Most adrenal tumors are not cancerous. The majority of adrenal incidentalomas are cortical adenoma. Many patients with nonfunctioning adrenal incidentalomas undergo adrenalectomy to exclude a cancer diagnosis. There are no reliable clinical, radiographic or laboratory studies that accurately distinguish between localized benign and malignant adrenal neoplasm.

Adrenal Gland Neoplasm

Age, Categorical

Age, Continuous

Sex: Female, Male

Ethnicity (NIH/OMB)

Race (NIH/OMB)

United States

Region of Enrollment

Dr. Naris Nilubol

Because the study was terminated due to poor accrual and all fine needle aspiration (FNA) samples were benign, molecular testing cannot be performed in the absence of cancerous tumors. Molecular testing was not done in any samples collected.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
A Study of Pancreatic Cancer in Xenografts From Liver Metastases	NCT01774643	Pancreatic Canc... Liver Metastase... Tumor Tissue Bi... Blood Samples		18 Years -	University Health Network, Toronto
Evaluation of Molecular Markers in Adrenal Tumors	NCT01348698	Adrenal Gland N...	Tumor tissue bi... Surgery	18 Years - 90 Years	National Institutes of Health Clinical Center (CC)
A Study of Pancreatic Cancer in Xenografts From Liver Metastases	NCT01774643	Pancreatic Canc... Liver Metastase... Tumor Tissue Bi... Blood Samples		18 Years -	University Health Network, Toronto

Spots Global Cancer Trial Database for tumor tissue biopsy