Tumor Treating Fields (TTFields) Therapy to Manage Brain Metastases in Small Cell Lung Cancer

Study Purpose

This phase II single-arm pilot study will evaluate the safety and preliminary efficacy of Optune-Tumor Treating Fields (TTFields) therapy as a prophylactic approach to reducing small cell lung cancer (SCLC) that has spread to the brain (brain metastases). Optune is a portable battery powered device that produces alternating electrical fields, termed tumor treatment fields ("TTFields") within the human body. These TTFields are applied to the patient by electrically insulated surface transducer arrays, which function to disrupt the rapid cell division of cancer cells.

Recruitment Criteria

Accepts Healthy Volunteers

Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms

No
Study Type

An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes.


An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes.


Searching Both is inclusive of interventional and observational studies.

Interventional
Eligible Ages 22 Years and Over
Gender All
More Inclusion & Exclusion Criteria

Inclusion Criteria:

  • - Ability to understand and the willingness to sign a written informed consent document.
  • - Pathologically confirmed limited stage (LS)-SCLC or extensive stage (ES)-SCLC.
  • - LS-SCLC - stage I-III (Tany, Nany, M0) that can be safely treated with radiation doses.
Excludes T3-4 due to multiple nodules that are too extensive of have tumor/nodal volume that is too large to be encompassed in a tolerable radiation plan.
  • - ES-SCLC - stage IV (Tany, Nany, M1), or T3-4 due to multiple nodules that are too extensive of have tumor/nodal volume that is too large to be encompassed in a tolerable radiation plan.
  • - Must be no more than 6 weeks from having received last dose of chemo- and/or radiotherapy for primary tumor to anticipated start of TTField therapy.
  • - Partial response to standard of care (chemo- and/or radiotherapy) as judged by treating physicians with no evidence of recurrence as observed by thoracoabdominal computed tomography (CT) within 12 weeks of enrollment.
  • - No brain metastases as observed by gadolinium (gd)-magnetic resonance imaging (MRI) within 12 weeks of enrollment.
  • - No previous or currently active second malignancy, with exception of non-metastatic prostate cancer, treated stage I breast cancer, skin malignancies.
  • - Life expectancy of at >= 3 months.
  • - Eastern Cooperative Oncology Group (ECOG) performance status =< 2 (Karnofsky >= 60) - Participants must be willing and able to fully comply with the minimum required 18 hours/day of TTField therapy.
  • - Women of child-bearing potential must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation.

Exclusion Criteria:

  • - Malignant disease, other than that being treated in this study, with exception of non-metastatic prostate cancer, treated stage I breast cancer, skin malignancies.
  • - Implanted pacemaker, defibrillator or deep brain stimulator, or documented clinically significant arrhythmias.
  • - Active implanted medical device (e.g. deep brain stimulators, spinal cord stimulators, vagus nerve stimulators, pacemakers, defibrillators, and programmable shunts) - External medical devices (e.g., insulin pumps) are permitted.
  • - Skull defect (e.g. missing bone with no replacement) - Shunt.
  • - Bullet fragments.
  • - Evidence of increased intracranial pressure (midline shift > 5 mm, clinically significant papilledema, vomiting and nausea or reduced level of consciousness) - Sensitivity to conductive hydrogels.
  • - Pregnant or lactating women.
  • - Underlying serious skin condition on the scalp, which in the opinion of the investigator, would prevent or interfere with TTField therapy.
- Any condition that, in the opinion of the investigator, would interfere with evaluation of study treatment or interpretation of participant safety or study results

Trial Details

Trial ID:

This trial id was obtained from ClinicalTrials.gov, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries.

NCT03995667
Phase

Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans.

Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data.

Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs.

Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use.

Phase 2
Lead Sponsor

The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data.

OHSU Knight Cancer Institute
Principal Investigator

The person who is responsible for the scientific and technical direction of the entire clinical study.

Timur Mitin, MD
Principal Investigator Affiliation OHSU Knight Cancer Institute
Agency Class

Category of organization(s) involved as sponsor (and collaborator) supporting the trial.

Other, Industry
Overall Status Recruiting
Countries United States
Conditions

The disease, disorder, syndrome, illness, or injury that is being studied.

Extensive Stage Lung Small Cell Carcinoma, Limited Stage Lung Small Cell Carcinoma, Stage I Lung Cancer AJCC v8, Stage IA1 Lung Cancer AJCC v8, Stage IA2 Lung Cancer AJCC v8, Stage IA3 Lung Cancer AJCC v8, Stage IB Lung Cancer AJCC v8, Stage II Lung Cancer AJCC v8, Stage IIA Lung Cancer AJCC v8, Stage IIB Lung Cancer AJCC v8, Stage III Lung Cancer AJCC v8, Stage IIIA Lung Cancer AJCC v8, Stage IIIB Lung Cancer AJCC v8, Stage IIIC Lung Cancer AJCC v8, Stage IV Lung Cancer AJCC v8, Stage IVA Lung Cancer AJCC v8, Stage IVB Lung Cancer AJCC v8
Additional Details

PRIMARY OBJECTIVE:

  • I. Observed rate of brain metastases following TTFields therapy at 6 months.
SECONDARY OBJECTIVES:
  • I. Observed rate of brain metastases following TTFields therapy at 12 months.
  • II. Survival of participants with SCLC after using TTFields therapy.
  • III. Usage and overall safety characteristics of TTFields therapy.
  • IV. Quality of life among participants using TTFields therapy.
  • V. Observed rate of SCLC brain metastases at 6 months from the beginning of the 4th cycle of chemotherapy to development of brain metastases.
OUTLINE: Participants will receive TTFields therapy on a continuous basis (i.e., 18-24 hours a day, 7 days a week) for a period of 12 months or until the development of brain metastases, whichever comes first. Participants will be able to carry the device in an over-the-shoulder bag or backpack so that they can receive continuous at-home treatment. The investigator or other designated healthcare provider will provide detailed instructions regarding the placement/replacement and positioning of the transducer arrays on the participants head. TTFields are applied to the shaved scalp via two pairs of orthogonally positioned transducer arrays. Each pair of transducer arrays will be centered on the participants shaved head such that one pair is placed on the left and right side of the head, and the second pair placed anteriorly and posteriorly. Transducer arrays should be replaced every 2 to 3 days, with a slight relocation of the new arrays ~2 cm from the prior location. After completion of study treatment, patients are followed up periodically.

Arms & Interventions

Arms

Experimental: Prevention (TTFields therapy, questionnaire)

Patients undergo TTFields therapy over 18-24 hours daily. Cycles repeat every 4 weeks for 12 months in the absence of disease progression or unacceptable toxicity.

Interventions

Other: - Questionnaire Administration

Ancillary studies

Device: - Tumor Treating Fields Therapy

Optune-Tumor Treating Fields (TTFields). Transducer arrays affixed to scalp, worn continuously.

Contact a Trial Team

If you are interested in learning more about this trial, find the trial site nearest to your location and contact the site coordinator via email or phone. We also strongly recommend that you consult with your healthcare provider about the trials that may interest you and refer to our terms of service below.

Mayo Clinic Hospital in Arizona, Phoenix, Arizona

Status

Not yet recruiting

Address

Mayo Clinic Hospital in Arizona

Phoenix, Arizona, 85054

Site Contact

Terence T. Sio, MD, MS

sio.terence@mayo.edu

480-342-1267

Columbus, Ohio

Status

Not yet recruiting

Address

Ohio State University Comprehensive Cancer Center

Columbus, Ohio, 43210

Site Contact

Joshua D. Palmer, MD

joshua.palmer@osumc.edu

614-293-8415

OHSU Knight Cancer Institute, Portland, Oregon

Status

Recruiting

Address

OHSU Knight Cancer Institute

Portland, Oregon, 97239

Site Contact

Timur Mitin, MD

trials@ohsu.edu

503-494-1080

University of Washington Medical Center, Seattle, Washington

Status

Recruiting

Address

University of Washington Medical Center

Seattle, Washington, 98195

Site Contact

Jing Zeng, MD

trials@ohsu.edu

206-598-4100

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