Tumor Treating Fields for the Treatment of Leptomeningeal Metastases of the Spine in Patients With Breast Cancer

Study Purpose

This clinical trial evaluates the safety and feasibility of tumor treating fields (TTF) in the treatment of spinal leptomeningeal disease in patients with breast cancer that has spread from where it first started (primary site) to other places in the body (metastatic). Patients wear the portable Novo TTF-200T device that produces electric fields to target areas on the body to stop the growth of tumor cells. The information from this study will help researchers develop a better treatment for leptomeningeal metastases in the future.

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 18 Years and Over
Gender All
More Inclusion & Exclusion Criteria

Inclusion Criteria:

  • - Age >= 18.
  • - Prior tissue diagnosis of breast cancer.
  • - Confirmed diagnosis of leptomeningeal metastases (LM) with positive cerebrospinal fluid (CSF) cytology for malignancy and meningeal enhancement (type 1A, 1B, and 1C) - Radiographic evidence on MRI of leptomeningeal enhancement within the cervical, thoracic or lumbar spine on spinal MRI.
  • - Life expectancy of at least 6 weeks.
  • - Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1, 2, or 3.
  • - Recovery from any neurotoxic effects of prior therapy.
  • - Platelet count greater than 25 x 10^9/L.
  • - Absolute neutrophil count (ANC) greater than 0.5 x 10^9/L.
  • - Patients must have adequate liver function, total bilirubin < 2.5 mg/dL, unless elevated total bilirubin is due to elevated indirect bilirubin from known Gilbert's disease, aspartate aminotransferase (AST) =< 3.5 times upper limits of normal; adequate renal function [calculated estimated glomerular filtration rate (eGFR) >= 30 mL/min/ body surface area (BSA)] - Patients or legal medical representative must provide written informed consent.
  • - Patients must have suitable body habitus for placement of transducer arrays.
  • - Patients must be willing to wear the device for at least 18 hours a day (averaged over monthly) - Patients must be willing to return for the scheduled evaluations and perform the required assessments.
  • - Patients are without other disease or situation which would significantly compromise adequate assessment of safety and feasibility of the TTF.
  • - Patient willing to start a study treatment with TTF =< 14 days from registration.

Exclusion Criteria:

  • - Concomitant therapy: - Must not be receiving concurrent high-dose methotrexate (>= 3 g/m^2), high dose thiotepa, or high-dose cytarabine (>= 3 g/m^2).
Any other systemic chemotherapy, targeted treatment, hormonal or immunotherapy directed at the primary systemic malignancy is permitted.
  • - Must not have received radiation therapy (RT) to the brain or spinal cord within 2 weeks of initiation of TTF.
  • - Must be at least 1 week from cessation of any prior intrathecal chemotherapy.
  • - Women of childbearing age who are pregnant or lactating.
(Male and female patients who are fertile must be willing to use an effective means of birth control to avoid pregnancy)
  • - Patients with uncontrolled or untreated infection including active hepatitis, and human immunodeficiency virus (HIV) - Patients receiving any other investigational agents and must not have received any other investigational agent within 14 days prior to registration.
The 14-day period should be extended if the investigational agent is known to have delayed toxicity.
  • - Patients known to be allergic to the hydrophilic gel utilized for transducer attachment.
- Patients with surgical hardware within the planned area of treatment in the spine (e.g., titanium rods, screws, fixation devices)

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.

NCT05746325
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.

N/A
Lead Sponsor

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

Mayo Clinic
Principal Investigator

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

Wendy J. Sherman, MD
Principal Investigator Affiliation Mayo Clinic
Agency Class

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

Other
Overall Status Recruiting
Countries United States
Conditions

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

Anatomic Stage IV Breast Cancer AJCC v8, Metastatic Breast Carcinoma, Metastatic Malignant Neoplasm in the Leptomeninges
Study Website: View Trial Website
Additional Details

PRIMARY OBJECTIVE:

  • I. To determine whether the TTF device can be successfully placed in the three protocol-specified treatment field arrays (cervical, thoracic, and lumbar) and worn by the study patients for a meaningful period of time in the treatment of leptomeningeal metastases within the spine.
SECONDARY OBJECTIVE:
  • I. To document any preliminary signals of activity, as measured by radiographic and clinical response, or durable stability of objective neurologic examination, utilizing Leptomeningeal Assessment in Neuro-Oncology (LANO) criteria, magnetic resonance imaging (MRI) imaging, cerebrospinal fluid (CSF) cytologic examination, and patient-reported symptom assessment (M.
D. Anderson Symptom Inventory [MDASI]-spine module). OUTLINE: Patients have transducer arrays applied and digital photographs taken of placement on study. Patients wear the NovoTTF-200T portable system on study. Patients also undergo MRI during screening and on study and may undergo lumbar puncture (LP) and collection of cerebrospinal fluid (CSF) samples during screening if no CSF testing for malignancy has been done previously. After completion of study intervention, patients are followed up every 3 months or every 6 months.

Arms & Interventions

Arms

Experimental: Treatment (TTFields, digital photos)

Patients have transducer arrays applied and digital photographs taken of placement on study. Patients wear the NovoTTF-200T portable system on study. Patients also undergo MRI and may undergo LP during screening and on study.

Interventions

Other: - Digital Photography

Digital photographs taken of array placement

Procedure: - Lumbar Puncture

Undergo LP

Procedure: - Magnetic Resonance Imaging

Undergo MRI

Device: - Medical Device Usage and Evaluation

Transducer arrays applied and wear NovoTTF-200T

Procedure: - Biospecimen Collection

Undergo collection of cerebrospinal fluid (CSF) during screening if no CSF testing for malignancy has been done previously

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 in Florida, Jacksonville 4160021, Florida 4155751

Status

Recruiting

Address

Mayo Clinic in Florida

Jacksonville 4160021, Florida 4155751, 32224-9980

Site Contact

Clinical Trials Referral Office

[email protected]

855-776-0015

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