Clinical Trial Finder

Inclusion Criteria:

• - Age >5 years.

• - Age <18 years at time of radiotherapy.

• - Has received cranial/craniospinal radiation treatment of brain tumor within the last 7 years.

• - Adequate contraceptive method to prevent pregnancy* during the entire lithium treatment period and six months thereafter.

• - Negative pregnancy test* at screening, at start of study treatment, and monthly thereafter.

• - Written informed consent from patient and/or caregiver.

Exclusion Criteria:

• - Allergy/hypersensitivity to lithium or any of the excipients.

• - Renal failure (Cystatin C derived Glomerular Filtration Rate < 60).

• - Cardiac failure or heart disease, including Brugada syndrome (or family history thereof).

• - Uncontrolled hypothyroidism.

• - Pregnancy or breast feeding.

• - Severe fluid or electrolyte imbalance.

• - Karnofsky-Lansky score < 60.

• - Other condition deemed incompatible with inclusion in this study (estimated 2 year survival prognosis less than 25 %, expected poor protocol compliance, inability to swallow tablets, language difficulties).

• - Inclusion in other study protocol precluding inclusion in this study.

Late-appearing cognitive side effects after brain radiotherapy is a potential disabling condition in pediatric brain tumor survivors. It can have profound negative effects on education, career options and quality of life. There is no current interventional drug treatment to prevent this intellectual impairment after brain tumor treatment. Primary objective: To assess the efficacy of lithium treatment (up to 7 years) after brain radiotherapy (both whole brain and focal) for central nervous system malignancy in preventing late-appearing cognitive processing speed impairment in children aged 5 or older. Secondary objectives:

• - To assess the efficacy of lithium treatment through evaluation of other neuropsychological/quality of life test scores.

• - To assess the efficacy of lithium treatment through evaluation of radiological findings after lithium treatment using Magnetic Resonance Imaging (MRI) of the brain.

Exploratory objectives: To explore the feasibility, safety and tolerability of lithium treatment in this patient group, using side effect forms/adverse events (AE) reporting and laboratory measures.

Arms

Experimental: Lithium

Lithionit 42 mg (lithium sulphate, 6 mmol), start dose 1x1, then slow dose escalation using therapeutic drug monitoring (TDI) to establish a target serum level of 0.5-1.0 mmol/liter.

Placebo Comparator: Placebo

Identical looking placebo (white round tablet, 10 mm diameter) will be dose escalated and monitored the same way as lithium, with sham values guiding the dosing.

Interventions

Drug: - Lithium

Lithium sulphate, 42 mg (6 mmol lithium)

Drug: - Placebo

White round tablet, 10 mm. Identical to experimental drug (lithium)