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The aim of the present Phase III study is to assess the positive predictive value of NPC-07 (5-aminolevulinic acid hydrochloride) induced tissue fluorescence, safety and pharmacokinetics following a single dose of NPC-07 orally, at a dose of 20mg/kg/body weight, 3 hours prior to induction of anaesthesia for surgery of patients with newly or recurrent malignant glioma (WHO grades III/IV).
Positive predictive value will be confirmed by percentage of patients showing positive tumor cell identification in all biopsies taken from areas of strong and weak fluorescence. This study will be divided into two stages. After reviewing of the result of safety and pharmacokinetics of NPC-07 in small number of subjects by independent safety monitoring committee, more subjects will receive NPC-07 in Step II.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| NPC-07 | Experimental | Single administration of NPC-07 at a dose of 20mg/kg body weight |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| NPC-07 for oral administration | Drug | NPC-07, containing 1.5g of 5-aminolevulinic acid hydrochloride per vial, is dissolved in 50 mL of water and will be administered orally 3 hours (range 2-4 hours) prior to induction of anesthesia at a dose of 20mg/kg body weight. |
| Measure | Description | Time Frame |
|---|---|---|
| Positive predictive value of tissue fluorescence | Positive predictive value of tissue fluorescence defined as the percentage of patients showing positive tumor cell identification in all 6 biopsies taken from areas of strong and weak fluorescence. | 1 day |
| Measure | Description | Time Frame |
|---|---|---|
| Quality of fluorescent tissue | Quality of fluorescent tissue by the judgement of the investigator | 1 day |
| Positive predictive value of tissue fluorescence in each biopsy tissue sample | Positive predictive value of tissue fluorescence at the biopsy level defined as the number of tumor positive biopsies among all biopsies taken from areas of strong and weak fluorescence. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Soichiro Shibui, MD, PhD | Neurosurgery & Neuro-Oncology Division, National Cancer Center Hospital | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| International Medical Center, Saitama Medical University | Hidaka | Saitama | 350-1298 | Japan | ||
| National Cancer Center Hospital |
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| ID | Term |
|---|---|
| D005910 | Glioma |
| ID | Term |
|---|---|
| D018302 | Neoplasms, Neuroepithelial |
| D017599 | Neuroectodermal Tumors |
| D009373 | Neoplasms, Germ Cell and Embryonal |
| D009370 | Neoplasms by Histologic Type |
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| ID | Term |
|---|---|
| D000284 | Administration, Oral |
| ID | Term |
|---|---|
| D004333 | Drug Administration Routes |
| D004358 | Drug Therapy |
| D013812 | Therapeutics |
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|
| 1 day |
| Percentage of patients without residual tumor | Percentage of patients without residual tumor in the MRI within 72 hours after surgery | 3 days |
| Positive predictive value of non-fluorescent tissue at the biopsy level | Positive predictive value of tissue fluorescence at the biopsy level defined as the number of tumor positive biopsies among the non-fluorescent tissue adjacent to fluorescent tissue areas and the tumor distant cortex with respect to tumor (if available). | 1 day |
| Sensitivity as percentage of actual positives and specificity as percentage of actual negatives of fluorescence detection at the biopsy level (if available). | Sensitivity as percentage of actual positives(True positive fraction/True positive fraction + False negative fraction)and specificity as percentage of actual negatives of fluorescence detection (True negative fraction/False positive fraction + True negative fraction) at the biopsy level (if available). | 1 day |
| Safety | AEs during study period (Day 0 to Day 28), laboratory parameter, vital signs, EKG, pO2 | 28 days |
| Pharmacokinetic parameters of NPC-07 and active metabolite (Cmax, AUCt, tmax, t1/2) | Pharmacokinetic parameters of 5-ALA and PPVX (Cmax, AUCt, tmax, t1/2) | 2 days |
| Chuo-ku |
| Tokyo |
| 104-0045 |
| Japan |
| Kyorin University Hospital | Mitaka | Tokyo | 181-8611 | Japan |
| D009369 | Neoplasms |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009380 | Neoplasms, Nerve Tissue |