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| Name | Class |
|---|---|
| Fred Hutchinson Cancer Center | OTHER |
| University of Washington | OTHER |
| Northwell Health | OTHER |
| Oregon Health and Science University |
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This is a feasibility study in patients with localized or metastatic soft tissue sarcoma undergoing surgery to determine how sarcoma in situ responds to injected microdoses of anti-cancer therapeutics.
This is a single arm, pilot study designed to test the feasibility of using the CIVO (Comparative In Vivo Oncology) system in patients with soft tissue sarcoma accessible for percutaneous injection. Patients who are scheduled for surgical biopsy or tumor resection surgery will be injected 4 to 72 hours prior to surgery using the CIVO device. Minute volumes (up to 8.3 microliters) of saline (negative control) or microdoses of anti-cancer agents will be percutaneously injected in a columnar fashion through each of 8 needles into a single solid tumor. Following the patient's biopsy surgery or tumor resection surgery, the injected portion and a small uninjected portion will be used to determine the in situ drug response in the tumor. None of the data from this evaluation will be shared with patients or used to make clinical decisions. Study clinicians will have access to the patient's health record for 1 year after the study to monitor patient treatment responses. Such information will be used to help evaluate the correlation between clinical response and tumor response assessed via CIVO.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Multiple drug microinjection | Experimental | Patients who are scheduled for surgical biopsy or tumor resection surgery will be injected 4 to 72 hours prior to surgery using the CIVO device. Minute volumes (up to 8.3 microliters) of saline (negative control) or microdoses of anti-cancer agents will be percutaneously injected in a columnar fashion through each of 8 needles into a single enlarged solid tumor. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Multiple drug microinjection | Drug | This is a feasibility study in patients with localized or metastatic soft tissue sarcoma undergoing surgery to determine how sarcoma in situ responds to injected microdoses of anti-cancer therapeutics. |
| Measure | Description | Time Frame |
|---|---|---|
| Quantification of fraction of cells positive for apoptosis and drug target engagement biomarkers around injected drugs | Analysis will be performed to determine if there is a difference in responses caused by each drug versus the vehicle control | 4-72 hours after microinjection |
| Measure | Description | Time Frame |
|---|---|---|
| Number of patients with adverse events related to pain | Relationship of AE to study device or study procedure will be determined using an AE Relatedness Grading System. | up to 28 days after microinjection |
| Coefficient of variation and intra-class correlation coefficient of fraction of cells around injected drug in multiple tumor planes |
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Inclusion Criteria:
18 years of age or over.
At least one suspected soft tissue sarcoma tumor that is considered by the investigator to be: (1) accessible for percutaneous injection and (2) at least 2.5 cm in shortest dimension for patients undergoing an incisional biopsy, or at least 3 cm in shortest dimension for patients undergoing an excisional biopsy/tumor resection. Tumors should not be selected if the Investigator believes them to be necrotic or exhibit signs of radiation-induced fibrosis.
Prior surgical evaluation and plan for surgical biopsy or surgery to remove the tumor being injected.
ECOG performance status of 0-2 (or a Karnofsky performance status of >50%)
Labs required for enrollment (prior to microinjection):
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Gary Deutsch, MD | Northwell Health | Principal Investigator |
| Kenneth Gundle, MD | Oregon Health & Science University (OHSU) | Principal Investigator |
| Seth Pollack, MD | Fred Hutchinson Cancer Research Center/SCCA | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Monter Cancer Center (Northwell Health) | Lake Success | New York | 11042 | United States | ||
| OHSU Knight Cancer Institute |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32299817 | Derived | Gundle KR, Deutsch GB, Goodman HJ, Pollack SM, Thompson MJ, Davis JL, Lee MY, Ramirez DC, Kerwin W, Bertout JA, Grenley MO, Sottero KHW, Beirne E, Frazier J, Dey J, Ellison M, Klinghoffer RA, Maki RG. Multiplexed Evaluation of Microdosed Antineoplastic Agents In Situ in the Tumor Microenvironment of Patients with Soft Tissue Sarcoma. Clin Cancer Res. 2020 Aug 1;26(15):3958-3968. doi: 10.1158/1078-0432.CCR-20-0614. Epub 2020 Apr 16. |
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| ID | Term |
|---|---|
| D012509 | Sarcoma |
| ID | Term |
|---|---|
| D018204 | Neoplasms, Connective and Soft Tissue |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
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| ID | Term |
|---|---|
| D004317 | Doxorubicin |
| D000077143 | Docetaxel |
| D000093542 | Gemcitabine |
| D007371 | Interferon-gamma |
| C582435 | pembrolizumab |
| D000074324 | Ipilimumab |
| D000077190 | Interferon alpha-2 |
| D000069286 | Bortezomib |
| C082598 | aldesleukin |
| D000077606 | Trabectedin |
| C490954 | eribulin |
| C000589393 | olaratumab |
| C000594389 | atezolizumab |
| C000613593 | durvalumab |
| C000609138 | avelumab |
| D000077594 | Nivolumab |
| C000609083 | larotrectinib |
| C000607349 | entrectinib |
| C000707147 |
| ID | Term |
|---|---|
| D003630 | Daunorubicin |
| D018943 | Anthracyclines |
| D009279 | Naphthacenes |
| D011084 | Polycyclic Aromatic Hydrocarbons |
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| OTHER |
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|
| CIVO device | Device | Feasibility of assessing drug response to precise local injection of anti-cancer drugs using Presage's CIVO device in soft tissue sarcoma patients undergoing surgery. |
|
Analysis will be performed for fraction of cells positive for apoptosis and drug target engagement biomarkers |
| 4-72 hours after microinjection |
| Portland |
| Oregon |
| 97239 |
| United States |
| Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance (SCCA)/University of Washington | Seattle | Washington | 98109 | United States |
| avapritinib |
| D012965 | Sodium Chloride |
| D006841 |
| Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |
| D011083 | Polycyclic Compounds |
| D000617 | Aminoglycosides |
| D006027 | Glycosides |
| D002241 | Carbohydrates |
| D043823 | Taxoids |
| D043822 | Cyclodecanes |
| D003516 | Cycloparaffins |
| D006840 | Hydrocarbons, Alicyclic |
| D004224 | Diterpenes |
| D013729 | Terpenes |
| D006571 | Heterocyclic Compounds |
| D003841 | Deoxycytidine |
| D003562 | Cytidine |
| D011741 | Pyrimidine Nucleosides |
| D011743 | Pyrimidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D007372 | Interferons |
| D016207 | Cytokines |
| D036341 | Intercellular Signaling Peptides and Proteins |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
| D016215 | Macrophage-Activating Factors |
| D008222 | Lymphokines |
| D011506 | Proteins |
| D001685 | Biological Factors |
| D061067 | Antibodies, Monoclonal, Humanized |
| D000911 | Antibodies, Monoclonal |
| D000906 | Antibodies |
| D007136 | Immunoglobulins |
| D007162 | Immunoproteins |
| D001798 | Blood Proteins |
| D012712 | Serum Globulins |
| D005916 | Globulins |
| D016898 | Interferon-alpha |
| D007370 | Interferon Type I |
| D001897 | Boronic Acids |
| D000148 | Acids, Noncarboxylic |
| D000143 | Acids |
| D007287 | Inorganic Chemicals |
| D001896 | Boron Compounds |
| D011719 | Pyrazines |
| D004149 | Dioxoles |
| D044005 | Tetrahydroisoquinolines |
| D007546 | Isoquinolines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D002712 | Chlorides |
| D006851 | Hydrochloric Acid |
| D017606 | Chlorine Compounds |
| D017670 | Sodium Compounds |