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This research is being done to assess the quality of life and symptom burden in participants who receive (normal tissue sparing whole brain radiation therapy (NTS-WBRT).
This research study involves:
This is a Phase 2 trial testing the safety and effectiveness of NTS-WBRT (normal tissue sparing whole brain radiation therapy) in treating brain metastases.
NTS-WBRT is a targeted radiation therapy that further reduces radiation dose to tissue that does not need radiation therapy treatment.
The research study procedures include screening for eligibility and study treatment including evaluations and follow up visits.
It is expected that about 41 people will take part in this research study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| NTS-WBRT (normal tissue sparing whole brain radiation therapy) + Memantine | Experimental | Participants will be randomly assigned to NTS-WBRT (normal tissue sparing whole brain radiation therapy) administration group and receive:
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| NTS-WBRT (normal tissue sparing whole brain radiation therapy) | Radiation | Radiation |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in Patient Reported Quality of Life for NTS-WBRT (normal tissue sparing whole brain radiation therapy) | Assessed by Functional Assessment of Cancer Therapy-Brain (FACT-Br) questionnaire. Score range is 0-200 and the higher the score, the better the outcome. | 4 Months |
| Change in Patient Reported Symptom Burden for NTS-WBRT (normal tissue sparing whole brain radiation therapy) | Assessed by Functional Assessment of Cancer Therapy-Brain (FACT-Br) questionnaire. Score range is 0-200 and the higher the score, the better the outcome. | 4 Months |
| Measure | Description | Time Frame |
|---|---|---|
| Tumor local control Rates between NTS-WBRT+SIB and NTS-WBRT | Estimated by the cumulative incidence function treating death as a competing risk, compared using Gray's test | baseline, 2, 4, 6, 9, 12, 18 and 24 months |
| Intracranial- Progression Free Survival (PFS) between NTS-WBRT+SIB and NTS-WBRT |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Helen A Shih, MD, MS, MPH | Contact | (617) 724-9627 | hshih@mgh.harvard.edu |
| Name | Affiliation | Role |
|---|---|---|
| Helen A Shih, MD, MS, MPH | Massachusetts General Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Massachusetts General Hospital Cancer Center | Recruiting | Boston | Massachusetts | 02114 | United States |
The Dana-Farber / Harvard Cancer Center encourages and supports the responsible and ethical sharing of data from clinical trials. De-identified participant data from the final research dataset used in the published manuscript may only be shared under the terms of a Data Use Agreement. Requests may be directed to: [contact information for Sponsor Investigator or designee]. The protocol and statistical analysis plan will be made available on Clinicaltrials.gov only as required by federal regulation or as a condition of awards and agreements supporting the research.
Data can be shared no earlier than 1 year following the date of publication
Contact the Partners Innovations team at http://www.partners.org/innovation
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| ID | Term |
|---|---|
| D001932 | Brain Neoplasms |
| ID | Term |
|---|---|
| D016543 | Central Nervous System Neoplasms |
| D009423 | Nervous System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
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| ID | Term |
|---|---|
| D011878 | Radiotherapy |
| D008559 | Memantine |
| ID | Term |
|---|---|
| D013812 | Therapeutics |
| D000547 | Amantadine |
| D000218 | Adamantane |
| D001952 | Bridged-Ring Compounds |
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| Memantine | Drug | Capsule, taken orally |
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Estimated using the Kaplan-Meier method, compared using the logrank test |
| baseline, 2, 4, 6, 9, 12, 18 and 24 months |
| Overall survival (OS) between NTS-WBRT+SIB and NTS-WBRT | Estimated using the Kaplan-Meier method, compared using the logrank test | The date of randomization to the date of death, or otherwise censored at the last follow-up date for patients still alive up to 24 months |
| Change in Neurocognitive function between NTS-WBRT+SIB and NTS-WBRT | Assessed longitudinally by the HADS-D and HADS-A questionnaires | baseline, 2, 4, 6, 9, 12, 18 and 24 months |
| Change in Mood between NTS-WBRT+SIB and NTS-WBRT | Mixed effects models with treatment arm as a fixed effect will be used to compare changes in depression (HADS-D) and anxiety (HADS-A) scores over time | baseline, 2, 4, 6, 9, 12, 18 and 24 months |
| Change in Fatigue between NTS-WBRT+SIB and NTS-WBRT | Mixed effects models with treatment arm as a fixed effect will be used to compare changes in the fatigue score over time | baseline, 2, 4, 6, 9, 12, 18 and 24 months |
| Change in Neuroendocrine function between NTS-WBRT+SIB and NTS-WBRT | Estimated by the cumulative incidence function treating intracranial progression and death as competing risks; compared using Gray's test. | baseline, 2, 4, 6, 9, 12, 18 and 24 months |
| Change in Hearing between NTS-WBRT+SIB and NTS-WBRT Assessed by Pure Tone Average | Changes in pure tone average (PTA) from baseline to each subsequent assessment will be compared between treatment arms using Wilcox rank-sum test. Pure tone thresholds are found by presenting tones using standard headphones and methods in a sound treated booth. Pure tone thresholds will be tested by both bone (500, 1000, 2000 and 4000 Hz) and air conduction (250, 500, 1000, 2000, 3000, 4000, 6000, 8000, 10000, 12000, and 14000 Hz). Masking will be applied sufficient to determine the ear responsible for each value. The results of this testing will be used to determine the sensorineural hearing level. If significant conductive loss is found, bone conduction threshold will be used to report sensory ototoxicity. Threshold effects across frequency will be combined into a Pure Tone Average (PTA), defined as the average of audiometric thresholds at 500, 1000, 2000, and 4000. A significant decrease in Pure Tone Average is defined as an increase > 10 dB in relation to baseline threshold. | baseline, 2, 4, 6, 9, 12, 18 and 24 months |
| Change in Hearing between NTS-WBRT+SIB and NTS-WBRT Assessed by Word Recognition Score | Changes in word recognition score (WRS) from baseline to each subsequent assessment will be compared between treatment arms using Wilcox rank-sum test. Word recognition is defined as the percent correct on a standard, 50-item word list of English monosyllables: CID W-22, NU#6 or CNC. A significant decrease in word recognition is defined as a score exceeding the 95% critical difference from the table of Thornton and Raffin. | baseline, 2, 4, 6, 9, 12, 18 and 24 months |
| Change in Hearing between NTS-WBRT+SIB and NTS-WBRT Assessed by Otoacoustic Emissions | The rates of absent otoacoustic emissions (OAE) will be compared between treatment arms using Fisher's exact test. The OAE (Otoacoustic Emissions) test checks part of the inner ear's response to sound. Otoacoustic emissions are sounds given off by one small part of the cochlea when it is stimulated by soft clicking sounds. When the sound stimulates the cochlea, the outer hair cells vibrate. The vibration produces a nearly inaudible sound that echoes back into the middle ear. The results are either present or absent. Present OAEs are consistent with normal to near normal hearing. Absent OAEs may be a sign of a problem related to study treatment. | baseline, 2, 4, 6, 9, 12, 18 and 24 months |
| Alopecia Rates between NTS-WBRT+SIB and NTS-WBRT | Assessed by patient report and visual inspection with documented photography; compared by Fisher's exact test | baseline, 2, 4, 6, 9, 12, 18 and 24 months |
| Number of Participants With Treatment-Related Adverse Events as Assessed by CTCAE Version 5.0 | The number and proportion of adverse events, graded as defined by CTCAE version 5.0 will be tabulated by type and grade, compared using Fisher's exact test. | Up to 24 months |
| D001927 |
| Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D006844 |
| Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |