INtraoperative photoDYnamic Therapy for GliOblastomas (INDYGO): Study Protocol for a Phase I Clinical Trial.
5-ALA
Fluorescence-guided resection
Glioblastoma
Laser therapy
Medical device
Neurosurgery
Photodynamic therapy
Journal
Neurosurgery
ISSN: 1524-4040
Titre abrégé: Neurosurgery
Pays: United States
ID NLM: 7802914
Informations de publication
Date de publication:
01 06 2019
01 06 2019
Historique:
received:
09
05
2018
accepted:
17
06
2018
pubmed:
28
7
2018
medline:
9
4
2020
entrez:
28
7
2018
Statut:
ppublish
Résumé
Glioblastoma (GBM) is characterized by marked proliferation, major infiltration, and poor prognosis. Despite current treatments, including surgery, radiation oncology, and chemotherapy, the overall median survival is 15 mo and the progression-free survival is 7 to 8 mo. Because of systematic relapse of the tumor, the improvement of local control remains an issue. In this context, photodynamic therapy (PDT) may offer a new treatment modality for GBM. To assess the feasibility of intraoperative PDT early after surgical resection of GBM without unacceptable and unexpected toxicities. The INDYGO clinical trial (INtraoperative photoDYnamic Therapy for GliOblastomas) treatment will be carried out in addition to the current standard of care (SOC) of glioblastoma: maximum resection surgery followed by concomitant radio-chemotherapy and adjuvant chemotherapy. PDT treatment will be delivered during surgery early, after the fluorescence-guided resection. Immunological responses and biomarkers will also be investigated during the follow-up. A total of 10 patients will be recruited during this study. Clinical follow-up after the SOC with PDT is expected to be similar (no significant difference) to the SOC alone. This INDYGO trial assesses the feasibility of intraoperative 5-aminolevulinic acid PDT, a novel seamless approach to treat GBM. The technology is easily embeddable within the reference treatment at a low-incremental cost. The safety of this new treatment modality is a preliminary requirement before a multicenter randomized clinical trial can be further conducted to assess local control improvement by treating infiltrating and nonresected GBM cells.
Sections du résumé
BACKGROUND
Glioblastoma (GBM) is characterized by marked proliferation, major infiltration, and poor prognosis. Despite current treatments, including surgery, radiation oncology, and chemotherapy, the overall median survival is 15 mo and the progression-free survival is 7 to 8 mo. Because of systematic relapse of the tumor, the improvement of local control remains an issue. In this context, photodynamic therapy (PDT) may offer a new treatment modality for GBM.
OBJECTIVE
To assess the feasibility of intraoperative PDT early after surgical resection of GBM without unacceptable and unexpected toxicities.
METHODS
The INDYGO clinical trial (INtraoperative photoDYnamic Therapy for GliOblastomas) treatment will be carried out in addition to the current standard of care (SOC) of glioblastoma: maximum resection surgery followed by concomitant radio-chemotherapy and adjuvant chemotherapy. PDT treatment will be delivered during surgery early, after the fluorescence-guided resection. Immunological responses and biomarkers will also be investigated during the follow-up. A total of 10 patients will be recruited during this study.
EXPECTED OUTCOMES
Clinical follow-up after the SOC with PDT is expected to be similar (no significant difference) to the SOC alone.
DISCUSSION
This INDYGO trial assesses the feasibility of intraoperative 5-aminolevulinic acid PDT, a novel seamless approach to treat GBM. The technology is easily embeddable within the reference treatment at a low-incremental cost. The safety of this new treatment modality is a preliminary requirement before a multicenter randomized clinical trial can be further conducted to assess local control improvement by treating infiltrating and nonresected GBM cells.
Identifiants
pubmed: 30053213
pii: 5057028
doi: 10.1093/neuros/nyy324
doi:
Substances chimiques
Aminolevulinic Acid
88755TAZ87
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
E414-E419Informations de copyright
Copyright © 2018 by the Congress of Neurological Surgeons.