Mapping Molecular Markers of Brain Tumour Activity Using MRI

Study Purpose

Regions of tumour whose cells (the building blocks of the tumour) are actively multiplying generate a particular type of molecular footprint (consisting of various types of proteins) compared to tumours whose cells are relatively stable. In addition, tumour cells begin to develop a network of blood vessels that not only supply them with nutrients and oxygen, but also provide a pathway for tumour spread. There is a critical period between when these proteins and blood vessel network develops, and when tumour growth is visible using current MRI scanning. Therefore, making the process of tumour activity visible on clinical MRI scans is an important step in demonstrating and anticipating tumour growth. The study aims to do this by utilising various novel and non-invasive MRI techniques. This project is a collaboration between research groups at King's College London (UK) and the Erasmus University Rotterdam (The Netherlands). The novel MRI techniques will be incorporated into the pre-surgical imaging protocol of patients with primary brain tumours. The images will be compared with molecular measurements made from biopsies taken during surgery to show that they accurately map where activity is high and low within the tumour.

Recruitment Criteria

Accepts Healthy Volunteers Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms	No
Study Type An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes. An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes. Searching Both is inclusive of interventional and observational studies.	Interventional
Eligible Ages	18 Years and Over
Gender	All

More Inclusion & Exclusion Criteria

Inclusion Criteria:

- Individuals of 18 years or older.

- Referred for surgery (resection or biopsy) of primary brain tumour.

- Written informed consent.

Exclusion Criteria:

- Contra-indication for MRI contrast.

- Inability to give consent.

- Have received/are receiving chemotherapy at time of MRI.

- Patient is pregnant or planning to become pregnant

Trial Details

Trial ID: This trial id was obtained from ClinicalTrials.gov, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries.	NCT05140785
Phase Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans. Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data. Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs. Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use.	N/A
Lead Sponsor The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data.	King's College Hospital NHS Trust
Principal Investigator The person who is responsible for the scientific and technical direction of the entire clinical study.	Thomas C Booth, PhD
Principal Investigator Affiliation	King's College London
Agency Class Category of organization(s) involved as sponsor (and collaborator) supporting the trial.	Other
Overall Status	Not yet recruiting
Countries	United Kingdom
Conditions The disease, disorder, syndrome, illness, or injury that is being studied.	Glioma

Additional Details

Patients recruited into this study will be those for whom a surgical resection or biopsy of a primary brain tumour has already been planned by the King's College Hospital Neuro-oncology team. All patients in the UK arm of this international study will be recruited at the King's College Hospital site. Research imaging performed on patients enrolled in this study will take place at the Guy's and St Thomas' Hospital site. For patients who have consented to be included in our research study, novel MRI techniques will be included in addition to the standard primary brain tumour imaging protocol, to provide additional information about the nature of the primary tumour: for example, the structural components and metabolism. The MRI scan will last approximately 60 minutes, which is approximately 30 minutes longer than the standard brain tumour biopsy protocol. Further MRI scans will be performed after surgery and, if necessary, at recurrence (up to a maximum of three scans per patient) to look at advanced imaging changes at each time-point alongside structural changes. These additional scans should also last a maximum of 60 minutes. All patients will undergo surgery for biopsy/resection of the tumour as part of the standard of care. All routine surgical procedures, pre-surgical and post-surgical care will take place predominantly at King's College Hospital site. Before craniotomy takes place for tumour resection, the neurosurgeon will take 3 tissue samples of the tumour. This will occur via stereotactic (computer-guided) biopsies. A needle will be guided through to a location of interest determined by the novel MRI techniques. This should result in an extension of the surgery time of approximately 30 minutes (10 minutes per biopsy), in addition to the approximately 4 hours needed for the surgery. After removal, each biopsy specimen is put into a suitable container for preservation. The container will be de-identified and shipped to the Department of Pathology, Erasmus University Rotterdam, The Netherlands where the specimen will be securely stored. The samples will be cut and slide-mounted for staining. When looking at the specimen under a microscope, particular features which suggest how aggressive the tumour is will be looked for. Information gathered from the tissue biopsies will then be compared and matched to information on the original MRI scan to see whether the novel images obtained can accurately predict the aggressiveness of different parts of the tumour.

Arms & Interventions

Arms

Experimental: Brain tumour patients

Patients will be those undergoing routine care of primary brain tumours. Study group patients will undergo additional MRI sequences and biopsies in addition to the standard of care.

Interventions

Diagnostic Test: - Advanced MRI sequences

Advanced MRI sequences which look to a) determine structure of a primary brain tumour and b) metabolism within a primary brain tumour

Contact a Trial Team

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