Brain TumorsNCT02367469
Tryptophan Metabolism in Human Brain Tumors
An observational study of Brain Tumors, run by Wayne State University at 1 site in United States.
Trial summary
The main purpose of this study is to determine the potential clinical utility of PET imaging using the radiotracer [C-11]alpha-methyl-L-tryptophan in the diagnosis, differentiation and monitoring of various brain tumors, both before and after initial treatment. Read more about this study
- Who is it for?
- Ages 13 years and older
- Conditions the study is for
- Brain Tumors
- How many people
- 105 participants
- Where
- 1 siteUnited States
- Study dates
- Feb 2014to 31 Dec 2021
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 13 years and older
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Study population: Patients with newly diagnosed or recurrent brain tumors will be studied.
Who may be able to join
- Clinical and MRI diagnosis of an intracranial lesion suspicious for a brain tumor, including primary and metastatic tumors, or a possible residual or recurrent brain tumor (based on clinical imaging); or history of glioma treatment with chemoradiation, even if no definite progression is found on clinical MRI.
- Age ≥13 years.
Who cannot join
- Severe increased intracranial pressure, status epilepticus, or other symptoms requiring emergency or urgent intervention.
- Resective surgery within 2 months prior to the PET scan (acute/subacute post-surgical inflammatory changes may cause false positive increases on AMT PET).
- Positive pregnancy test (because of radiation involved in PET scanning).
Trial locations and contacts
1 site in 1 country.
About this study
The main purpose of this study is to determine the potential clinical utility of PET imaging using the radiotracer [C-11]alpha-methyl-L-tryptophan in the diagnosis, differentiation and monitoring of various brain tumors, both before and after initial treatment. We will also study mechanisms and clinical significance of abnormal brain tumor tryptophan metabolism using resected tumor tissues.
Read the detailed description
If you agree to take part in this research study, you will be asked to have:
- a PET scan, 2. brief clinical questionnaires, and 3. biochemical studies of blood and tumor tissue. You may also have a second PET scan later, if you undergo therapy (such as surgery and/or brain radiation), to determine if there are PET signs of tumor. Your ability to participate in the study will be based, in part, on the results of the magnetic resonance images (MRI) in your medical chart from earlier clinical procedures. Once we receive the results of the PET scan, these will be compared to the MRI in order to help us analyze whether the tryptophan uptake tells us anything about the type of tumor in your brain. It will take about 3 hours to complete the PET scan; this includes the completion of the questionnaires, preparation and scanning. The actual scanning time will be 70 minutes. If you are a female of child-bearing age, we will need a small urine sample from you before starting the PET scanning procedure to make absolutely sure that you do not have unknown pregnancy for which radiation exposure might be harmful.
- The PET scan will be used to measure the accumulation of the injected radioactive tracer AMT in your brain. To make this measurement more accurate, we will use your clinically obtained MRI scan(s), which was used to diagnose the tumor, to identify the exact location and extent of the tumor. For the PET scan, an intravenous catheter (a small tube placed in your vein) will be inserted for the injection of the AMT for this PET scan. It is the tracer that the PET scanner "sees" when performing the scan. The amount of the tracer, which will be given is very small (5 ml, the volume of a teaspoon), and therefore no side effects are expected from the tracer itself. A second intravenous catheter will be inserted to collect blood samples during the scan; a total of less than 2 teaspoons of blood will be collected. Participants may be sedated (put into sleep with some medicine) if they are unable to remain still for the scanning period.
- On the day of the PET scan, we will ask you to fill out a brief clinical questionnaire, and also an additional multiple-choice questionnaire to screen for potential mood problems (which often coincide with brain tumors). Participants with a potential speech (comprehension) problem will also be administered a brief speech test. The goal of these tests is to identify various clinical problems that can be associated with brain tumors and affected by abnormal tryptophan metabolism that we measure with the PET scan.
- If you have surgery to remove the tumor, a portion of the removed tissue will be used for biochemical studies. The doctor will not remove more tissue than needed for your care. The blood (obtained during the PET scanning) and tumor tissue (obtained during surgery) will be processed for analysis and stored in a locked container or freezer in a laboratory. In addition, we will review the clinical pathology report, so that we can correlate your PET results to type and grade of the tumor.
- Conditions
- Brain Tumors
- Keywords
- recurrent brain tumors, brain tumors, Newly diagnosed brain tumors
- Medical subject headings
- Brain Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
| Study group | Role | What they receive |
|---|---|---|
| Brain Tumors | Patients with newly diagnosed or recurrent brain tumors will be studied. |
What is being measured
The primary outcome is the main question the study is designed to answer.
In newly diagnosed tumors
Diagnostic accuracy of AMT-PET to differentiate brain tumor types and detect tumor infiltration of the brain.
Measured: single time-point
In previously treated tumors
Accuracy of AMT-PET to predict post-treatment progression and differentiate recurrent tumors from radiation-induced changes, as compared to clinical MRI.
Measured: single time-point
Secondary outcomes (1)
Tryptophan metabolism
To evaluate activity of the kynurenine pathway of tryptophan metabolism in resected tumor tissues.
Measured: single time-point
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted20 Feb 2015 (estimated)
- Study startFeb 2014
- Primary completion31 Dec 2021
- Study completion31 Dec 2021
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (9)Papers the sponsor has linked to this study.
- Other trials for Brain TumorsStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Case-control
- Time perspective
- Prospective
- Enrolment
- 105 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Wayne State University
- Sponsor type
- University, hospital or other
- Collaborators
- National Cancer Institute (NCI)
- Responsible party
- Principal investigator, Csaba Juhasz, Wayne State University
- Investigators
- Csaba Juhasz, Principal investigator, Wayne State University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02367469
- Sponsor's protocol ID
- NCI Tryptophan
- Other IDs
- CA123451
- Status last verified
- Jan 2022
- First submitted
- 12 Feb 2015
- Last updated
- 5 Jan 2022
- Results posted
- No
- Data monitoring committee
- No
- Individual data sharing
- No
Publications
Jeong JW, Lee MH, John F, Robinette NL, Amit-Yousif AJ, Barger GR, Mittal S, Juhasz C. Feasibility of Multimodal MRI-Based Deep Learning Prediction of High Amino Acid Uptake Regions and Survival in Patients With Glioblastoma. Front Neurol. 2019 Dec 17;10:1305. doi: 10.3389/fneur.2019.01305. eCollection 2019.
PubMed 31920928John F, Robinette NL, Amit-Yousif AJ, Bosnyak E, Barger GR, Shah KD, Mittal S, Juhasz C. Multimodal Imaging of Nonenhancing Glioblastoma Regions. Mol Imaging. 2019 Jan-Dec;18:1536012119885222. doi: 10.1177/1536012119885222.
PubMed 31736437John F, Bosnyak E, Robinette NL, Amit-Yousif AJ, Barger GR, Shah KD, Michelhaugh SK, Klinger NV, Mittal S, Juhasz C. Multimodal imaging-defined subregions in newly diagnosed glioblastoma: impact on overall survival. Neuro Oncol. 2019 Feb 14;21(2):264-273. doi: 10.1093/neuonc/noy169.
PubMed 30346623Guastella AR, Michelhaugh SK, Klinger NV, Fadel HA, Kiousis S, Ali-Fehmi R, Kupsky WJ, Juhasz C, Mittal S. Investigation of the aryl hydrocarbon receptor and the intrinsic tumoral component of the kynurenine pathway of tryptophan metabolism in primary brain tumors. J Neurooncol. 2018 Sep;139(2):239-249. doi: 10.1007/s11060-018-2869-6. Epub 2018 Apr 17.
PubMed 29667084Bosnyak E, Michelhaugh SK, Klinger NV, Kamson DO, Barger GR, Mittal S, Juhasz C. Prognostic Molecular and Imaging Biomarkers in Primary Glioblastoma. Clin Nucl Med. 2017 May;42(5):341-347. doi: 10.1097/RLU.0000000000001577.
PubMed 28195901Bosnyak E, Kamson DO, Robinette NL, Barger GR, Mittal S, Juhasz C. Tryptophan PET predicts spatial and temporal patterns of post-treatment glioblastoma progression detected by contrast-enhanced MRI. J Neurooncol. 2016 Jan;126(2):317-25. doi: 10.1007/s11060-015-1970-3. Epub 2015 Oct 29.
PubMed 26514361Bosnyak E, Kamson DO, Behen ME, Barger GR, Mittal S, Juhasz C. Imaging cerebral tryptophan metabolism in brain tumor-associated depression. EJNMMI Res. 2015 Dec;5(1):56. doi: 10.1186/s13550-015-0136-9. Epub 2015 Oct 17.
PubMed 26475140Jeong JW, Juhasz C, Mittal S, Bosnyak E, Kamson DO, Barger GR, Robinette NL, Kupsky WJ, Chugani DC. Multi-modal imaging of tumor cellularity and Tryptophan metabolism in human Gliomas. Cancer Imaging. 2015 Aug 6;15(1):10. doi: 10.1186/s40644-015-0045-1.
PubMed 26245742John F, Michelhaugh SK, Barger GR, Mittal S, Juhasz C. Depression and tryptophan metabolism in patients with primary brain tumors: Clinical and molecular imaging correlates. Brain Imaging Behav. 2021 Apr;15(2):974-985. doi: 10.1007/s11682-020-00305-7.
PubMed 32767048
Study at a glance
From the registry record, last updated by the sponsor on 5 Jan 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Tryptophan Metabolism in Human Brain Tumors
- ClinicalTrials.gov ID
- NCT02367469
- Acronym / sponsor ID
- NCI Tryptophan
- Conditions
- Brain Tumors
- Keywords
- recurrent brain tumors, brain tumors, Newly diagnosed brain tumors
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 105 participants (estimated)
- Lead sponsor
- Wayne State UniversityUniversity, hospital or other
- Collaborators
- National Cancer Institute (NCI)
- Study start
- Feb 2014 (actual)
- Primary completion
- 31 Dec 2021 (actual)
- Study completion
- 31 Dec 2021 (actual)
- First posted
- 20 Feb 2015 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The main purpose of this study is to determine the potential clinical utility of PET imaging using the radiotracer [C-11]alpha-methyl-L-tryptophan in the diagnosis, differentiation and monitoring of various brain tumors, both before and after initial treatment. We will also study mechanisms and clinical significance of abnormal brain tumor tryptophan metabolism using resected tumor tissues.
Detailed description
If you agree to take part in this research study, you will be asked to have:
- a PET scan, 2. brief clinical questionnaires, and 3. biochemical studies of blood and tumor tissue. You may also have a second PET scan later, if you undergo therapy (such as surgery and/or brain radiation), to determine if there are PET signs of tumor. Your ability to participate in the study will be based, in part, on the results of the magnetic resonance images (MRI) in your medical chart from earlier clinical procedures. Once we receive the results of the PET scan, these will be compared to the MRI in order to help us analyze whether the tryptophan uptake tells us anything about the type of tumor in your brain. It will take about 3 hours to complete the PET scan; this includes the completion of the questionnaires, preparation and scanning. The actual scanning time will be 70 minutes. If you are a female of child-bearing age, we will need a small urine sample from you before starting the PET scanning procedure to make absolutely sure that you do not have unknown pregnancy for which radiation exposure might be harmful.
- The PET scan will be used to measure the accumulation of the injected radioactive tracer AMT in your brain. To make this measurement more accurate, we will use your clinically obtained MRI scan(s), which was used to diagnose the tumor, to identify the exact location and extent of the tumor. For the PET scan, an intravenous catheter (a small tube placed in your vein) will be inserted for the injection of the AMT for this PET scan. It is the tracer that the PET scanner "sees" when performing the scan. The amount of the tracer, which will be given is very small (5 ml, the volume of a teaspoon), and therefore no side effects are expected from the tracer itself. A second intravenous catheter will be inserted to collect blood samples during the scan; a total of less than 2 teaspoons of blood will be collected. Participants may be sedated (put into sleep with some medicine) if they are unable to remain still for the scanning period.
- On the day of the PET scan, we will ask you to fill out a brief clinical questionnaire, and also an additional multiple-choice questionnaire to screen for potential mood problems (which often coincide with brain tumors). Participants with a potential speech (comprehension) problem will also be administered a brief speech test. The goal of these tests is to identify various clinical problems that can be associated with brain tumors and affected by abnormal tryptophan metabolism that we measure with the PET scan.
- If you have surgery to remove the tumor, a portion of the removed tissue will be used for biochemical studies. The doctor will not remove more tissue than needed for your care. The blood (obtained during the PET scanning) and tumor tissue (obtained during surgery) will be processed for analysis and stored in a locked container or freezer in a laboratory. In addition, we will review the clinical pathology report, so that we can correlate your PET results to type and grade of the tumor.
Study design
- Observational model
- Case-control
- Time perspective
- Prospective
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Brain Tumors | – | –Patients with newly diagnosed or recurrent brain tumors will be studied. |
Who may qualify
- Ages
- 13 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
- Study population
- Patients with newly diagnosed or recurrent brain tumors will be studied.
Key inclusion criteria (2 listed)
- Clinical and MRI diagnosis of an intracranial lesion suspicious for a brain tumor, including primary and metastatic tumors, or a possible residual or recurrent brain tumor (based on clinical imaging); or history of glioma treatment with chemoradiation, even if no definite progression is found on clinical MRI.
- Age ≥13 years.
Key exclusion criteria (3 listed)
- Severe increased intracranial pressure, status epilepticus, or other symptoms requiring emergency or urgent intervention.
- Resective surgery within 2 months prior to the PET scan (acute/subacute post-surgical inflammatory changes may cause false positive increases on AMT PET).
- Positive pregnancy test (because of radiation involved in PET scanning).
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
In newly diagnosed tumors
Time frame: single time-point
Diagnostic accuracy of AMT-PET to differentiate brain tumor types and detect tumor infiltration of the brain.
In previously treated tumors
Time frame: single time-point
Accuracy of AMT-PET to predict post-treatment progression and differentiate recurrent tumors from radiation-induced changes, as compared to clinical MRI.
1 secondary outcome
Tryptophan metabolism
Time frame: single time-point
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 5 Jan 2022.
- Results publication: PubMed 31920928Jeong JW, Lee MH, John F, Robinette NL, Amit-Yousif AJ, Barger GR, Mittal S, Juhasz C. Feasibility of Multimodal MRI-Based Deep Learning Prediction of High Amino Acid Uptake Regions and Survival in Patients With Glioblastoma. Front Neurol. 2019 Dec 17;10:1305. doi: 10.3389/fneur.2019.01305. eCollection 2019.
- Results publication: PubMed 31736437John F, Robinette NL, Amit-Yousif AJ, Bosnyak E, Barger GR, Shah KD, Mittal S, Juhasz C. Multimodal Imaging of Nonenhancing Glioblastoma Regions. Mol Imaging. 2019 Jan-Dec;18:1536012119885222. doi: 10.1177/1536012119885222.
- Results publication: PubMed 30346623John F, Bosnyak E, Robinette NL, Amit-Yousif AJ, Barger GR, Shah KD, Michelhaugh SK, Klinger NV, Mittal S, Juhasz C. Multimodal imaging-defined subregions in newly diagnosed glioblastoma: impact on overall survival. Neuro Oncol. 2019 Feb 14;21(2):264-273. doi: 10.1093/neuonc/noy169.
- Results publication: PubMed 29667084Guastella AR, Michelhaugh SK, Klinger NV, Fadel HA, Kiousis S, Ali-Fehmi R, Kupsky WJ, Juhasz C, Mittal S. Investigation of the aryl hydrocarbon receptor and the intrinsic tumoral component of the kynurenine pathway of tryptophan metabolism in primary brain tumors. J Neurooncol. 2018 Sep;139(2):239-249. doi: 10.1007/s11060-018-2869-6. Epub 2018 Apr 17.
- Results publication: PubMed 28195901Bosnyak E, Michelhaugh SK, Klinger NV, Kamson DO, Barger GR, Mittal S, Juhasz C. Prognostic Molecular and Imaging Biomarkers in Primary Glioblastoma. Clin Nucl Med. 2017 May;42(5):341-347. doi: 10.1097/RLU.0000000000001577.
- Results publication: PubMed 26514361Bosnyak E, Kamson DO, Robinette NL, Barger GR, Mittal S, Juhasz C. Tryptophan PET predicts spatial and temporal patterns of post-treatment glioblastoma progression detected by contrast-enhanced MRI. J Neurooncol. 2016 Jan;126(2):317-25. doi: 10.1007/s11060-015-1970-3. Epub 2015 Oct 29.
- Results publication: PubMed 26475140Bosnyak E, Kamson DO, Behen ME, Barger GR, Mittal S, Juhasz C. Imaging cerebral tryptophan metabolism in brain tumor-associated depression. EJNMMI Res. 2015 Dec;5(1):56. doi: 10.1186/s13550-015-0136-9. Epub 2015 Oct 17.
- Results publication: PubMed 26245742Jeong JW, Juhasz C, Mittal S, Bosnyak E, Kamson DO, Barger GR, Robinette NL, Kupsky WJ, Chugani DC. Multi-modal imaging of tumor cellularity and Tryptophan metabolism in human Gliomas. Cancer Imaging. 2015 Aug 6;15(1):10. doi: 10.1186/s40644-015-0045-1.
- Results publication: PubMed 32767048John F, Michelhaugh SK, Barger GR, Mittal S, Juhasz C. Depression and tryptophan metabolism in patients with primary brain tumors: Clinical and molecular imaging correlates. Brain Imaging Behav. 2021 Apr;15(2):974-985. doi: 10.1007/s11682-020-00305-7.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Csaba Juhasz principal investigator
Wayne State University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Brain Tumors, run by Wayne State University at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 2 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 5 Jan 2022. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
In newly diagnosed tumors (time frame: single time-point). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT02367469, which also lists 9 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 5 Jan 2022.