Targeting the Mechanisms Underlying Cutaneous Neurofibroma Formation in NF1: A Clinical Translational Approach.

Study Overview
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Brief Summary
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The purpose of the research study is intended to use specimens (such as tissue) and medical information in the Laboratory of Musculoskeletal Oncology at the Van Andel Research Institute for laboratory research in Grand Rapids, Michigan. Small tissue samples of cutaneous neurofibromas will be collected as part of this research. The samples will help researchers learn more about cutaneous neurofibroma and help them better understand NF1. There are many different types of studies, both now and in the future, that can be done using the specimens they receive. These include using the specimens and information to look for new ways to diagnose and treat Neurofibromatosis Type 1 (NF1). The specimens may be used to study how genes affect health and disease, or how genes affect the way a disease or condition responds to treatment. Some of these studies may lead to new products, such as treatments or tests for diseases. Through this study, we hope to find better ways to understand and treat NF1 in the future.

Detailed Description
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Skin tumors in Neurofibromatosis Type 1 (NF1) are very common and diminish quality of life. Apart from surgery, very few treatment options exist. In comparison to other types of tumors in NF1, skin tumors receive less attention in the research world because they almost never turn into cancer. Under the microscope, skin tumors and plexiform tumors look similar, however they do not share the same growth potential, nor do they appear at the same time during development. These differences suggest that skin tumors are driven by different factors than plexiform tumors. In this study we will be harvesting CNFs from 3 groups of subjects in order to obtain a minimum of 18 tumors in three size categories: <5mm, 5-10mm, and >1cm. These sizes were selected based on the variable natural history of CNF progression where incipient lesions (typically <5mm) are more numerous and demonstrate a less aggressive growth pattern, whereas the intermediate group (5-10mm) represent a transition state towards growth to larger (>1cm) lesions. Interestingly, CNF growth tends to stall out at 3cm. We plan to do experiments that identify which factors are important to CNF progression, and then find matching drugs that can shrink the tumors.

Official Title
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Targeting the Mechanisms Underlying Cutaneous Neurofibroma Formation in NF1: A Clinical Translational Approach.

Conditions
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Cutaneous Neurofibromas, Neurofibromatosis Type 1, Plexiform Neurofibromas

Intervention / Treatment
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* Procedure: Skin Biopsy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Any subject with an established diagnosis NF1 and CNFs. The diagnosis may be based on clinical criteria or genetic testing. Age >18 years. Specific Vulnerable Populations:Pregnant women and Adults with diminished decision-making capacity with defined legal guardian. Exclusion Criteria: Adults with diminished decision-making capacity with no defined legal guardian. Prisoners. Breastfeeding mothers.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Procedure: Skin Biopsy|The procedure to sample the cutaneous neurofibroma involves a skin incision and will take approximately 10 to 15 minutes. The tissue will be taken in the following way: The skin area will be cleaned The skin area will be numbed (by either a numbing cream or a tiny numbing shot) Cutaneous (skin) Neurofibroma: will be taken via a small incision and removal of the neurofibroma whenever possible. A small piece of normal (skin) tissue will be numbed as above and taken using a special skin biopsy device. Afterward, the area will be cleaned and the skin put back together with medical super glue or 1 to 2 dissolvable stitches that will dissolve as the incision heals, they do not require removal. The purpose of taking this piece of skin is to compare normal skin with the skin of a cutaneous neurofibroma.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Harvesting Up To 74 CNFs From Patients to obtain 8 tumors in three size categories: <5mm, 5-10mm, and >1cm. | Identify which factors are important to CNF progression, and then find matching drugs that can shrink the tumors and improve quality of life. | 2 Years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| UV Exposure and NF1 History Questionaires | Measuring the relationship between sun exposure and CNF growth and development. | 2 Years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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NF1, CNF, PNF, Skin Tumors