Recurrent High Grade Glioma Treated by LITT

Study Overview
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Brief Summary
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This clinical trial aims to investigate the efficiency and safety of laser interstitial thermal therapy (LITT) in recurrent high-grade glioma (rHGG) patients. The main questions it aims to answer are: The LITT would increase the progression-free survival and overall survival of rHGG patients compared to other treatments. The LITT is safe and applicable to rHGG patients Participants will be randomized to the intervention group (LITT) or control group at a ratio of 2:1. The intervention group patients will receive LITT. The control group will be treated with any other treatment. The primary outcome of this trial is progression-free survival. The estimated sample size is 135, 90 in the LITT group and 45 in the control group.

Official Title
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Randomized Clinical Trial of Efficiency and Safety of Recurrent High Grade Glioma Treated by Laser Interstitial Thermal Therapy

Conditions
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Recurrent High Grade Glioma

Intervention / Treatment
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* Device: LITT
* Other: Control


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Aged 18 years old or above; Patients with previous pathological diagnosis of 2021 World Health Organization Classification of Central Nervous System Tumors (WHO CNS5) grade 3 or 4 glioma and received standard treatment; Meet any of the following: Meets the disease progression criteria in the Response Evaluation of Neuro-Oncology (RANO) criteria; At least one image other than T1 contrast indicates progression; Pathology shows progression or recurrence; Other progress determined by the Clinical Events Committee (CEC); All tumor lesions are located supratentorial and the maximum cross-sectional short-axis length in the T1 contrast is ≤30 mm; Karnofsky score (KPS) ≥ 60 and the patient can tolerate the intervention; The subjects or their agent can understand the purpose of the trial, show sufficient compliance with the trial protocol, and sign the informed consent form. Exclusion Criteria: Patients may benefit from other treatments or may not benefit from this trial; No more than three months since the patient underwent craniotomy; MRI contrast cannot be performed; Severe coagulation disorder; Women who are pregnant, lactating, or planning to become pregnant within 6 months; Participated in any other clinical trials of drugs or medical devices within 3 months; Combined diseases that may interfere with treatment or prognosis assessment; Refuse or unlikely to complete follow-up assessment; Other circumstances in which the researcher deems it inappropriate to participate in this clinical trial.

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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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: LITT<br>LITT+potential other treatment | Device: LITT<br>* The patients in the intervention group will receive LITT, other treatments, including systematic therapy and radiology therapy, would be not restricted except the craniotomy of resection before tumor progression or emergency. The patient is supposed to receive LITT post-randomization within 7 days.<br>|
| Active Comparator: Control<br>Best medical management under guidelines | Other: Control<br>* The patients in the control group will receive the best medical management under guidelines except LITT before tumor progression. Craniotomy will not be restricted,<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Progression-free survival | The progression was defined by RANO criteria and assessed by the third-party clinical events committees which are blinded to the allocation. | estimate 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Lesion ablation rate | LITT group only, measured on enhanced MRI within 2 days post LITT | within 2 days Post LITT | 
| Lesion remaining volume | LITT group only, measured on enhanced MRI within 2 days post LITT | within 2 days Post LITT | 
| Overall survival |  | up to 2 years | 
| Karnofsky Performance Status (KPS) shift | The difference between baseline KPS and follow-up KPS | Day 30,Day 90, Day 180 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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laser interstitial thermal therapy, Recurrent High Grade Glioma