Conditions: Brain Neoplasms
Keywords: Combidex Diagnostic imaging
Allocation: NON_RANDOMIZED | Intervention model: PARALLEL
Enrollment: 116
Healthy volunteers: no

Brief summary:
Combidex (ferumoxtran-10) is an ultra-small iron oxide particle covered with a sugar coating. It has been evaluated as an MRI contrast agent for use in imaging well perfused organs such as the liver and spleen and for imaging lymph nodes. In this study, Combidex is being used to compare the standard imaging agent, Gadolinium, in imaging brain tumors and the area adjacent to the tumor location. Combidex may provide the ability to better see brain tumors and inflammatory lesions on magnetic resonance imaging (MRI) scans. Combidex may be useful in its ability to cross blood vessels into brain tumors, and because of its size and ability to get into the area next to brain tumors, could assist in the treatment of brain tumors with other drugs in the future.

Detailed description:
Subjects are recruited as patients in one of the neurology, neurosurgery or neuro-oncology clinics at OHSU. There are four groups of the study:

* Subjects receive the combidex infusion only.
* Subjects receive Combidex and undergo a previously schedule neurosurgery.
* Subjects undergo surgery only and provide a sample of their tumor tissue to be used in pathology studies of Combidex.
* Subjects with MS or stroke are invited to participate in receiving Combidex to evaluate the effectiveness of enhancing the area of damage within the brain.

Subjects are deemed eligible for the study and undergo a baseline MRI within 28 days of receiving Combidex. Subjects receiving Combidex are admitted for a half day into the Oregon Clinical \& Translational Research Institute(OCTRI). Combidex is infused I.V. over 30 minutes. Subjects are monitored for side effects and are discharged within about 5 hours after the infusion, if no complications have been noted. Subjects return 24 hours after the infusion for a post infusion MRI scan and return again to one of the neurology clinics for one month follow-up. Subjects enrolled in group 2 undergo surgery 1-2 days after the Combidex infusion and also undergo a 24 post infusion MRI and return for one month follow-up. These subjects are also followed closely by the neurosurgical physician during the course of follow-up. Subjects enrolled in group 3 only undergo surgery and agree to have a piece of their tumor resection or biopsy donated for use in the study. Group 4 is the same as group 1, except the patient population includes multiple sclerosis and stroke instead of patients with brain tumors.

Arms:
arm 1: Adults with brain tumor to receive Combidex infusion only arm 2: Adults with brain tumors to receive Combidex infusion and neurosurgery arm 3: Adults with brain tumors to receive neurosurgery only (NO Combidex) arm 4: Children with brain tumors to receive Combidex only arm 5: Children with brain tumors to receive Combidex and neurosurgery arm 6: Children with brain tumors to receive neurosurgery only, NO Combidex arm 7: Adults with Inflammatory lesions (stroke or MS) to receive Combidex only

Interventions: intervention 1: Ferumoxtran-10 (Combidex) intervention 2: Neurosurgery
Intervention descriptions: intervention 1: 2.6 mg/kg intervention 2: neuro-surgical tumor biopsy or resection to assess particle localization. Biopsy (stereotactic, when possible) will take place following the 24 hour post- Combidex MR and within 48 hrs of i.v. Combidex administration. Biopsies will be taken from the tumor, brain around tumor (BAT) and brain distant to tumor and the MR localization and histology will be compared. The tissue will be obtained by either resection or needle frameless stereotactic biopsy.

Protocol document: