Clinical Trial Details
— Status: Active, not recruiting
Administrative data
NCT number |
NCT03948490 |
Other study ID # |
19103 |
Secondary ID |
NCI-2019-03245 |
Status |
Active, not recruiting |
Phase |
N/A
|
First received |
|
Last updated |
|
Start date |
June 7, 2019 |
Est. completion date |
March 31, 2025 |
Study information
Verified date |
February 2024 |
Source |
University of California, San Francisco |
Contact |
n/a |
Is FDA regulated |
No |
Health authority |
|
Study type |
Interventional
|
Clinical Trial Summary
Patients with glial brain tumors have increasingly improved outcomes, with median survival of
5-15 years. However, the treatments, including surgery, radiation, and chemotherapy, often
lead to impaired attention, working memory, and other cognitive functions. These cognitive
deficits frequently have significant impact on patient quality of life. Although currently,
there is no established standard of care to treat cognitive deficits in brain tumor patients,
standard cognitive rehabilitative treatments have been developed for those with traumatic
brain injury and stroke. However, the feasibility and efficacy of these cognitive treatments
in individuals with brain tumors remains unclear.
Description:
This trial studies how well cognitive rehabilitation therapy works in improving cognitive
function in patients with lower grade gliomas. Patients with low grade gliomas frequently
have symptoms of cognitive impairment, such as difficulty with short term memory and
processing information, that impacts their daily lives. The ReMind application (app) is an
iPad app developed for cognitive rehabilitation for patients. The healthy texting platform
was developed to help patients with depression and cognitive difficulty to provide education
and track their mood. Methods of cognitive rehabilitation therapy such as in person cognitive
rehabilitation, computerized cognitive rehabilitation, and healthy text messaging may help
improve cognition and quality of life in patient with low grade gliomas.
PRIMARY OBJECTIVES:
- Assess feasibility of each interventional arm independently (Arm 1)
- Detect a decline of >= 1.5 standard deviation (SD) from baseline on the Wechsler Adult
Intelligence Scale (WAIS)- IV Working Memory Score or Hopkins Verbal Learning Test
(HVLT) during the 36 month follow-up after surgery. (Arm 2)
SECONDARY OBJECTIVES:
- Measure changes in cognition at post-intervention and follow-up for each cohort - cohort
1 in-person; cohort 1A telehealth; cohort 2 ReMind; and cohort 3 short message service
(SMS) texting - at 3 months and 6 months post-intervention. (Arm 1)
- Measure changes in health related quality of life (HRQOL) at post-intervention and
follow-up for each cohort - cohort 1 in-person; cohort 2 ReMind; and cohort 3 SMS
texting - as captured by Patient Reported Outcomes Measurement Information
System-quality of life (PROMIS-QOL) - at 3 months and 6 months post-intervention. (Arm
1)
- Assess relationships between cognitive changes and clinical factors (molecular subtype,
age, tumor location, treatment, and radiation fields when appropriate). (Arm 2)
- Assess relationships between cognitive changes and serial magnetic resonance (MR)
imaging (T2 and contrast-enhancing tumor volume, diffusion tensor imaging (DTI) scalar
quantification, structural connectivity, resting-state functional magnetic resonance
imaging (fMRI) connectivity). (Arm 2)
- Assess relationships between HRQOL and cognitive changes. (Arm 2)
EXPLORATORY OBJECTIVES:
- Assess relationships between cognitive and HRQOL. (Arm 1)
- Assess relationships between cognitive changes and clinical factors (molecular subtype,
age, tumor location, and radiation fields when appropriate). (Arm 1)
- Assess relationships between HRQOL changes and clinical factors (molecular subtype, age,
tumor location, and radiation fields when appropriate). (Arm 1)
- Assess relationships between cognitive changes and serial MR imaging (T2 and
contrast-enhancing tumor volume, DTI scalar quantification, structural connectivity,
resting-state fMRI connectivity). (Arm 1)
- Identify predictive power of tumor characteristics (tumor volume, location, molecular
characteristics), patient characteristics (extent of resection, treatment, and radiation
fields when appropriate), imaging characteristics (e.g. fMRI, DTI changes), and decline
in cognition or HRQOL. (Arm 2)
OUTLINE:
Patients are invited to participant in Cohort 1A. Patients unable to participant in Cohort 1A
are randomized to Cohort 2 or Cohort 3.
ARM 1:
- COHORT 1 (CLOSED): Patients receive standard in-person cognitive rehabilitation sessions
with a neuropsychologist every 2 weeks over 1 hour each for 12 weeks.
- COHORT 1A: Patients receive telehealth cognitive rehabilitation with University of
California, San Francisco (UCSF) Zoom visits with a neuropsychologist who specializes in
brain tumors over 60 minutes every 2 weeks for 3 months.
- COHORT 2 (CLOSED): Patients receive computerized cognitive rehabilitation using the
ReMind app over 3 hours per week for 12 weeks.
- COHORT 3 (CLOSED): Patients receive healthy text messages daily at random points during
the week (Monday - Friday) for 12 weeks.
ARM 2:
- COHORT 4: Patients who receive radiation after surgery, undergo longitudinal cognitive
and health related quality of life assessments prior to surgery, prior to start of
radiation, at 4-6 week after radiation, 6 and 12 months after surgery, and then every 6
months for 36 months after surgery.
- COHORT 5: Patients who do not receive radiation after surgery, undergo longitudinal
cognitive and health related quality of life assessments prior to surgery, within 1
month after surgery, 2-4 months after surgery, 6 and 12 months after surgery, and then
every 6 months for 36 months after surgery.
After completion of study, patients in cohorts 1-3 are followed up at 3 and 9 months.