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NCT ID: NCT04758455 Recruiting - Death Clinical Trials

The Use of Immunohistochemical Staining for the Prediction of Wilms Tumour Progression and Recurrence

Start date: February 14, 2021
Phase: N/A
Study type: Interventional

Wilms' tumour staging and grading are used to give an idea about the prognosis. Advanced staging, diffuse anaplasia, predominant blastemal elements and lymph node invasion are indicators of poor prognosis. In spite of using the previously mentioned parameters, some tumours which were considered of low risk did not respond to therapy and eventually resulted in mortality. In contrast, other tumours assumed to be of poor prognosis responded dramatically to treatment. In light of the above, it is crucial to search for predictors of Wilms' tumour prognosis other than tumour staging and grading. Many immunohistochemical (IHC) stains have been studied as prognostic markers for nephroblastoma in literature.

NCT ID: NCT04723901 Recruiting - Relapse Clinical Trials

Dual Target CAR-T Cells in B-cell Acute Lymphoblastic Leukemia

CAR-T
Start date: October 20, 2020
Phase: Phase 1/Phase 2
Study type: Interventional

Prospectively evaluate the safety and effectiveness of CD19/CD22 dual-target CAR-T cells in the treatment of relapsed/refractory B-cell acute lymphoblastic leukemia.

NCT ID: NCT04674345 Recruiting - Acute Leukemia Clinical Trials

Sorafenib Maintenance for Prophylaxis of Leukemia Relapse in Allo-HSCT Recipients With FLT3 Negative Acute Leukemia

Start date: December 15, 2020
Phase: Phase 2/Phase 3
Study type: Interventional

The purpose of this study is to evaluate the efficacy and safety of sorafenib maintenance after allo-HSCT in FLT3-negative acute leukemia patients.

NCT ID: NCT04662138 Recruiting - Hepatitis C Clinical Trials

Safety and Efficacy of Different Antiviral Regimens for Hepatitis C Virus Relapse

Start date: August 24, 2020
Phase:
Study type: Observational

The primary goal of hepatitis C virus (HCV) Direct Acting Antivirals (DAAs) is to achieve undetectable HCV RNA in the blood. A response that should be maintained for at least 12 weeks from completion of therapy. This is called sustained virological response (SVR) which corresponds to cure of HCV infection as risk of later relapse is very small. SVR is important to achieve improvement in liver necroinflammation and fibrosis and to decrease complications of cirrhosis. Failing to achieve SVR after treatment requires another regimen for these experienced patients. Real-world data are always needed to evaluate and improve our practices. Here investigators aim to assess tolerability and efficacy of different regimens used for management of genotype 4 HCV relapse.

NCT ID: NCT04228315 Recruiting - Malaria Clinical Trials

Biomarkers of P. Vivax Relapse

Start date: November 19, 2019
Phase: N/A
Study type: Interventional

Plasmodium vivax malaria is difficult to manage because even after taking medicine that kills the infection in the blood, it can continue to hide quietly in the liver, later re-emerging into the blood and causing another episode of malaria illness (relapse). This clinical trial aims to enroll patient with P. vivax infections and try to detect signals in blood, urine and/or saliva coming from the silent liver stages to help identify who could benefit from treatment with primaquine. It also will explore if certain factors of patients negatively impact primaquine efficacy.

NCT ID: NCT04176718 Recruiting - Multiple Myeloma Clinical Trials

Daratumumab, Carfilzomib, Pomalidomide, Dexamethasone In MM

Start date: May 18, 2020
Phase: Phase 2
Study type: Interventional

This research study is studying the combination of daratumumab with weekly carfilzomib, pomalidomide, and dexamethasone in people with relapsed and refractory multiple myeloma. Relapsed and Refractory Multiple Myeloma is the condition of returned or previous treatment resistant Multiple Myeloma. This research study involves two study drugs and two standard of care drugs. - The names of the study drugs involved in this study are: - Carfilzomib - Daratumumab - The names of the standard of care drugs involved in this study are: - Dexamethasone - Pomalidomide

NCT ID: NCT04162041 Recruiting - Solid Tumors Clinical Trials

Topotecan Plus M6620 (VX-970) vs. Topotecan Alone in People With Relapsed Small-Cell Lung Cancer

Start date: November 20, 2019
Phase: Phase 2
Study type: Interventional

Background: Small cell cancers are aggressive and grow fast. They can appear in the lungs and in other parts of the body. These tumors often don t respond well to treatment if they come back after chemotherapy. Treatment with two drugs combined may be able to help. Objective: To compare M6620 plus topotecan to topotecan alone in people with small cell lung cancer (SCLC). Also, to test the effects of M6620 plus topotecan in people with small cell cancer outside the lungs. Eligibility: People ages 18 and older with relapsed SCLC or small cell cancer outside the lungs Design: Participants will be screened with: Physical exam Blood and heart tests CT scan Tumor biopsy: This is mandatory for participants with SCLC. It is optional for those with small cell cancer outside the lungs. Participants with SCLC will be randomly assigned to 1 of 2 groups: to receive either M6620 and topotecan or topotecan alone. Outside of the lungs small cell cancer participants will be assigned to receive both drugs. Participants will receive treatment in 21-day cycles. They will get topotecan through a vein in the arm on days 1 5 of each cycle. Some participants also will receive M6620 through a vein in the arm on days 2 and 5 of each cycle. Participants will have blood tests and physical exams every cycle. They will have CT scans every 6 weeks. Participants will continue treatment as long as their cancer does not get worse and they can handle the side effects. After treatment, participants will have visits every 3 months. Visits will include blood tests and CT scans. Patients randomized 2:1 ie 2 times more likely to get the combination vs. single drug Patients who receive single drug may receive the combination at the time of progression

NCT ID: NCT03710512 Recruiting - Relapse Clinical Trials

Evaluation of Early Relapse After Mandibular Lengthening Surgery

Start date: September 11, 2018
Phase:
Study type: Observational [Patient Registry]

The goal of this study is to evaluate whether the use of a bone graft substitute at the osteotomy site will result in better stability and diminish early relapse after mandibular lengthening surgery. The study focuses on the evaluation of the following hypothesis: The use of bone graft substitute at the osteotomy site has an influence on: - The 3-dimensional stability of the osteotomy site - Early relapse based in the plasticity of the site

NCT ID: NCT03691077 Recruiting - Multiple Sclerosis Clinical Trials

Effect of Ocrelizumab on Brain Innate Immune Microglial Cells Activation in MS Using PET-MRI With 18F-DPA714

INN-MS
Start date: November 11, 2018
Phase: Phase 3
Study type: Interventional

Ocrelizumab is a humanized anti-CD20 monoclonal antibody that showed in phase III trials a powerful effect on relapse rate and lesion load accumulation in the relapsing form of multiple sclerosis (RMS). This therapeutic agent also showed for the first time a significant reduction of disability progression in Primary Progressive Multiple Sclerosis (PPMS) patients, whereas all other anti-inflammatory drugs had failed to do so in well-conducted studies. This raises the possibility that ocrelizumab, beyond its effects on the adaptive immune system activation underlying white matter lesions and clinical relapses, could beneficially influence other mechanisms involved in the progressive phase of the disease, such as the innate immune microglial cells activation, that has been described to persist in a diffuse manner in the Central Nervous system (CNS). To date the activation of these cells is not accessible to classical Magnetic Resonance Imaging (MRI) techniques, impeding the full investigation of the therapeutic efficacy of drugs such as ocrelizumab.

NCT ID: NCT03672721 Recruiting - Clinical trials for Glioblastoma Multiforme

IA Carboplatin + Radiotherapy in Relapsing GBM

Start date: July 10, 2018
Phase: Phase 1/Phase 2
Study type: Interventional

Treatment of glioblastoma involves an optimal surgery, followed by a combination of radiation and temozolomide chemotherapy. Progression-free survival (PFS) with this treatment is only 6.9 months and relapse is the norm. The rationale behind the fact that limited chemotherapy agents are available in the treatment of malignant gliomas is related to the blood-brain barrier (BBB), which limits drug entry to the brain. Intraarterial (IA) chemotherapy allows to circumvent this. Using IA delivery of carboplatin, the investigators have observed responses in 70% of patients for a median PFS of 5 months. Median survival from study entry was 11 months, whereas the overall survival 23 months. How can this be improved? By coupling radiation with a chemotherapeutic which is also a potent radiosensitizer such as carboplatin. Study design: In this phase I/II trial, patients will be treated at recurrence; a surgery will be performed for cytoreduction and to obtain tumor sample, followed with a combination of re-irradiation and IA carboplatin chemotherapy. A careful escalation scheme from 1.5Gy/fraction up to 3.5Gy/fraction will allow the investigators to determine the optimal re-irradiation dose (10 fractions of radiation over 2 weeks). Toxicity will be assessed according to the NCIC common toxicity criteria. Combined with radiation, patients will receive 2 treatments of IA carboplatin, 400 mg/m2, 4 hours prior to the first and the sixth radiation fraction. IA treatments will then be continued on a monthly basis, up to a total of 12 months, or until progression. Outcome measurements: Tumor response will be evaluated using the RANO criteria by magnetic resonance imaging monthly. The investigators will also acquire a sequence that enables the measurement of cerebral blood flow, cerebral blood volume and blood vessel permeability that are all relevant to understand the delivery of therapeutics to the CNS. Primary outcome will be OS and PFS. Secondary outcome will be QOL, neurocognition, and carboplatin delivery. In vitro intracellular carboplatin accumulation: Tumor samples from re-operation will be be analyzed for intracellular Pt concentration by ICP-MS. The amount of Pt bound to DNA will be measured. The level of apoptosis will be determined for each of the sample. Putting together these data will allow to correlate clinical and radiological response to QOL, NC (MOCA), and to delivery surrogates for the IA infusion and intracellular penetration of carboplatin.