Using Cytalux for better cancer surgery in children

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This clinical trial investigates the safety and feasibility of using Cytalux, a tumor imaging agent, during surgery to remove lung metastases in pediatric patients aged 6-17 with confirmed cancer. The study aims to enhance fluorescence-guided surgery by targeting tumor-specific receptors, potentially improving the detection of small metastatic nodules. Participants will undergo pulmonary metastasectomy, and the effectiveness of Cytalux in improving surgical outcomes will be evaluated. The trial builds on previous findings in adults, suggesting that this approach could be beneficial for children as well.

Why it matters

Who can join: the full rules

Inclusion Criteria:

1. Patients 6-17 years of age at the time of study enrollment
2. Willingness of research participant or legal guardian/representative to give written informed consent
3. Willingness of patients (subjects) age 12-17 to provide written adolescent assent
4. Patient weight greater than or equal to 20 kg
5. Histologically confirmed diagnosis of osteosarcoma, synovial sarcoma, hepatoblastoma, rhabdomyosarcoma, Ewing sarcoma, Wilms tumor or other non-rhabdomyosarcoma soft tissue sarcoma
6. Imaging findings highly suspicious for pulmonary metastatic disease based on CT, PET-CT or other imaging and warranting pulmonary surgery based on the judgment of the treating team. At least one nodule ≥4mm measured by preoperative imaging.
7. Female (assigned female at birth) participant is not pregnant and agrees to an acceptable form of contraception from the time of consent through 30 days after study intervention. Confirmed abstinence is an acceptable form of contraception.
8. Female (assigned female at birth) participant must agree to not donate ova from time of consent until 30 days after study intervention
9. Male (assigned male at birth) participant must agree to not donate sperm from time of consent until 30 days after study intervention.

Exclusion Criteria:

1. Any medical condition that in the opinion of the investigators could potentially jeopardize the safety of the subject
2. History of anaphylactic reactions to products containing indocyanine green for near infrared imaging. Subjects with a medical history of 'idiopathic anaphylaxis' will also be excluded.
3. History of allergy to any of the components of CYTALUX™ (PAFOLACIANINE) INJECTION
4. Presence of any psychological, familial, sociological condition or geographical challenges potentially hampering compliance with the study protocol or follow-up schedule
5. Impaired renal function defined as eGFR\< 50 mL/min/1.73m2
6. Impaired liver function defined as values \> 3x the upper limit of normal (ULN) for alanine aminotransferase (ALT) or aspartate aminotransferase (AST), alkaline phosphatase (ALP), or \>2x ULN for total bilirubin except in subjects with Gilbert's syndrome.
7. Patient unable or unwilling to discontinue folate, folic acid, or folate-containing supplements 48 hours before study drug administration
8. History of drug-related serious adverse event with prior Cytalux administration will be an exclusion for re-enrollment for contralateral surgery (see section 5.7).
9. Participants will be excluded if their 12th or 18th birthday would occur during study participation
10. Male sex at birth and commitment to acceptable form of contraception from time of consent through 30 days after study intervention with confirmed abstinence as an acceptable form of contraception as an inclusion criterion.

Where it's running

• Ann & Robert H. Lurie Children's Hospital
  Chicago, Illinois, United States Recruiting

Study contacts

• Principal investigator: Timothy Lautz, MD — Ann & Robert H Lurie Children's Hospital of Chicago
• Study coordinator: Timothy Lautz, MD
• Email: tlautz@luriechildrens.org
• Phone: 312-227-4210

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.