Mapping Techniques for Recurrent Brain Cancer
(RECMAP Trial)
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial explores the best way to safely remove recurrent glioblastoma, a type of brain cancer, when it is near critical brain areas. It compares three methods: surgery with awake mapping (testing brain function while awake), asleep mapping, and no mapping. The goal is to determine which method reduces surgery-related issues and leaves less tumor behind. Individuals with recurrent glioblastoma, with tumors near areas controlling movement or speech, might be suitable for this trial. As a Phase 2 trial, this research focuses on measuring the treatment's effectiveness in an initial, smaller group, offering participants a chance to contribute to advancements in glioblastoma treatment.
Do I have to stop taking my current medications for the trial?
The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.
Is there any evidence suggesting that this trial's treatments are likely to be safe?
Research has shown that both awake and asleep mapping techniques during brain surgery are generally safe for patients. Studies indicate that the risk of temporary or permanent nerve issues after surgery is similar for both methods, meaning safety is comparable whether patients are awake or asleep during mapping.
For asleep mapping, research suggests a low rate of permanent nerve issues, particularly with less severe brain tumors. This technique helps doctors locate and avoid important brain areas during surgery, potentially improving outcomes.
Awake mapping also aids doctors in identifying and protecting critical brain areas, such as those controlling speech and movement, while the patient is awake. This can reduce the risk of affecting these functions.
Overall, both mapping methods are well-tolerated and enhance surgical safety by protecting important brain functions.12345Why are researchers excited about this trial?
Researchers are excited about this trial because it explores innovative techniques for glioblastoma surgery. Unlike traditional surgery, which typically doesn't involve mapping, this trial investigates intraoperative mapping methods—both asleep and awake—to potentially enhance tumor removal precision. Asleep mapping focuses on motor mapping while the patient is under anesthesia, and awake mapping involves motor or language mapping with the patient conscious, which might allow for better protection of critical brain functions. By comparing these approaches to standard surgery without mapping, researchers hope to identify strategies that may improve outcomes and preserve patients' quality of life.
What evidence suggests that this trial's mapping techniques could be effective for recurrent glioblastoma?
This trial will compare different intraoperative mapping techniques for tumor resection. Research has shown that both awake and asleep mapping techniques can help surgeons safely remove brain tumors like glioblastoma. These techniques involve monitoring brain functions such as movement and speech during surgery to avoid damaging critical areas. Studies indicate that both awake and asleep mapping enable surgeons to remove more of the tumor while preserving patients' abilities. Specifically, awake mapping reduces language problems, while asleep mapping is associated with fewer movement issues. Although these methods are effective for newly diagnosed tumors, their benefits for recurring glioblastoma remain under investigation.23567
Who Is on the Research Team?
Jasper Gerritsen, MD PhD
Principal Investigator
Erasmus Medical Center
Are You a Good Fit for This Trial?
Inclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Surgery
Participants undergo tumor resection with either awake mapping, asleep mapping, or no mapping
Follow-up
Participants are monitored for safety and effectiveness after surgery, with evaluations at 6 weeks, 3 months, and 6 months postoperatively
Long-term follow-up
Participants are monitored for overall survival and progression-free survival
What Are the Treatments Tested in This Trial?
Interventions
- Asleep Mapping
- Awake Mapping
- Resection without Mapping
How Is the Trial Designed?
3
Treatment groups
Experimental Treatment
No mapping: Tumor resection without intraoperative mapping
Awake mapping: Tumor resection with intraoperative awake motor or language mapping
Asleep mapping: Tumor resection with intraoperative asleep motor mapping
Find a Clinic Near You
Who Is Running the Clinical Trial?
Erasmus Medical Center
Lead Sponsor
Universitaire Ziekenhuizen KU Leuven
Collaborator
Haaglanden Medical Centre
Collaborator
University Hospital Heidelberg
Collaborator
Technical University of Munich
Collaborator
Insel Gruppe AG, University Hospital Bern
Collaborator
Massachusetts General Hospital
Collaborator
University of California, San Francisco
Collaborator
Citations
Neurological outcomes following awake and asleep ...
The rates of transient and permanent postoperative neurologic deficits among awake versus asleep cortical mapping groups are similar.
Comparative efficacy of awake and asleep motor mapping ...
This meta-analysis suggests that AC and GA are comparable approaches to maximize extent of resection and achieve safe resection in eloquent glioma surgery.
Asleep triple-modality motor mapping for perirolandic gliomas
Asleep triple motor mapping results in a low rate of permanent deficits, especially for low-grade gliomas.
Awake vs. asleep motor mapping for glioma resection
Intraoperative stimulation (IS) mapping allows real-time and accurate identification of the cortical and subcortical eloquent areas as well as tumor-related ...
a systematic review and meta-analysis - eClinicalMedicine
This study aims to evaluate the efficacy of preoperative and intraoperative mapping techniques on resection outcomes and post-operative deficits. Methods.
Neurological outcomes following awake and asleep ...
Review of the current evidence suggests that the rates of transient and permanent postoperative neurologic deficits among awake versus asleep cortical mapping ...
7.
journals.lww.com
journals.lww.com/neurosurgery/fulltext/2021/03000/clinical_pearls_and_methods_for_intraoperative.3.aspxClinical Pearls and Methods for Intraoperative Motor Mapping
The use of motor mapping improves resection and outcomes in patients harboring tumors involving motor areas and pathways, and should be considered the gold ...
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