A Study Comparing Green Fluorescent Dye and Radioactive Dye for Sentinel Lymph Node Biopsy in Pediatric Cancers

Overview

This study is being done in patients that have tumors to find out how well sentinel lymph nodes (SLNs) can be found with a special dye called indocyanine green (ICG).

Full Title of Study: “Non-inferiority Study of Intra-operative Indocyanine Green Fluorescent Dye Versus Technetium Lymphoscintigraphy for Sentinel Lymph Node Biopsy in Pediatric Malignancies”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: N/A
    • Intervention Model: Single Group Assignment
    • Primary Purpose: Diagnostic
    • Masking: None (Open Label)
  • Study Primary Completion Date: September 2021

Interventions

  • Procedure: Sentinel Lymph Node Biopsy
  • Drug: indocyanine green (ICG)

Arms, Groups and Cohorts

  • Experimental: Sentinel Lymph Node Biopsy
    • This is a single-center clinical trial to evaluate non-inferiority of ICG-guided SLN biopsy compared with the gold standard TcL-guided SLN biopsy in pediatric patients with solid tumors. Each patient will undergo TcL, consistent with the standard of care, but the surgeon will be blinded to the results preoperatively. Intraoperatively, ICG injection and transdermal lymphography will be used to identify the draining nodal basin and the position of the sentinel nodes. ICG transdermal lymphography will be considered successful if SLNs can be visualized on near-infrared imaging. After the transdermal lymphography results have been recorded, the surgeon will be unblinded to the TcL mapping.

Clinical Trial Outcome Measures

Primary Measures

  • % of patients in whom a Sentinel Lymph Node is identified
    • Time Frame: 1 year
    • These percentages will be compared using a non-inferiority comparison for matched pair data.

Participating in This Clinical Trial

Inclusion Criteria

  • Patients <30 years old with an extracoelomic solid tumor, diagnosis confirmed at the enrolling institution, requiring SLN biopsy
  • Women of childbearing potential must have a negative pregnancy test (urine or blood) pre-operatively as per the standard hospital policy. A woman of childbearing potential is defined as one who is biologically capable of becoming pregnant.
  • Patients who are cleared for surgery

Exclusion Criteria

  • History of reaction to ICG, iodides, or technetium radiocolloid
  • Intracoelomic primary tumors or tumors expected to drain to an intracoelomic SLN
  • Patients with extensive prior surgery at the primary site or nodal basin expected to affect the lymphatic drainage
  • Patients unwilling or unable to sign informed consent
  • Women who are pregnant or breast-feeding

Gender Eligibility: All

Minimum Age: N/A

Maximum Age: 30 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Memorial Sloan Kettering Cancer Center
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • Todd Heaton, MD, Principal Investigator, Memorial Sloan Kettering Cancer Center

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