Patients Diagnosed With a Malignant Glioma
Conditions
Keywords
Glioma, Magnetoencephalography, Intra-tumoral heterogeneity, Feasibility, Radiological patterns
Brief summary
With more than 3,000 new cases per year in France, malignant gliomas are the most common malignant brain tumors in adults. Treatment consists of surgical removal when possible. If this is not possible, a biopsy is performed to obtain a definitive anatomical and molecular diagnosis. Standard medical management after removal or biopsy is based on radio-chemotherapy. Despite this multimodal treatment, progression is the norm due to the invasive nature of these tumors. The prognosis remains very poor, with a median overall survival of around 18 months for glioblastomas. Recent preliminary data indicate that magnetoencephalography (MEG) recordings can identify functional heterogeneity within a glioma. Functional analysis of these two types of areas has shown that the expression of synaptogenic factors is increased in areas of high functional connectivity compared to areas of low functional connectivity. Areas of high functional connectivity are more aggressive and more resistant to treatment. In general, gliomas are characterized by a high degree of inter- and intra-tumoral heterogeneity. The latter has been well characterized at the transcriptomic level, and several distinct cell subpopulations have been described (classical, mesenchymal, proneural) This intra-tumoral heterogeneity is one of the factors contributing to resistance to current therapies, but it remains incompletely understood and explored. MEG is a tool capable of exploring intra- and inter-tumor heterogeneity from an electrophysiological perspective. This represents an original approach that will provide a better understanding of intra-tumor heterogeneity and lead to new therapeutic perspectives.
Interventions
DEVICEMEG
Eligible patients will undergo a complete Magnetoencephalography, of approximatively 45min
Sponsors
Hospices Civils de Lyon
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Male or female aged over 18 * With a newly diagnosed malignant glioma based on brain imaging * Eligible for surgical removal * Having given their consent
Exclusion criteria
* Contraindications to Magnetic resonance imaging (MRI) (claustrophobia, metallic implants, particularly intraocular implants, pacemakers) * Contraindications to magnetoencephalography (MEG) (metallic implants in the mouth-dentures, fillings, crowns) * Coagulation disorders * Pregnancy, breastfeeding, or patients not using effective contraception * Subjects participating in another interventional study with an exclusion period still in progress at the time of pre-inclusion, etc. * Subjects deprived of their liberty by judicial or administrative decision * Subjects receiving psychiatric care * Subjects admitted to a health or social care facility for purposes other than research * Adult subjects subject to legal protection measures (guardianship, curatorship) * Subjects not affiliated with a social security system or beneficiaries of a similar system
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Assess the technical feasibility of studying tumor electrophysiological heterogeneity using magnetoencephalography (MEG) in a series of patients with glioma at the initial stage of treatment. | At baseline and during the 10 days prior to the date of surgery, according to the standard of care. | Percentage of patients with a complete and usable magnetoencephalography (MEG) recording, allowing intra- and peri-tumoral electrophysiological data to be collected and resting functional connectivity to be studied for all areas of the brain. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Define the radiological characteristics of the different types of areas of interest identified by MEG by comparing MEG mapping and preoperative MRI (anatomical and functional). | At baseline and during the 10 days prior to the date of surgery, according to the standard of care. | Radiological patterns of areas identified by MEG, based on preoperative brain Magnetic resonance imaging (MRI) (morphological and functional) |
| Define the prognostic impact of ablation of areas with different electrophysiological properties, using an analysis that integrates MEG mapping data, post-operative MRI data, and survival data. | At baseline and during the 10 days prior to the date of surgery, according to the standard of care. | Survival of patients with residual High Frequency Channel/ Low Frequency Channel (HFC/LFC) areas on postoperative MRI and survival of patients without such areas. |
Countries
France
Contacts
CONTACTThiébaud PICART
CONTACTJulien BERTHILLER
Outcome results
None listed