The Gilbert Family Foundation in Detroit, a private nonprofit foundation founded by Jennifer and Dan Gilbert to accelerate a cure for neurofibromatosis type 1 (NF1), today announced the launch of a clinical study that seeks to validate optical coherence tomography (OCT) as a tool to objectively assess the visual system and its response to treatment in NF1 patients with optic pathway gliomas.
NF1 is a multisystem genetic disorder characterized primarily by the growth of benign and malignant nervous system tumors. Approximately one in five NF1 patients develop a tumor in their visual system called an optic pathway glioma, causing many of them to lose their sight.
Clinicians typically base their decision on whether to treat a patient with an NF1 optic pathway glioma on changes in visual acuity, which is highly dependent on patient cooperation. This becomes particularly challenging with younger patients, meaning there is a great need for a more reliable, quantitative biomarker for vision loss.
Led by Drs. Robert Avery and Michael Fisher at Children’s Hospital of Philadelphia (CHOP), the study is an exploratory aim of the ongoing Children’s Oncology Group Phase III randomized clinical trial ACNS1831 (NCT03871257). The trial compares the treatment response of a new targeted therapy (selumetinib) to the present standard of care (carboplatin and vincristine) in children with newly diagnosed or previously untreated NF1 low-grade gliomas, including NF1 optic pathway gliomas.
The clinical study will collect three sets of OCT measurements for 60 NF1 optic pathway glioma patients enrolled in the Phase III trial: pre-treatment and after 6 and 12 months of receiving treatment. Avery and Fisher will then determine whether OCT measurements can predict treatment response prior to treatment initiation or provide early indication of treatments that are not working.
Previous studies have established the relationship between the data collected with OCT and visual acuity and visual field in children with optic pathway gliomas, suggesting that OCT could serve as a technique to predict progressive vision loss. The evidence could greatly support the clinical decision on when to treat a patient and prevent patients from receiving unnecessary treatment.
“Understanding how OCT metrics change during this trial will provide much needed information to understand how they can optimize treatment outcomes and their role in clinical practice,” says Avery. “Depending on the outcomes of the primary study, our OCT results could elucidate important factors about why children’s visual outcomes may differ. This ancillary study would also help us justify OCT’s inclusion as a secondary outcome in future clinical trials.”
ACNS1831, known as the “Quantitative Ophthalmic Biomarkers of NF1 Associated Optic Pathway Gliomas in a Phase 3 Clinical Trial,” is sponsored by the National Cancer Institute (NCI), part of the National Institutes of Health, and supported by AstraZeneca under a Cooperative Research and Development Agreement between NCI and AstraZeneca.
This study will also be supported as part of GFF’s Vision Restoration Initiative. In April 2019, GFF announced an initial investment of $11 million in its Vision Restoration Initiative to fund research focused on developing innovative therapies that either repair or replace damaged visual systems caused by NF1-associated optic pathway gliomas. In parallel with the primary clinical trial, this study will take place over the course of six years.
COG (childrensoncologygroup.org), a member of the NCI funded National Clinical Trials Network (NCTN), is the world’s largest organization devoted exclusively to childhood and adolescent cancer research. COG unites over 10,000 experts in childhood cancer at more than 200 leading children’s hospitals, universities, and cancer centers across North America, Australia, and New Zealand in the fight against childhood cancer.
Today, more than 90 percent of the 16,000 children and adolescents diagnosed with cancer each year in the United States are cared for at COG member institutions. Research performed by COG institutions over the past 50 years has transformed childhood cancer from a virtually incurable disease to one with a combined 5-year survival rate of 80 percent. COG’s mission is to improve the cure rate and outcomes for all children with cancer.
The Gilbert Family Foundation is a private nonprofit foundation founded by Jennifer and Dan Gilbert to accelerate a cure for neurofibromatosis type 1 (NF1) and build economic opportunity and equity in the city of Detroit. The Gilbert Family Foundation supports groundbreaking, cutting-edge research in hopes of eradicating NF1, a genetic disorder that causes tumors to grow on nerves anywhere in the body.
Additionally, the foundation supports the economic stability and mobility of residents in Detroit by investing in wealth-building opportunities and breaking down systemic barriers such as inequitable property tax debt among low-income homeowners. For more information on the Gilbert Family Foundation, visit gilbertfamilyfoundation.org.