Isolated Liver Perfusion With Oxaliplatin

NCT ID: NCT01042691

Last Updated: 2017-12-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1

Total Enrollment

10 participants

Study Classification

INTERVENTIONAL

Study Start Date

2003-05-31

Study Completion Date

2011-11-30

Brief Summary

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The primary goal of this research study is to determine a safe dose for the drug oxaliplatin when delivered by isolated hepatic perfusion. The second goal of this research study is to determine if isolated hepatic perfusion with oxaliplatin can improve the efficacy of standard hepatic arterial infusional (HAI) therapy with floxuridine (FUDR)/leucovorin.

Detailed Description

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Conditions

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Unresectable Colorectal Liver Metastases

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Oxaliplatin

Subjects who are planning to undergo surgery for placement of HAI therapy pump will be considered for enrollment. Standard HAI therapy requires a laparotomy and placement of an intrahepatic arterial catheter that is connected to one of several commercially available subcutaneous electronic pumps. The pump is then used to deliver FUDR and Leucovorin directly to the liver, usually beginning four weeks after surgery and lasts on average for a period of six to twelve months after the study. This study will examine the addition of a one hour isolated hepatic perfusion with oxaliplatin to this standard treatment

Group Type EXPERIMENTAL

Oxaliplatin

Intervention Type DRUG

The starting dose of oxaliplatin administered via isolated hepatic perfusion will be the safe tolerated dose of intra-arterial infusion and pharmacokinetics from intravenous studies. The dose will be 5 mg/m2 and will be escalated.

Interventions

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Oxaliplatin

The starting dose of oxaliplatin administered via isolated hepatic perfusion will be the safe tolerated dose of intra-arterial infusion and pharmacokinetics from intravenous studies. The dose will be 5 mg/m2 and will be escalated.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Patients will be included that are scheduled to undergo surgery for placement of hepatic arterial infusion pump for HAI therapy and
* Histologically or cytologically proven measurable metastatic colorectal cancer limited to the parenchyma of the liver with no evidence of unresectable extrahepatic disease by preoperative radiological studies. Limited resectable extrahepatic disease is acceptable.
* No chemotherapy, radiotherapy, or biologic therapy for their malignancy in the 4 weeks prior to the liver perfusion and must have recovered from all side effects.
* An ECOG performance standard of 0, 1 or 2 for 24 hours prior to surgery.
* Adequate hepatic function as evidenced by bilirubin \< 2.0 mg/dL and a PT \< 2 seconds greater than the upper limit of normal.
* Age equal to 18 years or older and greater than 30 kg.
* Platelet counts greater than 100,000, a hematocrit \> 27.0, a white blood count \> 3000/microliter, and a creatinine less than or equal to 1.5 mg/dL or a creatinine clearance of \> 60 mL/min. Patients with elevations in hepatic transaminases secondary to the presence of metastatic disease in the liver are eligible.
* Aware of the neoplastic nature of his/her illness, the experimental nature of the therapy, alternative treatments, potential benefits, and risks and willing to sign an informed consent.
* The disease in the liver must be considered unresectable as defined by greater than three sites of disease in the liver, bilobar disease, and tumor abutting major vascular or ductal structures making anatomic resection with preservation of liver function impossible.

Exclusion Criteria

* Pregnant patients and nursing mothers will be excluded due to the unknown effects of oxaliplatin on the fetus or newborn
* Patients taking immunosuppressive drugs or on chronic anticoagulation will not be eligible.
* Patients with active infections are not eligible.
* Patients with biopsy proven cirrhosis or evidence of significant portal hypertension manifested by ascites, esophageal varices on endoscopy, or radiologic studies showing significant collateral vessels around the organs drained by the portal venous system will be excluded.
* Patients with ischemic cardiac disease or history of congestive heart failure with an LVEF \< 40% will be excluded.
* Patients with COPD or other chronic pulmonary disease with PFT's indicating an FEV\< 50% predicted for age will be excluded.
* Patients with a history of veno-occlusive disease of the liver are ineligible.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The Pittsburgh Foundation

OTHER

Sponsor Role collaborator

Sanofi

INDUSTRY

Sponsor Role collaborator

David Bartlett

OTHER

Sponsor Role lead

Responsible Party

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David Bartlett

Professor of Surgery

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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David L Bartlett, M.D.

Role: PRINCIPAL_INVESTIGATOR

University of Pittsburgh

Locations

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UPMC Presbyterian

Pittsburgh, Pennsylvania, United States

Site Status

UPMC Cancer Centers, Hillman Cancer Center

Pittsburgh, Pennsylvania, United States

Site Status

UPMC Shadyside

Pittsburgh, Pennsylvania, United States

Site Status

Countries

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United States

References

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Lahr CJ, Soong SJ, Cloud G, Smith JW, Urist MM, Balch CM. A multifactorial analysis of prognostic factors in patients with liver metastases from colorectal carcinoma. J Clin Oncol. 1983 Nov;1(11):720-6. doi: 10.1200/JCO.1983.1.11.720.

Reference Type BACKGROUND
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Reference Type BACKGROUND
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Choti MA, Bulkley GB. Management of hepatic metastases. Liver Transpl Surg. 1999 Jan;5(1):65-80. doi: 10.1002/lt.500050113.

Reference Type BACKGROUND
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Bartlett DL. Treatment of patients with hepatic metastases. Cancer J. 2000 Apr;6 Suppl 2:S169-76. No abstract available.

Reference Type BACKGROUND
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Kemeny,M.M., S.Adak, and S.Lipsitz. 1999. Results of the intergroup [Eastern Cooperative Oncology Group (ECOG) and Southwest Oncology Group (SWOG) prospective randomized study of surgery alone versus continuous hepatic artery infusion of FuDR and continuous systemic infusion of 5FU after hepatic resection for colorectal liver metastases. Proc ASCO 18:1012.

Reference Type BACKGROUND

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Alexander HR Jr, Bartlett DL, Libutti SK, Fraker DL, Moser T, Rosenberg SA. Isolated hepatic perfusion with tumor necrosis factor and melphalan for unresectable cancers confined to the liver. J Clin Oncol. 1998 Apr;16(4):1479-89. doi: 10.1200/JCO.1998.16.4.1479.

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Alexander,H.R., D.L.Bartlett, D.L.Fraker, S.K.Libutti, T.Moser, and S.A.Rosenberg. 1997. Results of a Phase II study of isolated hepatic perfusion (IHP) with tumor necrosis factor (TNF) and melphalan for unresectable primary or metastatic cancer confined to the liver. Proc.Soc.Surg.Oncol. 6:8. (Abstr.)

Reference Type BACKGROUND

Alexander HR, Libutti SK, Bartlett DL, Puhlmann M, Fraker DL, Bachenheimer LC. A phase I-II study of isolated hepatic perfusion using melphalan with or without tumor necrosis factor for patients with ocular melanoma metastatic to liver. Clin Cancer Res. 2000 Aug;6(8):3062-70.

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Other Identifiers

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02-135

Identifier Type: -

Identifier Source: org_study_id