Study of Cryoablation for Metastatic Lung Tumors

NCT ID: NCT01957787

Last Updated: 2021-07-19

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

131 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-04-10

Study Completion Date

2018-08-20

Brief Summary

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The purpose of this study is to evaluate the safety and efficacy of cryoablation therapy used to treat tumors in participants with pulmonary metastatic disease. This study is to enroll participants who will undergo cryoablation of at least 1 metastatic pulmonary tumor that is less than or equal to 3.5 centimeter (cm). Participants will be followed 24 months post their cryoablation procedure.

Detailed Description

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Treatment for pulmonary metastatic disease may include surgery, chemotherapy, radiation therapy, or a combination of treatments. However, several variables may exclude participants from these treatments such as multiple tumors, multiple previous surgeries, pulmonary dysfunction, or co-morbid medical conditions. For these participants, percutaneous cryoablation may be a suitable option.

Ablation of metastatic lung tumors is a rapidly expanding area within interventional oncology. Cryotherapy, radiofrequency, laser, and microwave have all been shown to be effective. Cryotherapy offers a wide range of anatomic and tumor treatment options because of the ability to visualize the ice under imaging guidance and the preservation of collagenous tissue structure. Cryoablation has been extensively performed in the prostate and kidney with favorable outcomes reported in the literature. More recently, cryoablation has been shown to be safe in the treatment of lung tumors with CT guidance.

Conditions

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Neoplasm Metastasis

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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Cryoablation

Participants will undergo a cryoablation procedure with the Galil Medical Cryoablation System according to the manufacturer's guidelines. Participant preparation, anesthesia, intra-operative monitoring, and postoperative management for the study cryoablation procedure will be identical to those for standard cryoablation treatment routinely performed at the clinical centers that participated in this study and will be at the discretion of the Investigators. Tumors in both lungs are to be treated at an appropriate interval, determined on an individual basis. Treatment of bilateral index tumors in a single treatment session will not be performed. All participants will receive cryoablation of up to 6 metastatic lung tumors. Treatment of all study index tumors are to be completed within an 8-week window.

Group Type EXPERIMENTAL

Cryoablation

Intervention Type DEVICE

Application of extremely cold temperatures to the identified tumor(s).

Interventions

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Cryoablation

Application of extremely cold temperatures to the identified tumor(s).

Intervention Type DEVICE

Other Intervention Names

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Cryotherapy Visual-ICE® Cryoablation System PresIce® Cryoablation System SeedNet® Cryoablation System IceEDGE® 2.4 Cryoablation Needles IceRod® PLUS Cryoablation Needles IceSphere™ Cryoablation Needles

Eligibility Criteria

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Inclusion Criteria

* Participant must be at least 18 years old.
* Participant has signed a written informed consent.
* Participant presents with Stage 4 pulmonary metastatic disease with metastatic disease previously confirmed by prior biopsy; or Participant presents with Stage 4 pulmonary metastatic disease previously confirmed on imaging (for example, computerized tomography or CT) with histology proven primary cancer.
* Participant has up to 6 local pulmonary metastases targetable by cryoablation.
* Targeted index tumor(s) defined as intra pulmonary or pleural with a maximum size of 3.5 cm, measured in the longest cross-sectional dimension.
* The target index tumor(s) is determined (by CT images) to be in a location where cryoablation is technically achievable based on the proximity of adjacent organs/ structures and is greater than 0.5 cm from any critical organ/structure (possibly achieved with additional maneuvers such as iatrogenic pneumothorax or hydrodissection).
* Karnofsky Performance Scale (KPS) score greater than or equal to 60.
* Platelet count greater than 50,000/millimeters (mm)\^3 within 8 weeks prior to initial cryoablation procedure.
* International Normalized Ratio (INR) less than 1.5 within 8 weeks prior to initial cryoablation procedure.
* Participant has a life expectancy of greater than 3 months.

Exclusion Criteria

* Participant's index tumor(s) is primary lung cancer.
* Participant has uncontrollable primary or metastatic disease outside of the lung.
* Participant is unable to lie flat or has respiratory distress at rest.
* Participant has a coagulopathy or bleeding disorder which is uncontrolled.
* Absolute Neutrophil Count (ANC) \<1000 within 8 weeks prior to initial cryoablation procedure.
* Participant has evidence of active systemic, pulmonary, or pericardial infection.
* Participant has a debilitating medical or psychiatric illness that would preclude giving informed consent or receiving optimal treatment or follow up.
* Participant is currently participating in other experimental studies that could affect the primary endpoint (for example, experimental chemotherapy regimen).
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Boston Scientific Corporation

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Thierry de Baere, MD

Role: STUDY_CHAIR

Gustave Roussy, Cancer Campus, Grand Paris

Matthew Callstrom, MD

Role: STUDY_CHAIR

Mayo Clinic

Locations

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UCLA Ronald Reagan Medical Center

Los Angeles, California, United States

Site Status

Cancer Treatment Centers of America at Southeastern Regional Medical Center

Newnan, Georgia, United States

Site Status

Mayo Clinic Rochester

Rochester, Minnesota, United States

Site Status

Memorial Sloan Kettering Cancer Center

New York, New York, United States

Site Status

New York Presbyterian Hospital - Cornell Medical Center

New York, New York, United States

Site Status

State University of New York at Stony Brook

Stony Brook, New York, United States

Site Status

Rhode Island Hospital

Providence, Rhode Island, United States

Site Status

Inova Alexandria Hospital CVIR

Alexandria, Virginia, United States

Site Status

Institut Bergonié

Bordeaux, Aquitaine, France

Site Status

Institut Gustave Roussy

Villejuif, Île-de-France Region, France

Site Status

Countries

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United States France

References

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Gillams A. Lung tumour ablation - where are we now? Cancer Imaging. 2008 Apr 22;8(1):116-7. doi: 10.1102/1470-7330.2008.0015.

Reference Type BACKGROUND
PMID: 18442957 (View on PubMed)

Ahmed A, Littrup P. Percutaneous cryotherapy of the thorax: safety considerations for complex cases. AJR Am J Roentgenol. 2006 Jun;186(6):1703-6. doi: 10.2214/AJR.04.1068. No abstract available.

Reference Type BACKGROUND
PMID: 16714662 (View on PubMed)

Kawamura M, Izumi Y, Tsukada N, Asakura K, Sugiura H, Yashiro H, Nakano K, Nakatsuka S, Kuribayashi S, Kobayashi K. Percutaneous cryoablation of small pulmonary malignant tumors under computed tomographic guidance with local anesthesia for nonsurgical candidates. J Thorac Cardiovasc Surg. 2006 May;131(5):1007-13. doi: 10.1016/j.jtcvs.2005.12.051.

Reference Type BACKGROUND
PMID: 16678583 (View on PubMed)

Asimakopoulos G, Beeson J, Evans J, Maiwand MO. Cryosurgery for malignant endobronchial tumors: analysis of outcome. Chest. 2005 Jun;127(6):2007-14. doi: 10.1378/chest.127.6.2007.

Reference Type BACKGROUND
PMID: 15947313 (View on PubMed)

Wang H, Littrup PJ, Duan Y, Zhang Y, Feng H, Nie Z. Thoracic masses treated with percutaneous cryotherapy: initial experience with more than 200 procedures. Radiology. 2005 Apr;235(1):289-98. doi: 10.1148/radiol.2351030747.

Reference Type BACKGROUND
PMID: 15798173 (View on PubMed)

Inoue M, Nakatsuka S, Yashiro H, Ito N, Izumi Y, Yamauchi Y, Hashimoto K, Asakura K, Tsukada N, Kawamura M, Nomori H, Kuribayashi S. Percutaneous cryoablation of lung tumors: feasibility and safety. J Vasc Interv Radiol. 2012 Mar;23(3):295-302; quiz 305. doi: 10.1016/j.jvir.2011.11.019. Epub 2012 Jan 20.

Reference Type BACKGROUND
PMID: 22265246 (View on PubMed)

Yamauchi Y, Izumi Y, Kawamura M, Nakatsuka S, Yashiro H, Tsukada N, Inoue M, Asakura K, Nomori H. Percutaneous cryoablation of pulmonary metastases from colorectal cancer. PLoS One. 2011;6(11):e27086. doi: 10.1371/journal.pone.0027086. Epub 2011 Nov 9.

Reference Type BACKGROUND
PMID: 22096520 (View on PubMed)

Pusceddu C, Sotgia B, Fele RM, Melis L. CT-guided thin needles percutaneous cryoablation (PCA) in patients with primary and secondary lung tumors: a preliminary experience. Eur J Radiol. 2013 May;82(5):e246-53. doi: 10.1016/j.ejrad.2012.12.010. Epub 2013 Feb 8.

Reference Type BACKGROUND
PMID: 23394762 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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CUC13-LNG079

Identifier Type: -

Identifier Source: org_study_id

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