Surefire Infusion System vs. Standard Microcatheter Use During Holmium-166 Radioembolization

NCT ID: NCT02208804

Last Updated: 2016-11-09

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

UNKNOWN

Clinical Phase

PHASE2/PHASE3

Total Enrollment

25 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-11-30

Brief Summary

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The objective of the SIM trial is to investigate whether using the Surefire Infusion System during holmium-166 radioembolization increases the posttreatment tumor to non-tumor activity concentration ratio, compared with using a standard end-hole microcatheter.

Detailed Description

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Study design: clinical within-subject randomized controlled trial.

Study population: 25 patients with unresectable, chemorefractory, liver-dominant colorectal liver metastases.

Intervention: scout and therapeutic doses of holmium-166 microspheres will be administered in the left and right hepatic artery during two sequential angiography procedures on the same day. In all subjects, the use of the Surefire Infusion System and the standard end-hole catheter will be randomly allocated to the infusion site (left and right hepatic artery).

Baseline and follow-up investigation: at baseline and during follow-up, patients will undergo physical examination and laboratory investigations for toxicity assessment, and a whole-body 18F-FDG-PET + dual-phase liver CT (at baseline and 3-months follow-up) for tumor response assessment. After the scout procedure and therapeutic procedure, a holmium-166 SPECT/CT will be obtained for the assessment of the microsphere distribution.

Main study parameters/endpoints:

The primary endpoint is the tumor to non-tumor activity concentration ratio on SPECT/CT.

Secondary endpoints include mean absorbed doses of radioactivity in tumorous and healthy liver tissue, tumor response, the predictive value of holmium-166 scout dose and infusion efficiency. These endpoints will be compared between the Surefire Infusion System and standard microcatheter infusions. A dose-response relationship, clinical toxicity and overall survival will be assessed for the entire cohort.

Conditions

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Colorectal Neoplasms Neoplasm Metastasis Liver Diseases Digestive System Neoplasms

Keywords

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Colorectal Cancer Liver Metastases

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Surefire Infusion System

Hepatic arterial administrations using the Surefire Infusion System

Group Type EXPERIMENTAL

Holmium-166-poly (L-lactic acid) microspheres

Intervention Type DEVICE

Standard End-hole Microcatheter

Hepatic arterial administrations using the standard end-hole microcatheter

Group Type ACTIVE_COMPARATOR

Holmium-166-poly (L-lactic acid) microspheres

Intervention Type DEVICE

Interventions

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Holmium-166-poly (L-lactic acid) microspheres

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Written informed consent
* Histopathologically confirmed diagnosis of adenocarcinoma of the colon or rectum
* Hepatic metastases with measurable morphological appearance (≥ 1 cm) on cross sectional imaging, located in the right and left hepatic arterial perfusion territory
* Unresectable, liver dominant disease
* Progressive disease after second line chemotherapy or no further chemotherapeutical treatment options due to severe side effects or unwillingness of the patient to undergo systemic chemotherapy
* Age ≥ 18 years
* Expected adequacy of follow-up

Exclusion Criteria

* World health organization performance score \> 2
* Inadequate bone marrow function (hemoglobin \< 6.0 mmol/l, leukocyte count \< 3.0 x 109/l, platelet count \< 75x 109/l), inadequate liver function (bilirubin \> 35 µmol/l, aspartate aminotransferase / alanine aminotransferase (AST/ALT) \> 5 x upper limit of normal (ULN)) or inadequate renal function (creatinine \> 1.5 x ULN)
* Prior hemihepatectomy
* Compromised biliary system (biliary stent or hepaticojejunostomy)
* Child Pugh score B7 or worse
* Active hepatitis B or C
* Main portal vein thrombosis on CT (or previous portal vein embolization)
* Severe celiac axis stenosis on CT
* Unsuitable hepatic arterial anatomy on CT
* Treatment with systemic chemotherapy within 4 weeks prior to radioembolization
* Previous participation in a study classified as class III by a radiation safety committee
* Bleeding diathesis
* Pregnancy or breast feeding
* Life expectancy \< 3 months
* Patients who are declared incompetent
* Any condition that prevents from safe treatment with radioembolization
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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UMC Utrecht

OTHER

Sponsor Role lead

Responsible Party

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Maurice A.A.J. van den Bosch

Prof. dr.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Maurice AAJ van den Bosch, Prof. dr.

Role: PRINCIPAL_INVESTIGATOR

UMCU Utrecht, The Netherlands

Max A Viergever, Prof. dr. ir.

Role: STUDY_DIRECTOR

UMC Utrecht, The Netherlands

Locations

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Department of Radiology and Nuclear Medicine, University Medical Center Utrecht

Utrecht, , Netherlands

Site Status RECRUITING

Countries

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Netherlands

Central Contacts

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Maurice AAJ van den Bosch, Prof. dr.

Role: CONTACT

Phone: + 31 88 7554755

Email: [email protected]

Andor F van den Hoven, MD

Role: CONTACT

Phone: + 31 88 7567375

Email: [email protected]

References

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van Roekel C, van den Hoven AF, Bastiaannet R, Bruijnen RCG, Braat AJAT, de Keizer B, Lam MGEH, Smits MLJ. Use of an anti-reflux catheter to improve tumor targeting for holmium-166 radioembolization-a prospective, within-patient randomized study. Eur J Nucl Med Mol Imaging. 2021 May;48(5):1658-1668. doi: 10.1007/s00259-020-05079-0. Epub 2020 Oct 31.

Reference Type DERIVED
PMID: 33128132 (View on PubMed)

van den Hoven AF, Prince JF, Bruijnen RC, Verkooijen HM, Krijger GC, Lam MG, van den Bosch MA. Surefire infusion system versus standard microcatheter use during holmium-166 radioembolization: study protocol for a randomized controlled trial. Trials. 2016 Oct 25;17(1):520. doi: 10.1186/s13063-016-1643-3.

Reference Type DERIVED
PMID: 27782851 (View on PubMed)

Other Identifiers

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14-287/D

Identifier Type: -

Identifier Source: org_study_id