Endorotor Resection In Refractory Barrett's Dysplasia Patients

NCT ID: NCT03364114

Last Updated: 2022-08-03

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

NA

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-02-09

Study Completion Date

2024-12-31

Brief Summary

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The aim of the clinical trial is to evaluate the EndoRotor®'s ability to completely remove areas of Barrett's esophagus considered refractory after 3 failed ablation treatments (Radiofrequency Ablation (RFA) and/or Cryotherapy) or in patients with at least 1 failed ablative procedure (RFA and/or Cryotherapy) and are intolerant to the procedure due to pain, where intolerant is defined as post-dysphagia or odynophagia persisting for 24 hours or greater or requiring narcotic analgesia for a duration of more than 24 hours.

Detailed Description

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Prospective, multi-center, randomized controlled trial, pivotal, investigational device exemption (IDE) to compare the safety and performance of the EndoRotor® Mucosal Resection System with continued ablative therapy in subjects with refractory Barrett's Esophagus.

The EndoRotor® Endoscopic Mucosal Resection System is an automated mechanical endoscopic mucosal resection system for use in the gastrointestinal tract for benign neoplastic or pre-malignant tissue removal by interventional gastroenterologists and GI surgeons. The EndoRotor® System performs both tissue dissection and resection with a single device through an endoscope's instrument biopsy channel.

Conditions

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Barrett's Esophagus With Dysplasia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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EndoRotor Resection

For the purpose of this study the EndoRotor System is investigationally indicated for use during endoscopic procedures to resect and remove refractory Barrett's esophagus tissue in conjunction with a submucosal saline injection mix using adrenaline and dye. Subjects randomized to the EndoRotor arm will be treated up to 3 times through the 9 month follow-up period to remove gross visible Barrett's.

Group Type EXPERIMENTAL

EndoRotor Mucosal Resection System

Intervention Type DEVICE

The EndoRotor® Endoscopic Mucosal Resection System is an automated mechanical endoscopic mucosal resection system for use in the gastrointestinal tract for benign neoplastic or pre-malignant tissue removal by interventional gastroenterologists and GI surgeons. The EndoRotor® System performs both tissue dissection and resection with a single device through an endoscope's instrument biopsy channel.

Continued Ablation (Control)

The investigator shall exercise standard of care for subjects undergoing continued ablative therapies (RFA and/or Cryotherapy). These will constitute the control devices. The investigator will choose the system in this arm. Operation of each system will be done according to the manufacturer's IFU. Subjects randomized to the control arm may be treated up to 3 time through the 9 month follow-up period to remove gross visible Barrett's.

Group Type ACTIVE_COMPARATOR

Continued Ablation

Intervention Type DEVICE

Continued ablation control shall include either cryotherapy or continued radial frequency ablation.

Interventions

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EndoRotor Mucosal Resection System

The EndoRotor® Endoscopic Mucosal Resection System is an automated mechanical endoscopic mucosal resection system for use in the gastrointestinal tract for benign neoplastic or pre-malignant tissue removal by interventional gastroenterologists and GI surgeons. The EndoRotor® System performs both tissue dissection and resection with a single device through an endoscope's instrument biopsy channel.

Intervention Type DEVICE

Continued Ablation

Continued ablation control shall include either cryotherapy or continued radial frequency ablation.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1. Subjects who are greater than 30 and less than 90 years of age; inclusive of males and females.
2. Subjects with confirmed Barrett's esophagus with dysplasia (low-grade or high-grade) and meeting at least one of the following criteria:

1. Failed 3 ablative procedures (RFA and/or Cryotherapy).
2. Failed at least 1 ablative procedure (RFA and/or Cryotherapy) and are intolerant to the procedure due to pain, where intolerant is defined as post-procedure dysphagia or odynophagia persisting for 24 hours or greater or requiring narcotic analgesia for a duration of more than 24 hours.
3. Residual Barrett's length is ≥1 cm and ≤6 cm.
4. No confirmed evidence of esophageal adenocarcinoma (EAC) at the time of therapy.
5. Subject capable of giving informed consent.
6. Subject has a reasonable expectation for prolonged survival (greater than 2 years).
7. Subject can tolerate repeated endoscopic procedures.
8. Absence of strictures refractory to dilation that preclude the passage of the endoscope
9. Patients who were on acid suppression therapy (i.e. PPIs) during the course of failed primary ablative therapy, and who can continue acid suppression therapy for the entire time they are on the clinical study.
10. Subjects with the ability to understand the requirements of the study, who have provided written informed consent, and who are willing and able to return for the required follow-up assessments through 12 months, as indicated.

Exclusion Criteria

1. Subject unable to give informed consent.
2. Subject is unwilling to return for repeated endoscopies.
3. Confirmed endoscopic and or histologic evidence of EAC at time of therapy.
4. Residual Barrett's longer than 6 cm.
5. Subjects with nodular Barrett's esophagus.
6. Subjects who are on anticoagulant therapy that cannot be discontinued for 5 days before and after the procedure.
7. Subjects with known coagulopathy defined as abnormal prothrombin or partial thromboplastin time.
8. History of esophageal varices
9. LA Grade B, C, or D esophagitis.
10. Esophageal stricture refractory to dilation preventing passage of endoscope or catheter.
11. Any previous esophageal surgery, except fundoplication without complications.
12. Medically uncorrectable hypotension or hypertension.
13. Any condition that in the opinion of the investigator would create an unsafe clinical situation that would not allow the patient to safely undergo an endoscopic procedure (lack of medical clearance).
14. Pregnant or lactating women or women of childbearing potential who do not employ a reliable method of contraception as judged by the Investigator, and/or are not willing to use reliable contraception for the duration of study participation.
15. Subject has known severe psychiatric disorder, substance abuse, or other reason for being unable to follow trial follow-up instructions.
16. Patient has a known significant concomitant illness with a life expectancy of less than 2 years.
17. Subject is known to be currently enrolled in another investigational trial that could interfere with the endpoint analyses of this trial.
Minimum Eligible Age

30 Years

Maximum Eligible Age

89 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Interscope, Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Kenneth Wang, MD

Role: PRINCIPAL_INVESTIGATOR

The Mayo Clinic

Locations

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The Mayo Clinic

Rochester, Minnesota, United States

Site Status RECRUITING

University of Rochester Medical Center

Rochester, New York, United States

Site Status RECRUITING

Sahlgrenska University Hospital

Gothenburg, , Sweden

Site Status RECRUITING

NHS University College Hospital

London, , United Kingdom

Site Status RECRUITING

Nottingham University Hospitals NHS Trust and University of Nottingham

Nottingham, , United Kingdom

Site Status RECRUITING

Countries

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United States Sweden United Kingdom

Central Contacts

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Alexis James, BA

Role: CONTACT

508-847478

Jeffery B Ryan Jr, BA

Role: CONTACT

617-360-1168

Facility Contacts

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Bryan Linn

Role: primary

507-255-4631

Krystle Bittner, BSN, RN

Role: primary

585-737-5242

Nima Mottacki, MS

Role: primary

Mohamed HUSSEIN, MD

Role: primary

+44 7799 843218‬

Christwishes Makahamadze

Role: backup

+447578254350

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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CLIN-0010

Identifier Type: -

Identifier Source: org_study_id

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