Radioembolization for HCC Patients With Personalized Yttrium-90 Dosimetry for Curative Intent (RAPY90D)

NCT ID: NCT03896646

Last Updated: 2025-11-21

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

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

42 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-10-10

Study Completion Date

2026-09-30

Brief Summary

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This trial aims to improve hepatocellular carcinoma (HCC) tumor responses in patients undergoing Y90 radioembolization by using personalized dosimetry as part of treatment planning. Using standard calculations for Y90 doses may not be specific enough for individual patients given that there can be differences in how tumor cells and liver cells respond to radiation. Personalized dose plans may help improve treatment and outcomes in liver cancer.

Detailed Description

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PRIMARY OBJECTIVES:

I. To achieve tumor objective response rates of 75% using voxel based dosimetry when the mean dose (Dmean) to tumor is targeted to be greater than 200 Gray (Gy).

SECONDARY OBJECTIVES:

I. Correlate changes in liver function and Common Terminology Criteria for Adverse Events (CTCAE) incidence to the mean absorbed dose to normal liver.

II. Prospectively validate the accuracy of our published tumor dose response prediction based on the yttrium Y 90 glass microspheres (yttrium-90 \[Y90\]) tumor dose volume histograms (DVHs).

III. Correlate predicted tumor doses macroaggregated albumin (MAA) scan with actual doses delivered (Y90 scan).

IV. Develop a tumor dose response model prediction based on the MAA dose maps. V. Develop a model correlating normal liver radiation dose to liver function using single-photon emission computed tomography/computed tomography hepatobiliary iminodiacetic acid (SPECT/CT HIDA) imaging.

VI. Develop a model correlating the relative tumor to normal liver enhancement on CT imaging and Cone beam CT imaging to the uptake on SPECT CT Tc99m MAA imaging (gold standard).

VII. Compare tumor and normal liver doses estimations from SPECT CT Bremsstrahlung imaging to positron emission tomography (PET) CT imaging.

OUTLINE:

Patients undergo yttrium-90 microsphere radioembolization with yttrium Y 90 glass microspheres using personalized dose measurements. Patients also undergo SPECT/CT HIDA scan before radioembolization and 2-4 months after radioembolization.

After completion of study treatment, patients are followed up at 3 and 6 months.

Conditions

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Stage III Hepatocellular Carcinoma AJCC v8 Stage IIIA Hepatocellular Carcinoma AJCC v8 Stage IIIB Hepatocellular Carcinoma AJCC v8 Stage IV Hepatocellular Carcinoma AJCC v8 Stage IVA Hepatocellular Carcinoma AJCC v8 Stage IVB Hepatocellular Carcinoma AJCC v8 Unresectable Hepatocellular Carcinoma

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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Treatment (personalized radioembolization, SPECT/CT HIDA)

Patients undergo yttrium-90 microsphere radioembolization with yttrium Y 90 glass microspheres using personalized dose measurements. Patients also undergo SPECT/CT HIDA scan before radioembolization and 2-4 months after radioembolization.

Group Type EXPERIMENTAL

Computed Tomography

Intervention Type PROCEDURE

Undergo SPECT/CT HIDA scan

Hepatobiliary Iminodiacetic Acid Scan

Intervention Type OTHER

Undergo SPECT/CT HIDA scan

Single Photon Emission Computed Tomography

Intervention Type PROCEDURE

Undergo SPECT/CT HIDA scan

Yttrium Y 90 Glass Microspheres

Intervention Type RADIATION

Undergo radioembolization with yttrium Y 90 glass microspheres

Yttrium-90 Microsphere Radioembolization

Intervention Type PROCEDURE

Undergo yttrium-90 microsphere radioembolization

Interventions

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Computed Tomography

Undergo SPECT/CT HIDA scan

Intervention Type PROCEDURE

Hepatobiliary Iminodiacetic Acid Scan

Undergo SPECT/CT HIDA scan

Intervention Type OTHER

Single Photon Emission Computed Tomography

Undergo SPECT/CT HIDA scan

Intervention Type PROCEDURE

Yttrium Y 90 Glass Microspheres

Undergo radioembolization with yttrium Y 90 glass microspheres

Intervention Type RADIATION

Yttrium-90 Microsphere Radioembolization

Undergo yttrium-90 microsphere radioembolization

Intervention Type PROCEDURE

Other Intervention Names

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CAT CAT Scan Computerized Axial Tomography computerized tomography CT CT SCAN tomography HIDA Scan Medical Imaging, Single Photon Emission Computed Tomography Single Photon Emission Tomography single-photon emission computed tomography SPECT SPECT imaging SPECT SCAN SPET tomography, emission computed, single photon Tomography, Emission-Computed, Single-Photon TheraSphere Yttrium Y 90 Microsphere Therapy Yttrium-90 Radioembolization

Eligibility Criteria

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Inclusion Criteria

1. Patients over 18 years of age, of any race or sex, who have unresectable hepatocellular carcinoma of the liver, and who are able or have a fully able legal guardian to give informed consent, will be eligible. Patients must have an ECOG Performance Status score of \</=2, with a life expectancy of \>/=3 months, and must be non-pregnant with an acceptable contraception in premenopausal women. Patients must be \>4 weeks since prior radiation or prior surgery and at least one month post chemotherapy.
2. At least one lesion \>/= 3.0 cm in shortest dimension
3. AST or ALT \<5 times ULN
4. Bilirubin \</= 2.0 mg/dL (unless segmental infusion is used)
5. Negative pregnancy test in premenopausal women

Exclusion Criteria

1. Contraindications to angiography and selective visceral catheterization
2. Evidence of potential delivery of greater than 16.5 mCi (30 Gy absorbed dose) to the lungs with a single injection, or greater than 50 Gy for multiple injections
3. Evidence of any detectable Tc-99m MAA flow to the stomach or duodenum, after application of established angiographic techniques to stop or mitigate such flow (eg, placing catheter distal to gastric vessels)
4. Significant extrahepatic disease representing an imminent life-threatening outcome
5. Severe liver dysfunction or pulmonary insufficiency
6. Active uncontrolled infection
7. Significant underlying medical or psychiatric illness
8. Pregnant
9. Pre-existing diarrhea/illness, co-morbid disease or condition that would preclude safe delivery of TheraSphere® treatment and place the patient at undue risk
10. Infiltrative tumors
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

M.D. Anderson Cancer Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Armeen Mahvash

Role: PRINCIPAL_INVESTIGATOR

M.D. Anderson Cancer Center

Locations

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M D Anderson Cancer Center

Houston, Texas, United States

Site Status

Countries

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United States

Related Links

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http://www.mdanderson.org

MD Anderson Cancer Center Website

Other Identifiers

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NCI-2019-01586

Identifier Type: REGISTRY

Identifier Source: secondary_id

2018-1008

Identifier Type: OTHER

Identifier Source: secondary_id

P30CA016672

Identifier Type: NIH

Identifier Source: secondary_id

View Link

2018-1008

Identifier Type: -

Identifier Source: org_study_id

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