The HistoSonics System for Treatment of Primary and Metastatic Liver Tumors Using Histotripsy

NCT ID: NCT04572633

Last Updated: 2025-11-19

Basic Information

• Recruitment Status: ACTIVE_NOT_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 47 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2021-01-27
• Study Completion Date: 2027-09-30

Brief Summary

This trial is a single arm, non-randomized prospective trial. The objective of this trial is to evaluate the efficacy and safety of the HistoSonics System for the treatment of primary or metastatic tumors located in the liver. The co-primary safety and efficacy endpoints must be met for the trial to be successful.

Detailed Description

This trial is a single arm, non-randomized, multicenter, prospective trial. Following histotripsy treatment of liver tumor(s), subjects will undergo imaging ≤36 hours post-index procedure to determine technical success. Subjects will then be followed for 30 days. Additionally, subjects will be evaluated at 6 months and followed annually for up to five (5) years post-index procedure.

The #HOPE4LIVER US trial required pooling data from #HOPE4LIVER US and #HOPE4LIVER EU/UK (NCT04573881). Subjects were treated with the same intervention (HistoSonics System) using identical protocols tailored to the regulatory requirements for each geography.

Conditions

Liver Neoplasms; Hepatocellular Carcinoma; Liver Metastases

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

HistoSonics System

Group Type: EXPERIMENTAL

HistoSonics System

Intervention Type: DEVICE

The HistoSonics System (System) is intended for the destruction of liver tissue using histotripsy, a non-thermal, mechanical process using focused ultrasound.

Interventions

HistoSonics System

The HistoSonics System (System) is intended for the destruction of liver tissue using histotripsy, a non-thermal, mechanical process using focused ultrasound.

Intervention Type: DEVICE

Other Intervention Names

Histotripsy

Eligibility Criteria

Inclusion Criteria

1. Subject is ≥18 years of age

2. Subject has signed the Ethics Committee (EC) or Institutional Review Board (IRB) approved trial Informed Consent Form (ICF) prior to any trial related tests/procedures and is willing to comply with trial procedures and required follow-up assessments

3. Subject is diagnosed with hepatocellular carcinoma (HCC) or liver metastases (mets) from other primary cancers

4. Subject is able to undergo general anesthesia

5. Subject has a Child-Pugh Score of A or B

6. Subject has an Eastern Cooperative Oncology Group Performance Status (ECOG PS) grade 0-2 at baseline screening

7. Subject meets the following functional criteria, ≤7 days prior to the index-procedure:

• Liver function: Alanine transaminase (ALT) and Aspartate transaminase (AST) <2.5x upper limit of normal (ULN) and/or bilirubin <2.5 ULN, and
• Renal function: serum creatinine <2x ULN, and
• Hematologic function: neutrophil count >1.0 x 10^9/L and platelet >50 x 10^9/L

8. Subject has an International Normalized Ratio (INR) score of <2.0 , ≤7 days prior to the index procedure

9. Subject has not responded to and/or has relapsed and/or is intolerant of other available therapies including locoregional therapies, chemotherapy, immunotherapy and targeted therapies

10. The tumor(s) selected for histotripsy treatment must be ≤3 cm in longest diameter

11. Subject has an adequate acoustic window to visualize targeted tumor(s) using ultrasound imaging

12. Subject has a maximum of three (3) tumors to be treated with histotripsy during the index procedure, regardless of how many tumors the subject has.

Exclusion Criteria

1. Subject is pregnant or planning to become pregnant or nursing (lactating) during the trial period

2. Subject is enrolled in another investigational trial and/or is taking investigational medication and/or has been treated with an investigational device ≤30-days prior to planned index procedure date

3. In the Investigator's opinion, the subject has co-morbid disease(s) or condition(s) that would cause undue risk and preclude safe use of the HistoSonics System

4. Subject has a serum creatinine >2.0 mg/dL or estimated glomerular filtration rate (EGFR) <30, unless on dialysis

5. Subject has major surgical procedure or significant traumatic injury ≤2 weeks prior to the planned index procedure or not fully recovered (CTCAE grade 1 or better) from side effects/complications of such procedure or trauma

6. Subject has not recovered to common terminology criteria for adverse events (CTCAE) grade 1 or better from any adverse effects (except alopecia, fatigue, nausea, vomiting and peripheral neuropathy) related to previous anti-cancer therapy

7. Subject has a history of, or suspected to have, bleeding disorders that are uncorrectable

8. Subject has coagulopathy that is uncorrectable

9. Subject has a planned cancer treatment (e.g. resection, chemotherapy, etc.) after the planned index-procedure date and prior to completion of the 30-day follow-up visit

10. Subject has previous treatment with bevacizumab that has not been discontinued >40 days prior to the planned index-procedure date

11. Subject has planned bevacizumab treatment prior to completion of the 30-day follow-up visit

12. Subject has previous treatments with chemotherapy and/or radiotherapy that has not been discontinued ≥2 weeks prior to the planned index-procedure date and has not recovered (CTCAE grade 1 or better) from related toxicity (except alopecia and peripheral neuropathy)

13. Subject has previous treatment with immunotherapies that has not been discontinued ≥4 weeks prior to the index-procedure and has not recovered from related toxicity (CTCAE grade 1 or better)

14. Subject has a life expectancy less than six (<6) months

15. In the opinion of the Investigator, histotripsy is not a treatment option for the subject

16. Subject has a concurrent condition that, in the investigator's opinion, could jeopardize the safety of the subject or compliance with the protocol

17. Subjects' tumor(s) is not treatable by the System's working ranges (refer to User Manual)

18. Subject has a known sensitivity to contrast media and cannot be adequately pre-medicated

19. Subjects' target tumor(s) has/have had prior locoregional therapy (e.g. ablation, embolization, radiation)

20. Subject is eligible for surgical resection

21. Targeted tumor(s) treatment volume overlaps a non-targeted tumor visible via imaging

22. The targeted tumor(s) is not clearly visible with diagnostic ultrasound and computed tomography (CT) or magnetic resonance (MR) imaging

23. The targeted tumor(s) is located in liver segment 1

24. The Planned Treatment Volume intended to cover the targeted tumor includes or encompasses any portion of the main portal vein, common hepatic duct, common bile duct, gallbladder or stomach/bowel.

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

HistoSonics, Inc.

INDUSTRY

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Timothy J Ziemlewicz, MD

Role: PRINCIPAL_INVESTIGATOR

University of Wisconsin, Madison

Clifford S Cho, MD

Role: PRINCIPAL_INVESTIGATOR

University of Michigan

Locations

Miami Cancer Institute

Miami, Florida, United States

Tampa General Hospital

Tampa, Florida, United States

University of Chicago

Chicago, Illinois, United States

University of Kansas Medical Center

Kansas City, Kansas, United States

University of Michigan Hospital

Ann Arbor, Michigan, United States

University Hospital - UW Health

Madison, Wisconsin, United States

Medical College of Wisconsin/Froedtert Hospital

Milwaukee, Wisconsin, United States

Countries

United States

References

Mendiratta-Lala M, Wiggermann P, Pech M, Serres-Creixams X, White SB, Davis C, Ahmed O, Parikh ND, Planert M, Thormann M, Xu Z, Collins Z, Narayanan G, Torzilli G, Cho C, Littler P, Wah TM, Solbiati L, Ziemlewicz TJ. The #HOPE4LIVER Single-Arm Pivotal Trial for Histotripsy of Primary and Metastatic Liver Tumors. Radiology. 2024 Sep;312(3):e233051. doi: 10.1148/radiol.233051.

Reference Type: RESULT

PMID: 39225612 (View on PubMed)

Ziemlewicz TJ, Critchfield JJ, Mendiratta-Lala M, Wiggermann P, Pech M, Serres-Creixams X, Lubner M, Wah TM, Littler P, Davis CR, Narayanan G, White SB, Ahmed O, Collins ZS, Parikh ND, Planert M, Thormann M, Torzilli G, Solbiati LA, Cho CS. The #HOPE4LIVER single-arm Pivotal Trial for Histotripsy of Primary and Metastatic Liver Tumors: 1-year Update of Clinical Outcomes. Ann Surg. 2025 Apr 9. doi: 10.1097/SLA.0000000000006720. Online ahead of print.

Reference Type: RESULT

PMID: 40201962 (View on PubMed)

Provided Documents

Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

CSP1427

Identifier Type: -

Identifier Source: org_study_id