Preoperative Embolization of Hypervascular Head and Neck Tumors to Improve Surgical Outcomes

NCT ID: NCT05490381

Last Updated: 2023-12-12

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

WITHDRAWN

Clinical Phase

PHASE1

Study Classification

INTERVENTIONAL

Study Start Date

2023-12-21

Study Completion Date

2025-01-31

Brief Summary

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This phase I trial tests whether embolization done prior to surgery (preoperative) will improve surgical outcomes in head and neck tumors with large amounts of blood vessels (hypervascular). Embolization is a minimally invasive surgical technique performed under angiographic (imaging of blood vessels) guidance. Embolization therapy injects tiny particles into the arteries feeding tumors to cut off their blood supply which may help improve outcomes by preventing blood loss during surgery, reducing surgical times, and shrinking tumors or reducing recurrence.

Detailed Description

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OUTLINE:

Patients receive iodixanol via injection and undergo diagnostic cerebral angiogram over 30 minutes. If the tumor blood supply is suitable, patients undergo tumor vessel embolization with polyvinyl alcohol (PVA) suspended in ethiodized oil (EOV) and delivered via a catheter. Patients also undergo head and neck computed tomography (CT) scans immediately after completion of tumor vessel embolization, and again between 2-3 months later.

After completion of study, patients are followed for up to 6 months.

Conditions

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Malignant Neoplasm in the Head and Neck Metastatic Malignant Neoplasm in the Head and Neck

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 (PVA, EOV, tumor vessel embolization)

Patients receive iodixanol via injection and undergo diagnostic cerebral angiogram over 30 minutes. If the tumor blood supply is suitable, patients undergo tumor vessel embolization with PVA suspended in EOV and delivered via a catheter. Patients also undergo head and neck CT scans immediately after completion of tumor vessel embolization, and again between 2-3 months later.

Group Type EXPERIMENTAL

Iodixanol

Intervention Type OTHER

Given via injection

Angiogram

Intervention Type PROCEDURE

Undergo diagnostic cerebral angiogram

Arterial Embolization

Intervention Type PROCEDURE

Undergo tumor vessel embolization

Polyvinyl Alcohol

Intervention Type DRUG

Given via catheter

Ethiodized Oil

Intervention Type DRUG

Given via catheter

Computed Tomography

Intervention Type PROCEDURE

Undergo head and neck CT scans

Chart Abstraction

Intervention Type OTHER

Ancillary studies

Interventions

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Iodixanol

Given via injection

Intervention Type OTHER

Angiogram

Undergo diagnostic cerebral angiogram

Intervention Type PROCEDURE

Arterial Embolization

Undergo tumor vessel embolization

Intervention Type PROCEDURE

Polyvinyl Alcohol

Given via catheter

Intervention Type DRUG

Ethiodized Oil

Given via catheter

Intervention Type DRUG

Computed Tomography

Undergo head and neck CT scans

Intervention Type PROCEDURE

Chart Abstraction

Ancillary studies

Intervention Type OTHER

Other Intervention Names

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Indixanol OptiPrep Visipaque TAE Transarterial Embolization 9002-89-5 Polydesis Polyviol Poval 420 PVA Vinarol DT 8008-53-5 Ethiodol iodized oil Lipiodol CAT Scan Computed Axial Tomography CT SCAN

Eligibility Criteria

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Inclusion Criteria

* Primary or metastatic extra-axial tumor involving one or more anatomic structures in the head and neck
* Vascular supply from one or more branches of the external carotid artery
* Planned surgical resection
* All stages
* Extra-axial head and neck tumor greater than 1 cm in any dimension
* Confirmed by contrast-enhanced magnetic resonance imaging (MRI) or computed tomography (CT) of the head and/or neck
* Subjects who have undergone prior therapies are eligible
* Adults aged 18-80; no data outside this age range
* Minimum of 3-month life expectancy
* Estimated glomerular filtration rate (eGFR) greater than 30 mL/min/1.73 m\^2
* Subjects must be non-pregnant at the time of angiographic intervention
* Resectable tumor as determined by the Tumor Board
* Medically stable at the time of the planned intervention, despite potential comorbidities
* In English or Spanish. All study materials have been professionally translated into Spanish

Exclusion Criteria

* Recent hemorrhage or trauma
* Pregnancy
* Nursing mothers
* Contrast medium allergy
* Hypersensitivity or known allergy to ethiodized oil, poppy seeds, or poppy seed oil
* Uncontrolled or concurrent illness including ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
* Pregnancy is a contraindication to angiography outside of the emergency setting
* Active thyroid disease may be affected by iodinated products
* Subject is participating in another clinical trial at the enrollment of the study or duration of the study that can affect the treatment and outcome of the study
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Guerbet

INDUSTRY

Sponsor Role collaborator

University of Washington

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Melanie Walker

Role: PRINCIPAL_INVESTIGATOR

Fred Hutch/University of Washington Cancer Consortium

Do Lim

Role: STUDY_DIRECTOR

Fred Hutch/University of Washington Cancer Consortium

Locations

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Fred Hutch/University of Washington Cancer Consortium

Seattle, Washington, United States

Site Status

Countries

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United States

Other Identifiers

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NCI-2022-05693

Identifier Type: REGISTRY

Identifier Source: secondary_id

STUDY00009998

Identifier Type: OTHER

Identifier Source: secondary_id

RG1121599

Identifier Type: -

Identifier Source: org_study_id