EUS-RFA Versus Surgery for Pancreatic Insulinoma (ERASIN-RCT)

NCT ID: NCT05735912

Last Updated: 2024-12-11

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

RECRUITING

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-03-01

Study Completion Date

2029-02-28

Brief Summary

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The goal of this muticentre randomized controlled trial is to compare endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) with surgery for treatment of pancreatic insulinoma. The main questions it aims to answer are: 1) What is the safest treatment? 2) Is efficacy comparable? Patients will be randomized to undergo EUS-RFA or surgical resection. Researchers will compare the rate of adverse events and the clinical efficacy after the two treatments to see if EUS-RFA result safer and effective compare with surgery.

Detailed Description

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Conditions

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Pancreatic Insulinoma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Endoscopic ultrasound-guided radiofrequency ablation

Endoscopic ultrasound-guided radiofrequency ablation will be performed using the "EUSRA" system (Taewoong, Seoul, Korea). The system consists of a 19-gauge needle electrode (140-cm long), a radiofrequency current generator (VIVA RF generator; Taewoong), and an inner cooling system that circulates chilled saline solution during the radiofrequency ablation procedure. The inner metal part is insulated over its entire length, with the exception of the terminal 5 to 20mm for energy delivery. The needle electrode is attached to the radiofrequency current generator and to a cooling pump. The generator, in addition to providing radiofrequency current, allows the control of physical power and impedance parameters.

Group Type EXPERIMENTAL

Endoscopic ultrasound-guided radio frequency ablation

Intervention Type PROCEDURE

Radiofrequency ablation performed under endoscopic ultrasound guidance of pancreatic insulinoma

Surgery

Surgical resection will be performed in an inpatient setting. The type and extension of surgical resection, as well as need for lymphadenectomy, will be decided by the treating surgeons according to the tumor position, distance from the main pancreatic duct, and local expertise.

Group Type ACTIVE_COMPARATOR

Surgery

Intervention Type PROCEDURE

Surgical resection of pancreatic insulinoma

Interventions

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Endoscopic ultrasound-guided radio frequency ablation

Radiofrequency ablation performed under endoscopic ultrasound guidance of pancreatic insulinoma

Intervention Type PROCEDURE

Surgery

Surgical resection of pancreatic insulinoma

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Age ≥18 years
* Diagnosis of pancreatic insulinoma (38) (e.g., fasting test, insulin blood levels, C-peptide blood levels)
* Presence of a visible single pancreatic nodule on imaging (computed tomography, and/or magnetic resonance imaging, and/or endoscopic ultrasound).
* No evidence of distant localizations visualized at computed tomography, and/or magnetic resonance imaging, and/or endoscopic ultrasound
* Tumor ≤ 2cm
* Informed consent provided by the patient or closest relative.

Exclusion Criteria

* G2 with Ki-67 \>5% on histological examination at EUS-guided biopsy samples (if performed)
* Distance between lesion and main pancreatic duct ≤ 1mm or upstream dilation of the main pancreatic duct
* Metastatic tumor at the time of diagnosis
* Multiple pancreatic nodules
* Diagnosis of multiple endocrine neoplasia type 1 according to guidelines
* Unfit for surgery or high-risk surgical patients
* Endoscopic ultrasound not feasible for surgical altered anatomy
* Known bleeding disorder that cannot be sufficiently corrected with co-fact or fresh frozen plasma
* Use of anticoagulants that cannot be discontinued
* International normalized ratio \>1.5 or platelet count \<50.000
* Pregnancy or breast feeding
* Failure to sign the patient's or closest relative's informed consent
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Azienda Ospedaliera Universitaria Integrata Verona

OTHER

Sponsor Role lead

Responsible Party

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Stefano Francesco Crinò, MD

Doctor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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University Hospital of Verona

Verona, , Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Stefano Francesco Crinò, MD

Role: CONTACT

Phone: 00390458126191

Email: [email protected]

Facility Contacts

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Stefano Francesco Crinò, MD

Role: primary

Other Identifiers

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4121CESC

Identifier Type: -

Identifier Source: org_study_id