Additional Chemotherapy Administered Directly Into the Liver Using a Chemo Pump in Patients With Bile Duct Cancer Inside the Liver Treatable by Surgery

NCT ID: NCT06888063

Last Updated: 2025-03-21

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

RECRUITING

Clinical Phase

PHASE2

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-11-20

Study Completion Date

2031-09-30

Brief Summary

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The goal of this clinical trial is to learn if additional chemotherapy by means of a chemo pump can prevent return of disease in adult patients with bile duct cancer in the liver that can be treated with surgery. The main questions it aims to answer are:

* Does addition of chemotherapy by means of a chemo pump lead to less return of disease within the liver two years after surgery?
* Does addition of chemotherapy by means of a chemo pump lead to longer survival of patients?
* Does addition of chemotherapy by means of a chemo pump lead to an increase in quality of life?

Participants will receive an implanted chemo pump, through which additional chemotherapy will be given to the liver in addition to surgery.

Detailed Description

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Conditions

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Intrahepatic Bile Duct Cancer Intrahepatic Cholangiocarcinoma (Icc) Intrahepatic Bile Duct Carcinoma Intrahepatic Cholangiocarcinoma

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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Surgery + chemo pump (Hepatic Arterial Infusion Pump chemotherapy)

Surgery + chemo pump

Group Type EXPERIMENTAL

Hepatic Arterial Infusion Pump chemotherapy with floxuridin

Intervention Type COMBINATION_PRODUCT

Participants in this arm will receive in addition to standard care (surgery) a chemo pump. This pump will provide participants with 4 cycles of treatment with chemotherapy (Floxuridin), each lasting 4 weeks. Total treatment with chemotherapy will last 16 weeks (approx. 4 months)

Interventions

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Hepatic Arterial Infusion Pump chemotherapy with floxuridin

Participants in this arm will receive in addition to standard care (surgery) a chemo pump. This pump will provide participants with 4 cycles of treatment with chemotherapy (Floxuridin), each lasting 4 weeks. Total treatment with chemotherapy will last 16 weeks (approx. 4 months)

Intervention Type COMBINATION_PRODUCT

Other Intervention Names

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HAIP HAIC with floxuridin PUMP chemotherapy

Eligibility Criteria

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Inclusion Criteria

* 18 years or older
* ECOG or WHO performance status 0 or 1
* Diagnosis of resectable iCCA on imaging. No histological confirmation is needed before surgery, according to standard of care.
* Patient is able to undergo a laparotomy.
* Positioning of a catheter for HAIP chemotherapy is technically feasible based on a CT-scan with early arterial phase with 1mm cuts. The default site for the catheter insertion is the GDA. Accessory or aberrant hepatic arteries are no contraindication for catheter placement.
* Adequate bone marrow, liver, and renal function before inclusion (values may be max. 30 days old)
* Absolute neutrophil count (ANC) ≥ 1.5 x 10\^ 9/L
* White blood cell count (WBC) ≥ 2.5 x 10\^9/L
* Platelets ≥ 100 x 10\^9/L
* Glomerular filtration rate (GFR) ≥ 30 ml/min
* Haemoglobin (Hb) ≥ 5.5 mmol/L
* Total bilirubin ≤ 25 µmol/L
* Written informed consent must be given according to ICH/good clinical practice (GCP), and national/local regulations.

Exclusion Criteria

* Presence of extrahepatic disease at the time of first presentation. Patients with locoregional lymph node disease or with small (≤ 1 cm) extrahepatic lesions that are too small to characterize or biopsy are eligible.
* Second primary malignancy, except for adequately treated non-melanoma skin cancer, or other malignancy treated at least 3 years previously without evidence of recurrence or with a life expectancy longer than 5 years.
* Known homozygous dihydropyrimidine dehydrogenase (DPYD) deficiency
* Prior hepatic radiation, ablation, or resection for iCCA.
* Clinical evidence of portal hypertension (ascites, gastroesophageal varices, or portal vein thrombosis). Some postoperative ascites is allowed.
* (Partial) portal vein thrombosis in future liver remnant.
* Pregnant or lactating women.
* History of psychiatric disability judged by the investigator to be clinically significant, precluding informed consent or interfering with compliance for HAIP chemotherapy.
* Serious concomitant systemic disorders that would compromise the safety of the patient or his/her ability to complete the study, at the discretion of the investigator.
* Organ allografts requiring immunosuppressive therapy.
* Serious infections (uncontrolled or requiring treatment).
* Participation in another interventional study for iCCA with survival as outcome.
* Participation in another prospective study with an interventional medical product.
* Any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be discussed with the patient before registration in the trial
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Koningin Wilhelmina Fonds

OTHER

Sponsor Role collaborator

Erasmus Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Bas Groot Koerkamp, MD, PhD

Principal Investigator and Professor of Pancreato-Biliary Surgery

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Bas Groot Koerkamp, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Erasmus Medical Center

Locations

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Erasmus Medical Center

Rotterdam, South Holland, Netherlands

Site Status RECRUITING

Countries

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Netherlands

Central Contacts

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Bas Groot Koerkamp, MD, PhD

Role: CONTACT

+31(0)107031810

Thomas C Zwaan, MD

Role: CONTACT

+31(0)621218051

Facility Contacts

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Bas Groot Koerkamp, MD, PhD

Role: primary

+31(0)107031810

Thomas C Zwaan, MD

Role: backup

+31(0)621218051

Other Identifiers

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2024-513726-33-00

Identifier Type: CTIS

Identifier Source: secondary_id

MEC-2024-0324

Identifier Type: -

Identifier Source: org_study_id

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