Treatment of Liver Metastases With Electrochemotherapy (ECTJ)

The recruitment status of this study is unknown because the information has not been verified recently.
Verified March 2012 by Institute of Oncology Ljubljana.
Recruitment status was  Recruiting
Sponsor:
Collaborator:
University Medical Centre Ljubljana
Information provided by (Responsible Party):
Institute of Oncology Ljubljana
ClinicalTrials.gov Identifier:
NCT01264952
First received: December 15, 2010
Last updated: March 27, 2012
Last verified: March 2012
  Purpose

The aim of the study is to evaluate toxicity and effectiveness of electrochemotherapy with bleomycin in treatment of liver metastases of colorectal cancer in clinical study phase I and II.

The study will include 10-15 patients with colorectal cancer with synchronous or metachronous liver metastases, but electrochemotherapy will be performed on metastasis not more than 3 cm in the largest diameter.

Treatment effectiveness will be evaluated by magnetic resonance imaging (MRI) and ultrasonography (US) in a monthly interval. Two or three month after the first operation the treated and untreated metastases will be resected and through histological analyses performed.

The secondary objectives of the trial are to quantify the impact of the treatment on the patient's quality of life, tolerance to the therapy and suitability for larger study to be conducted.


Condition Intervention Phase
Liver Metastases
Procedure: Electrochemotherapy
Phase 1
Phase 2

Study Type: Interventional
Study Design: Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Treatment of Liver Metastases With Electrochemotherapy

Resource links provided by NLM:


Further study details as provided by Institute of Oncology Ljubljana:

Primary Outcome Measures:
  • Evaluation of toxicity related to electrochemotherapy (toxicity, symptoms) [ Time Frame: After operation on day 7 ] [ Designated as safety issue: Yes ]

Secondary Outcome Measures:
  • Clinical evaluation of the patient (pain scale, adverse events, concomitant treatment) [ Time Frame: After operation on tha days 2, 7, 30, monthly ] [ Designated as safety issue: Yes ]
  • Treatment evaluation of tumor response - measurements of tumor lesions by contrast enhanced ultrasonography (US-Doppler), magnetic resonance imaging (MRI), computed tomography (CT), histology [ Time Frame: After operation or 1st day after operation, 7th day, 30th day, monthly ] [ Designated as safety issue: No ]

Estimated Enrollment: 15
Study Start Date: November 2008
Estimated Study Completion Date: November 2013
Estimated Primary Completion Date: March 2013 (Final data collection date for primary outcome measure)
Intervention Details:
    Procedure: Electrochemotherapy

    Treatment procedure: anesthesia, positioning of electrodes, intravenous in bolus administration of bleomycin (15 mg/m2), within 5-30 min after administration of bleomycin application of electric pulses (8 pulses, duration 100 microseconds, frequency 4 Hz with amplitude adequate to cover the whole treated lesion with electric field necessary for reversible plasma membrane permeabilization), removal of electrodes.

    The maximum duration of procedure is 90 minutes.

    Other Names:
    • Device: Cliniporator Vitae®
    • Drug: Bleomicin PHC 15 e. (United States Pharmacopeia - USP)
Detailed Description:

The study will be conducted on patients with colorectal cancer with synchronous or metachronous liver metastases. Included will be 10-15 patients.

Predominantly, patients with synchronous metastases will be included into the study. These patients present liver metastases at the time of primary tumor resection. Electrochemotherapy will be performed on one metastasis not more than 3 cm in largest diameter at the time of the primary tumor operation, but patients have to have at least 2 to 8 metastases. These metastases will be aimed to be resected in the following operation. It is a standard procedure that liver metastases are resected 2-3 months after the primary tumor resection, in the meantime they are on standard chemotherapeutic protocol (FOLFOX, FOLFIRI, Capecitabine). Only in the case of solitary metastasis smaller than 3 cm in diameter, it is resected during the resection of the primary tumor. In the study additional antitumor effectiveness of electrochemotherapy to other treatment (chemotherapy) will be evaluated, compared to non-electrochemotherapy treated metastases. Treatment effectiveness will be evaluated by magnetic resonance imaging (MRI) and ultrasonography (US), in a monthly interval. Two to three month after the first operation the treated and untreated metastases will be resected and thorough histological analysis performed.

The second group of patients will be with metachronous liver metastases not larger than 3 cm in diameter, that location is in the vicinity of hollow liver structures and would not be possible to resect them without extensive and potentially jeopardizing liver resection. One of them will be treated by electrochemotherapy. In a month interval treatment effectiveness will be evaluated by MRI. In the case that metastases will decrease in size and to the situation that metastases are resectable, second operation will be performed, metastases resected and thorough histopathological evaluation performed. Otherwise standard treatment procedure will be performed (chemotherapy).

All patients will be treated after the procedure is thoroughly described to them, and have signed informed consent.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients with measurable liver metastases, presented simultaneously with primary tumor, aimed at primary tumor resection and in a 2-3 month interval resection of liver metastases. One metastasis will be treated by electrochemotherapy, not larger than 3 cm in diameter.
  • Metastasis has to be accessible for application of electrochemotherapy during the operation, without major liver manipulation or mobilization in order not to create situation that would hamper feasibility of the second operation; resection of metastases.
  • Patients with metachronous liver metastases, that are positioned in unresectable liver area, near blood vessels, but inoperable patients.
  • Recurrent liver metastases, not more than 3, that are not larger than 3 cm in diameter.
  • Histologically and cytologically confirmed cancer, any histological differentiation.
  • Life expectancy more than 3 month.
  • Performance status Karnofsky ≥ 70 or (World Health Organization) WHO ≥ 2.
  • Age more than 18.
  • The patient must be offered standard treatment.
  • Electrochemotherapy is offered to the patients in the case of the disease progression during the standard treatment, in the case or metastases recurrence, or when they refuse standard treatment.
  • Treatment free interval 2-5 weeks, depending on the drugs used.
  • Patient must be mentally capable of understanding the information given.
  • Patient must give informed consent.

Exclusion Criteria:

  • Metastases more than 3 cm in diameter.
  • Synchronous unresectable metastases.
  • Metachronous unresectable metastases or bigger than 3 cm in diameter.
  • Visceral, bone or diffuse metastases.
  • Coagulation disturbances.
  • Allergic reaction to bleomycin, or cumulative dose of 250 mg/m2 bleomycin received.
  • Impaired kidney function (creatinin > 150 µmol/l).
  • Patients with hearth failure or pace maker.
  • Patients with epilepsy.
  • Secondary primary tumor, except surgically treated noninvasive cancer of cervix, or surgically or irradiated basal cell carcinoma.
  • Pregnancy.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01264952

Contacts
Contact: Gregor Sersa, PhD (Biol.) +386 1 5879 434 gsersa@onko-i.si
Contact: Eldar Gadzijev, MD, PhD eldar.gadzijev@onko-i.si

Locations
Slovenia
Institute of Oncology Ljubljana Recruiting
Ljubljana, Slovenia, 1000
Contact: Violeta Kaluza    +386 1 5879 122    vkaluza@onko-i.si   
Sub-Investigator: Gregor Sersa, PhD (Biol.)         
Principal Investigator: Eldar Gadzijev, MD, PhD         
Sub-Investigator: Gorana Gasljevic, MD         
Sub-Investigator: Erik Brecelj, MD, PhD         
Sub-Investigator: Ibrahim Edhemovic, MD         
Sub-Investigator: Damijan Miklavcic, PhD (Electrical Engineering)         
Sub-Investigator: Tomaz Jarm, PhD (Electrical Engineering)         
Sponsors and Collaborators
Institute of Oncology Ljubljana
University Medical Centre Ljubljana
Investigators
Principal Investigator: Eldar Gadzijev, MD, PhD Institute of Oncology Ljubljana, Department of Surgical Oncology, Ljubljana, Slovenia
Study Director: Gregor Sersa, PhD (Biol.) Institute of Oncology Ljubljana, Department of Experimental Oncology, Ljubljana, Slovenia
  More Information

No publications provided by Institute of Oncology Ljubljana

Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Institute of Oncology Ljubljana
ClinicalTrials.gov Identifier: NCT01264952     History of Changes
Other Study ID Numbers: 03-Z 16/KSOPKR-6
Study First Received: December 15, 2010
Last Updated: March 27, 2012
Health Authority: Slovenia: Ethics Committee

Keywords provided by Institute of Oncology Ljubljana:
Liver metastases of colorectal cancer
Bleomycin
Electrochemotherapy

Additional relevant MeSH terms:
Neoplasm Metastasis
Neoplasms, Second Primary
Liver Neoplasms
Neoplastic Processes
Neoplasms
Pathologic Processes
Digestive System Neoplasms
Neoplasms by Site
Digestive System Diseases
Liver Diseases

ClinicalTrials.gov processed this record on July 22, 2014