Software-Aided Imaging (Morfeus) for Confirming Tumor Coverage With Ablation in Patients With Liver Tumors, the COVER-ALL Study
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ClinicalTrials.gov Identifier: NCT04083378 |
Recruitment Status :
Recruiting
First Posted : September 10, 2019
Last Update Posted : August 27, 2021
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Condition or disease | Intervention/treatment | Phase |
---|---|---|
Malignant Liver Neoplasm | Procedure: Ablation Therapy Procedure: Image-Guided Therapy Other: Quality-of-Life Assessment Other: Questionnaire Administration | Phase 2 |
PRIMARY OBJECTIVE:
I. To evaluate if the intra-procedure feedback of a biomechanical deformable registration volumetric image method during percutaneous ablation will increase the minimal ablation margins on a three-dimensional computed tomography-generated analysis.
SECONDARY OBJECTIVES:
I. To assess whether applying the proposed method during percutaneous ablation improves local tumor progression-free survival (LTPFS) rates.
II. Evaluate impact of software use on procedure workflow. III. Impact of software use on complication rates, quality of life, liver function.
IV. Evaluate oncological outcomes (intra-hepatic and overall progression-free survivals, and overall survival).
OUTLINE: Patients are randomized to 1 of 2 arms.
ARM I: Patients undergo standard of care ablation.
ARM II: Patients undergo standard of care ablation with software-aided imaging (Morfeus).
After completion of study, patients are followed up at 1, 3, and 6 months, and then at 1 and 2 years.
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 100 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Treatment |
Official Title: | Clinical Impact of a Volumetric Image Method for Confirming Tumor Coverage With Ablation on Patients With Malignant Liver Lesions (COVER-ALL) |
Actual Study Start Date : | January 10, 2020 |
Estimated Primary Completion Date : | January 10, 2024 |
Estimated Study Completion Date : | January 10, 2026 |

Arm | Intervention/treatment |
---|---|
Active Comparator: Arm I (standard of care ablation)
Patients undergo standard of care ablation.
|
Procedure: Ablation Therapy
Undergo standard of care ablation
Other Names:
Other: Quality-of-Life Assessment Ancillary studies
Other Name: Quality of Life Assessment Other: Questionnaire Administration Ancillary studies |
Experimental: Arm II (standard of care ablation, software-aided imaging)
Patients undergo standard of care ablation with software-aided imaging (Morfeus).
|
Procedure: Ablation Therapy
Undergo standard of care ablation
Other Names:
Procedure: Image-Guided Therapy Undergo software-aided imaging (Morfeus)
Other Names:
Other: Quality-of-Life Assessment Ancillary studies
Other Name: Quality of Life Assessment Other: Questionnaire Administration Ancillary studies |
- Impact of software use on the minimal margins of ablated lesions properly covered by ablation on a three-dimensional analysis [ Time Frame: Up to 2 years ]Will assess whether applying biomechanical models increase the minimal margins of ablated lesions properly covered by ablation on a three-dimensional analysis. The average minimum ablation margins will be compared between two arms using a 2-sample t-test (or Wilcoxon rank-sum test). The means and corresponding 95% confidence intervals will be reported for both arms of the study.
- Local tumor progression-free survival (LTPFS) [ Time Frame: From date of ablation to earliest date of progression at the ablated lesion, assessed up to 2 years ]Kaplan-Meier method will be used to estimate LTPFS and 95% confidence intervals for the quantiles of the LTPFS function based on the method of Brookmeyer and Crowley will be calculated for each arm.
- Intra-hepatic progression-free survival [ Time Frame: From date of ablation to earliest date of progression at the ablated lesion, assessed up to 2 years ]Kaplan-Meier method will be used to estimate intra-hepatic progression-free survival and 95% confidence intervals for the quantiles of the intra-hepatic progression-free survival function based on the method of Brookmeyer and Crowley will be calculated for each arm.
- Overall survival [ Time Frame: From date of ablation to death, assessed up to 2 years ]Kaplan-Meier method will be used to estimate overall survival and 95% confidence intervals for the quantiles of the overall survival function based on the method of Brookmeyer and Crowley will be calculated for each arm.
- Complication rates [ Time Frame: Up to 2 years ]Standard summary statistics will be computed for complication rates and compared between arms.
- Quality of life [ Time Frame: Up to 2 years ]Standard summary statistics will be computed for quality of life and compared between arms.
- Liver function [ Time Frame: Up to 2 years ]Standard summary statistics will be computed for liver function and compared between arms.

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Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patients with =< 3 liver tumors (biopsy-proven or documented by imaging) measuring 1 to 3 cm planned to undergo percutaneous thermal ablation with either microwave or radiofrequency ablation
- Ability to completely cover the target lesion as determined by routine pre-procedure imaging (CT or magnetic resonance [MR])
- Written informed consent to voluntarily participate in the study and follow-up CT scan schedule
- Performance status 0-2 (Eastern Cooperative Oncology Group Classification [ECOG])
- Target tumor should be visualized on contrast-enhanced CT
- Adequate glomerular filtration rate
Exclusion Criteria:
- Active bacterial infection or fungal infection on the day of the ablation
- Patients with implantable pacemakers or other electronic implants
- Platelet < 50,000/mm^3
- International normalized ratio (INR) > 1.5
- Patients with uncorrectable coagulopathy
- Currently breastfeeding or pregnant (latter confirmed by serum pregnancy test)
- Physical or psychological condition which would impair study participation
- ASA (American Society of Anesthesiologists) score of >= 4
- Any other loco-regional therapies at the target lesion(s) within 30 days of the ablation

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04083378
Contact: BRUNO C. ODISIO | 713-563-1066 | bcodisio@mdanderson.org |
United States, Texas | |
M D Anderson Cancer Center | Recruiting |
Houston, Texas, United States, 77030 | |
Contact: BRUNO C. ODISIO 713-563-1066 | |
Principal Investigator: BRUNO C. ODISIO |
Principal Investigator: | BRUNO C ODISIO | M.D. Anderson Cancer Center |
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: | M.D. Anderson Cancer Center |
ClinicalTrials.gov Identifier: | NCT04083378 |
Other Study ID Numbers: |
2019-0213 NCI-2019-05762 ( Registry Identifier: CTRP (Clinical Trial Reporting Program) ) 2019-0213 ( Other Identifier: M D Anderson Cancer Center ) |
First Posted: | September 10, 2019 Key Record Dates |
Last Update Posted: | August 27, 2021 |
Last Verified: | August 2021 |
Studies a U.S. FDA-regulated Drug Product: | No |
Studies a U.S. FDA-regulated Device Product: | No |
Liver Neoplasms Digestive System Neoplasms Neoplasms by Site |
Neoplasms Digestive System Diseases Liver Diseases |