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A Study of the Use of Irreversible Electroporation in Pancreatic Ductal Cancer

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ClinicalTrials.gov Identifier: NCT03257150
Recruitment Status : Recruiting
First Posted : August 22, 2017
Last Update Posted : February 4, 2019
Sponsor:
Information provided by (Responsible Party):
University Health Network, Toronto

Brief Summary:
This I/II study will evaluate to see how safe and useful irreversible electroporation (also called NanoKnife) is in patients with locally advanced pancreatic cancer.

Condition or disease Intervention/treatment Phase
Pancreatic Ductal Adenocarcinoma Procedure: Irreversible Electroporation Device: NanoKnife System Drug: 18F-Fluoroazomycin arabinoside Not Applicable

Detailed Description:

In this phase 1/II trial, patients with locally advanced pancreatic ductal carcinoma will be assigned to receive interventional treatment of irreversible electroporation (IRE).

IRE will be performed by laparotomy under general anesthesia in the operating room.

All patients enrolled of the study will have a biopsy at the time of laparotomy. A baseline positron emission tomography (PET) scan using a contrast called [F-18]-Fluoroazomycin Arabinoside (FAZA) will be performed post enrolment and pre-study treatment to evaluate the levels of hypoxia in the tumour. A further scan will be performed at the first follow-up 12 weeks post completion of treatment. Blood will be collected of regular blood tests and correlative studies at baseline and during the study. Computed tomography (CT) scans will be done at baseline, 4 weeks post treatment, 12 weeks and 24 weeks follow up. Quality of Life (QOL) questionnaires will be completed at baseline and during the study. Patients will be given optional consent for biobanking of left over tissue and blood for future analysis. Patients will be followed up 4 weeks post treatment, then every 12 weeks until death.


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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 47 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Irreversible Electroporation for Locally Advanced Pancreatic Ductal Adenocarcinoma (LEAP TRIAL): A Phase I/II Prospective Trial
Actual Study Start Date : September 22, 2017
Estimated Primary Completion Date : September 1, 2020
Estimated Study Completion Date : September 1, 2021

Arm Intervention/treatment
Experimental: Study Treatment

For the patients with locally advanced pancreatic ductal adenocarcinoma:

  • Irreversible electroporation using the NanoKnife system to treat cancer tumor.
  • Positron emission tomography (PET) scan using 18F-Fluoroazomycin arabinoside contrast to assess tumor hypoxia.
Procedure: Irreversible Electroporation
Irreversible electroporation (IRE) is a process that uses the NanoKnife system to sent electrical currents to a cancer tumor which will disrupt the tumor cell and therefore causing the cell to die.

Device: NanoKnife System
A system consisting of electrode probes connected to a machine. The probes will be surgically placed around the cancer tumor.

Drug: 18F-Fluoroazomycin arabinoside
Positron Emission Tomography (PET) imaging agent for assessment of tumor hypoxia.
Other Name: 18F-FAZA




Primary Outcome Measures :
  1. Adverse event rate [ Time Frame: 30 days post IRE or index hospitalization ]
  2. Overall survival rate [ Time Frame: Date of IRE treatment to the date of death, up to 2 years ]

Secondary Outcome Measures :
  1. Progression-free survival rate [ Time Frame: IRE treatment to the date of documented disease progression or death, up to 2 years ]
  2. Overall survival rate of disease [ Time Frame: Date of disease diagnosis to date of death, up to 2 years ]
  3. Progression-free survival rate of disease [ Time Frame: Date of disease diagnosis to date of death, up to 2 years ]


Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Histologically proven pancreatic ductal adenocarcinoma (PDAC)
  • Age ≥ 18 years
  • Locally advanced unresectable primary tumor
  • Tumors ≤5 cm in largest dimension at the time of enrollment that is technically amenable to treatment with irreversible electroporation (IRE)
  • At least 4 months of combination chemotherapy
  • Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 2
  • Acceptable organ and bone marrow function
  • Life expectancy estimated ≥6 months
  • Ability and willingness to sign informed consent form
  • Have a measurable primary tumor at the time of study enrollment
  • Suitable and fit to undergo general anesthetic and laparotomy
  • Women of child-producing potential must agree to use effective contraceptive methods prior to study entry, during study participation, and for at least 30 days after the last administration of study medication.

Exclusion Criteria:

  • Stage IV (i.e. metastatic) PDAC
  • Has a cystic subtype of PDAC
  • Previous local treatments for locally advanced PDAC including IRE or radiotherapy
  • Recent or concurrent cancer, that is distinct from PDAC in primary site/histology. Cancer curatively treated ≥3 years prior to entry is permitted
  • Prior chemotherapy within 3 years of diagnosis of PDAC. Chemotherapy for PDAC is permitted
  • Direct invasion of PDAC into the stomach or duodenum
  • Metallic biliary stent that cannot be substituted with a plastic stent
  • Allergy to computed tomography (CT) or magnetic resonance imaging (MRI) contrast that cannot be safely managed with premedication which preclude assessment and/or surveillance of PDAC
  • History of cardiac disease
  • Any active major medical illnesses of the respiratory or immune system, or other conditions that may affect patient's ability to tolerate general anesthesia and IRE therapy on this trial
  • History of solid organ transplantation or collagen vascular disease
  • Medical, psychological or social conditions that may interfere with the patient's participation in the study or evaluation of the study results
  • Pregnant or breast feeding women
  • Pre-menopausal women unwilling to take a pregnancy test
  • Any other condition that would, in the Investigator's judgment, contraindicate the patient's participation in the clinical study due to safety concerns or compliance with clinical study procedures
  • History of human immunodeficiency virus (HIV) infection
  • Have a working knowledge of English in order to complete the quality of life questionnaires being administered in this study. Patients who do not meet this requirement will be exempt from the quality of life assessments but remain eligible for all other components of the study.

Information from the National Library of Medicine

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): NCT03257150


Contacts
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Contact: Anna Dodd 416-946-4501 ext 3176 anna.dodd@uhn.ca

Locations
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Canada, Ontario
Princess Margaret Cancer Centre Recruiting
Toronto, Ontario, Canada, M5G 2M9
Contact: Anna Dodd    416-946-4501 ext 3176    anna.dodd@uhn.ca   
Principal Investigator: Alice C Wei, MD         
Sponsors and Collaborators
University Health Network, Toronto
Investigators
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Principal Investigator: Alice C Wei, MD Princess Margaret Cancer Centre

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Responsible Party: University Health Network, Toronto
ClinicalTrials.gov Identifier: NCT03257150     History of Changes
Other Study ID Numbers: LEAP
First Posted: August 22, 2017    Key Record Dates
Last Update Posted: February 4, 2019
Last Verified: January 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No

Additional relevant MeSH terms:
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Adenocarcinoma
Carcinoma
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Neoplasms
Fluoroazomycin arabinoside
Radiopharmaceuticals
Molecular Mechanisms of Pharmacological Action