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

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT03257150
Recruitment Status : Recruiting
First Posted : August 22, 2017
Last Update Posted : April 27, 2020
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 Not Applicable

Detailed Description:

In this phase I/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 in the study will have a biopsy at the time of laparotomy. Blood will be collected for 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, 24 weeks, and 36 weeks follow up. Quality of Life (QOL) questionnaires will be completed at baseline and during the study. Patients will be given optional consent for storage of any leftover tissue and blood samples 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
Allocation: N/A
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
Single arm trial of irreversible electroporation using the NanoKnife system for locally advanced pancreatic ductal adenocarcinoma.
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. Eligible patients will undergo in situ IRE performed via laparotomy surgery.

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




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

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, Learn About Clinical Studies.


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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
  • Have a cystic subtype PDAC of the pancreas
  • Previous local treatments for locally advanced PDAC including IRE or radiotherapy
  • Recent or concurrent cancer, that is distinct from PDAC in primary site/histology, except cervical carcinoma in situ, localized prostate cancer, treated basal cell carcinoma, superficial bladder tumours (Ta, Tis & T1) and those that can be permitted with sufficient clinical justification confirming patient safety to undergo the procedure per Principle Investigator and is in the best interest of the patient. 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 locally advanced 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 (including, but not limited to: congestive heart failure, active coronary artery disease, uncontrolled hypertension)
  • 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 (e.g.: infection/inflammation, intestinal obstruction, unable to swallow medication, social/ psychological issues, etc.)
  • History of human immunodeficiency virus (HIV) infection
  • Progression of the primary lesion as judged by the Investigator
  • Working knowledge of English is a must 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: Steven Gallinger, MD         
Sponsors and Collaborators
University Health Network, Toronto
Investigators
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Principal Investigator: Steven Gallinger, MD Princess Margaret Cancer Centre
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Responsible Party: University Health Network, Toronto
ClinicalTrials.gov Identifier: NCT03257150    
Other Study ID Numbers: LEAP
First Posted: August 22, 2017    Key Record Dates
Last Update Posted: April 27, 2020
Last Verified: April 2020
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