Indwelling Pleural Catheters With or Without Doxycycline in Treating Patients With Malignant Pleural Effusions
A Prospective Observational Cohort Study of Indwelling Pleural Catheters Versus Indwelling Pleural Catheters Plus Doxycycline Pleurodesis for Treatment of Malignant Pleural Effusions
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
PRIMARY OBJECTIVES:
I. To obtain preliminary data comparing indwelling pleural catheters (IPCs) versus IPCs plus doxycycline for pleurodesis as treatments for malignant pleural effusion (MPE).
OUTLINE: Patients choose 1 of 2 groups.
GROUP I: Patients undergo IPC placement and receive doxycycline via IPC 5 days later.
GROUP II: Patients undergo IPC placement.
After completion of study treatment, patients are followed up at 10-14 days and then monthly for up to a year.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Contacts and Locations
Study Contact
Study Contact
- Name: David Ost
- Phone Number: 713-792-6238
- Email: dost@mdanderson.org
Study Locations
-
-
Texas
-
Houston, Texas, United States, 77030
- Recruiting
- M D Anderson Cancer Center
-
Contact:
- David Ost
- Phone Number: 713-792-6238
-
Principal Investigator:
- David Ost
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
- Outpatients with MPE undergoing IPC placement
- Sufficient mental capacity to provide informed consent and answer Short-Form Six-Dimension health index (SF-6D) and Borg score questions
- Inpatients that are expected to be discharged within 5 days of receiving an indwelling pleural catheter
Exclusion Criteria:
- Patients undergoing pleurodesis for benign disease (e.g., spontaneous pneumothorax)
- Inability or unwillingness to give informed consent
- Inability to perform phone call and clinical follow-up at MD Anderson Cancer Center (MDACC)
- Pregnancy
- Previous intrapleural therapy for MPE on the same side
- Eastern Cooperative Oncology Group (ECOG) of 4 and life expectancy =< 2 weeks
- Doxycycline allergy
- Extensive loculations or hydropneumothorax or other contraindication to pleurodesis
- Chylous effusions associated with malignant disease
Study Plan
How is the study designed?
Design Details
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Group 2 (IPC alone)
Patients undergo IPC placement.
|
Ancillary studies
Ancillary studies
Ancillary studies
Other Names:
Receive IPC
|
|
Group I (IPC, doxycycline)
Patients undergo IPC placement and receive doxycycline via IPC 5 days later.
|
Ancillary studies
Ancillary studies
Ancillary studies
Other Names:
Receive IPC
Receive via IPC
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Time to pleural catheter removal
Time Frame: Up to 1 year
|
This outcome will be analyzed by cause-specific hazard Cox model with treatment group as a covariate.
Whenever a catheter is removed, the cause for removal will be documented.
For the analysis, causes will include removal due to decreased drainage (i.e., as per plan) as well as removal due to complications (e.g.
infection, empyema, refractory pain) or other reasons (e.g.
catheter plugged but no complication to the patient, patient preference without a complication).
We will also analyze time to catheter removal for any cause and conduct pre-specified secondary analyses to evaluate the effect of fluid drainage amount (i.e., how much was being put out from the indwelling pleural catheter (IPC) the day of IPC placement and on the day of doxycycline instillation) and size of residual effusion as assessed by chest x-ray (CXR) (on day of IPC placement and day of doxycycline instillation) on time to catheter removal.
|
Up to 1 year
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Recurrence of effusion requiring drainage after IPC
Time Frame: Up to 1 year
|
Up to 1 year
|
|
|
Indwelling pleural catheters (IPC) complications
Time Frame: Up to 1 year
|
Up to 1 year
|
|
|
Quality-adjusted survival measured using Short-Form Six-Dimension health index (SF-6D)
Time Frame: Baseline up to 1 year
|
Will use the Kaplan-Meier product-limit method to estimate median quality-adjusted life years (QALYs) following IPC placement.
|
Baseline up to 1 year
|
|
Change in dyspnea using Borg score
Time Frame: Baseline up to 1 year
|
Will use paired t-test to compare baseline and 1 month Borg scores and utilities.
A generalized linear model will be used to evaluate whether other variables have any impact on the pairwise differences between baseline and 1 month.
|
Baseline up to 1 year
|
|
Assessment of symptom burden
Time Frame: Baseline up to 1 year
|
Baseline up to 1 year
|
|
|
Procedure-associated pain
Time Frame: Up to 1 year
|
Up to 1 year
|
|
|
Need for hospitalization due to pleurodesis pain
Time Frame: Up to 1 year
|
Up to 1 year
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: David Ost, M.D. Anderson Cancer Center
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Neoplasms by Site
- Neoplasms
- Respiratory Tract Diseases
- Respiratory Tract Neoplasms
- Thoracic Neoplasms
- Pleural Diseases
- Pleural Neoplasms
- Organic Chemicals
- Hydrocarbons
- Hydrocarbons, Cyclic
- Polycyclic Aromatic Hydrocarbons
- Hydrocarbons, Aromatic
- Polycyclic Compounds
- Equipment and Supplies
- Naphthacenes
- Tetracyclines
- Catheters
- Doxycycline
- Catheters, Indwelling
Other Study ID Numbers
Other Study ID Numbers
- 2017-0973 (Other Identifier: M D Anderson Cancer Center)
- NCI-2018-00630 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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