Preoperative Y-90 Radioembolization for Tumor Control and Future Liver Remnant Hypertrophy in Patients With Colorectal Liver Metastases
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Primary Objective:
To examine the safety and feasibility of Y-90 TARE directed to the right hemi-liver for induction of left liver FLR hypertrophy as part of a planned hepatectomy for patients with CLM.
Secondary Objectives:
To describe changes in liver volume after Y-90 TARE, including:
- The kinetic growth rate (KGR) of the FLR
- Degree of hypertrophy 6 weeks after TARE
- Atrophy of targeted right hemi-liver from TARE date to date of surgery
- To describe additional interventional procedures needed to induce additional hypertrophy if insufficient hypertrophy from Y-90 TARE
- To assess the proportion of TARE patients who undergo attempted and complete curative-intent resection of CLM
To assess measures of disease control, including:
- Tumor marker trend
- RECIST/mRECIST criteria
- CT morphologic response
- PET CT response
- To describe Patient Reported Outcomes using MDASI-GI
- To assess FLR liver quality, right-sided surgical adhesions from TARE intraoperatively
- To describe dosimetry of individual liver lesions - using SPECT/CT, CT, and pathology correlation
- To describe change in liver function measured by the pre- and post-TARE HIDA SPECT/CT scans and hepatic function blood tests
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 1
Contacts and Locations
Study Contact
Study Contact
- Name: Ching-Wei Tzeng, MD
- Phone Number: (713) 792-0386
- Email: cdtzeng@mdanderson.org
Study Locations
-
-
Texas
-
Houston, Texas, United States, 77030
- Recruiting
- M D Anderson Cancer Center
-
Contact:
- Ching-Wei David Tzeng, MD
-
Principal Investigator:
- Ching-Wei David Tzeng, MD
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Borderline resectable unresectable (due to insufficient liver volume at presentation) colorectal liver metastases with potential curative intent, as determined by the surgeon and multidisciplinary team
- Anticipated standardized FLR (sFLR) that would require right portal vein embolization (PVE) to increase the sFLR prior to either a single major hepatectomy, or prior to the second stage hepatectomy as part of a two-stage hepatectomy strategy, all in the setting of curative-intent resection(s). This evaluation will be documented in the clinical chart
- Received at least four cycles (or two months) of chemotherapy
- Willing, able and mentally competent to provide written informed consent
- Medically and physically operable as determined by the surgeon
Exclusion Criteria:
- Extrahepatic disease that precludes intended curative intent treatment sequencing (treatable primary tumor and lung metastases allowed). "Treatable" is defined as having an intended future plan for local therapy (surgery, radiation, or ablation) as determined by the patient's medical oncologist and surgical oncologist
- Projected sFLR before Y-90 of <20% (starting with sFLR that is unrealistic for improvement to ≥30%)
- Performance status limitations (Karnofsky <80%, ECOG >1)
- Portal hypertension and/or cirrhosis
- Starting total bilirubin >1.3 mg/dL (except if patient has Gilbert's Disease)
- CEA >200 after 4 cycles of chemotherapy upon restaging visit
- Clinical progression of disease on imaging and/or tumor marker after 4 cycles of chemotherapy that is clinically judged by surgical oncology and medical oncology to preclude surgical resection
- Platelet count <100,000/µL
- Albumin <3.5 g/dl
- Symptomatic primary colon or rectal cancer (without pre-existing proximal diverting ostomy)
- Pregnant or breast-feeding patient
- Other medical or clinical contraindications to liver surgery
- Non-English-speaking participants
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Yttrium-90
Help to control the tumor(s) on the right side of the liver while the remaining left side of the liver, which is clear of cancer, grows.
|
Given by scan
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
The evaluation from using the feasibility of Y-90 TARE directed to the right hemi-liver for induction of left liver FLR hypertrophy as part of a planned hepatectomy for patients with CLM.
Time Frame: through study completion, an average of 1 year
|
through study completion, an average of 1 year
|
|
The evaluation of using the safety of Y-90 TARE directed to the right hemi-liver for induction of left liver FLR hypertrophy as part of a planned hepatectomy for patients with CLM.
Time Frame: through study completion, an average of 1 year
|
through study completion, an average of 1 year
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Ching-Wei Tzeng, MD, 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
Other Study ID Numbers
Other Study ID Numbers
- 2021-0521
- NCI-2021-13239 (Other Identifier: NCI-CTRP Clinical Trials Registry)
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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