Phase II Trial of Lung Chemoemobolization
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
PRIMARY OBJECTIVE:
I. To determine safety and efficacy (local progression free survival) of chemoembolization of lung cancer that is chemorefractory, unresectable, and unablatable.
OUTLINE:
Patients receive lung chemoembolization using Lipiodol, mitomycin, and Embospheres. Response to treatment is evaluated on computed tomography (CT) scans.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Contact
Study Contact
- Name: Franz Edward Boas, MD
- Phone Number: 626-218-8708
- Email: fboas@coh.org
Study Locations
-
-
California
-
Duarte, California, United States, 91010
- Recruiting
- City of Hope Medical Center
-
Contact:
- Franz E. Boas
- Phone Number: 626-218-8708
- Email: fboas@coh.org
-
Principal Investigator:
- Franz E. Boas
-
-
New York
-
New York, New York, United States, 10065
- Recruiting
- Memorial Sloan Kettering Cancer Center
-
Contact:
- Stephen B. Solomon, MD
- Phone Number: 212-639-5012
- Email: solomons@mskcc.org
-
Principal Investigator:
- Stephen B. Solomon, MD
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Lung cancer or lung metastases, with lung, endobronchial, pleural, or mediastinal tumors that are progressing on systemic therapy (or the patient cannot tolerate systemic therapy), and that are not amenable to resection, thermal ablation, or ablative radiation therapy
- Lung-dominant disease (majority of active tumor volume is in the chest)
- At least 18 years old
Exclusion Criteria:
- Eastern Cooperative Oncology Group (ECOG) performance status > 2
- Oxygen saturation < 92% on room air
- Forced expiratory volume in 1 second (FEV1) < 60%
- No measurable treatable disease, per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 (for example, unable to measure tumor size on CT, or lung nodules are all < 1 cm)
- Life expectancy < 6 months
- Pulmonary hypertension (diagnosed or suspected on echocardiography, CT, magnetic resonance imaging [MRI], or direct pressure measurement)
- Recent pulmonary embolism (within 3 months)
- Pulmonary arteriovenous malformation
- Active lung infection (pneumonia, empyema, or lung abscess requiring therapy within 1 month)
- Symptomatic heart failure (American College of Cardiology [ACC]/American Heart Association [AHA] stage C or D)
- Left bundle branch block (contraindication to pulmonary angiography)
- Renal failure (estimated glomerular filtration rate [eGFR] < 30 mL/min/1.73 m^2)
- Pregnancy or intent to become pregnant
- Breast feeding
- Altered mental status that would interfere with consent or follow-up
- Platelets < 50,000 (after transfusion, if needed)
- International normalized ratio (INR) > 2 (after transfusion, if needed)
- Hemoglobin < 7 (after transfusion, if needed)
- Hyperthyroidism or history of hyperthyroidism, including subclinical hyperthyroidism (contraindication to lipiodol)
- Planned radioactive iodine imaging or therapy (contraindication to lipiodol)
- Allergy to lipiodol or mitomycin
- Allergy to iodinated contrast that cannot be treated with steroid / diphenhydramine premedication
- Any condition that, in the opinion of the investigator, would interfere with evaluation of the investigational product, or that would affect subject safety
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: Lung chemoembolization
Patients receive lipiodol intra-arterially (IA), mitomycin IA, and embospheres IA and undergo TACE on study.
Patients also undergo angiography and computed tomography (CT) at baseline and follow up.
|
Undergo CT
Other Names:
Undergo TACE
Other Names:
Given IA
Other Names:
Given IA
Other Names:
Given IA
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Local progression free survival
Time Frame: Time from the initial transarterial chemoembolization (TACE) treatment to progression in a completely treated territory (or touching the border of a completely treated area), or death from any cause, assessed at 6 months
|
Progression is determined using Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1.
criteria, compared to the scan immediately prior to treatment of that territory, using the 2 largest measurable lesions per treated territory.
Local progression-free survival will be estimated using the Kaplan-Meier method.
|
Time from the initial transarterial chemoembolization (TACE) treatment to progression in a completely treated territory (or touching the border of a completely treated area), or death from any cause, assessed at 6 months
|
|
Incidence of adverse events
Time Frame: Up to 3 months after the last chemoembolization procedure
|
Complications will be classified using the National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0.
The rate of complications can be estimated with a standard error of less than 10%.
Further, any complication that occurs with a 10% incidence will be observed with greater than 95% probability.
|
Up to 3 months after the last chemoembolization procedure
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Objective response rate (best response)
Time Frame: Within 3 months of treatment
|
Evaluated on a per-treatment basis, using RECIST version 1.1 criteria.
|
Within 3 months of treatment
|
|
Overall survival
Time Frame: Up to 9 months
|
Will be estimated using the Kaplan-Meier method.
|
Up to 9 months
|
|
Progression-free survival
Time Frame: Up to 9 months
|
Will be estimated using the Kaplan-Meier method.
|
Up to 9 months
|
|
Bronchial versus pulmonary artery blood supply
Time Frame: Up to 9 months
|
Percentage of treatments where target tumors were supplied by bronchial artery, non-bronchial systemic artery, or pulmonary artery, based on catheter angiography.
Confidence intervals of proportions will be estimated using the equal-tailed Jeffreys prior interval.
|
Up to 9 months
|
|
Lipiodol retention in treated tumors
Time Frame: 4-6 weeks post-procedure
|
Correlation between lipiodol retention and change in tumor size will be evaluated using Spearman's rank correlation coefficient (rho) and Spearman's test.
|
4-6 weeks post-procedure
|
|
Growth of TACE targeted lesions versus non-TACE targeted lesions
Time Frame: 4-6 weeks post-procedure
|
Percentage change in size (largest diameter) of the largest treated, compared to the largest untreated tumor will be evaluated using the Wilcoxon signed-rank test.
|
4-6 weeks post-procedure
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Franz E Boas, MD, City of Hope Medical Center
Publications and 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
- Intestinal Diseases
- Respiratory Tract Diseases
- Neoplasms by Histologic Type
- Gastrointestinal Neoplasms
- Digestive System Neoplasms
- Digestive System Diseases
- Gastrointestinal Diseases
- Colorectal Neoplasms
- Intestinal Neoplasms
- Lung Diseases
- Respiratory Tract Neoplasms
- Thoracic Neoplasms
- Colonic Diseases
- Lung Neoplasms
- Carcinoma, Bronchogenic
- Bronchial Neoplasms
- Neoplasms, Connective and Soft Tissue
- Pleural Diseases
- Mediastinal Diseases
- Thoracic Diseases
- Colonic Neoplasms
- Carcinoma, Non-Small-Cell Lung
- Sarcoma
- Pleural Neoplasms
- Mediastinal Neoplasms
- Organic Chemicals
- Heterocyclic Compounds, 1-Ring
- Heterocyclic Compounds
- Heterocyclic Compounds, 2-Ring
- Heterocyclic Compounds, Fused-Ring
- Lipids
- Indoles
- Quinones
- Plant Preparations
- Biological Products
- Complex Mixtures
- Azirines
- Plant Oils
- Oils
- Mitomycins
- Indolequinones
- Mitomycin
- Ethiodized Oil
- Mitozytrex
- Iodized Oil
Other Study ID Numbers
Other Study ID Numbers
- 22067 (Other Identifier: City of Hope Medical Center)
- P30CA033572 (U.S. NIH Grant/Contract)
- NCI-2022-10436 (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
product manufactured in and exported from the U.S.
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