- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03274609
CT-controlled Advanced Navigation Techniques for Transbronchial Pulmonary Lesion Access; Evaluation of Augmented Fluoroscopy Bronchoscopic Navigation Based Diagnostic Yield (CONTROL-A)
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Lung cancer is one of the leading most frequent types of cancer and is the most lethal malignancy in the Netherlands. Mortality is high due to its advanced stage disease at diagnosis. To improve survival current guidelines are moving towards CT-screening of the high risk population. These CT-scans detect numerous nodules and rapidly increase the demand for minimal invasive accurate and safe diagnostic procedures.
The historically available and current first diagnostic procedure in the work-up of PPLs is fluoroscopy guided Trans Bronchial Biopsy (TBB) despite its low pooled yield of 31.1%. When the above transbronchial technique does not provide an unambiguous outcome, an additional and more invasive diagnostic work-up remains indicated. To exclude the possibility of missing malignancies, trans thoracic needle aspiration is first indicated. If deemed inaccessible, surgical biopsy may be alternatively indicated depending on patient risk of malignancy. Ideally, a transbronchial approach having high diagnostic accuracy would overcome the need of this sequential increasingly invasive diagnostic and consecutive treatment approach. Newer pilot studies now hypothesize that combining multiple new endobronchial modalities might provide a solution in preventing more invasive additional diagnostic staging, reporting diagnostic yields exceeding 70%. When an accurate and certain transbronchial diagnosis by combining multiple techniques can indeed be provided. We will study a combination of new advanced modalities for diagnosis of peripheral nodules endobronchially. The aim of this study is to determine diagnostic yield, cost-effectiveness, safety, and, to collect data for developing diagnostic algorithms to further cost-effectively increase yield, reduce complication rate and determine a future platform for clinical implementation.
Study Type
Enrollment (Actual)
Contacts and Locations
Study Locations
-
-
Gelderland
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Nijmegen, Gelderland, Netherlands, 6525GA
- Radboudumc
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
In order to be eligible to participate in this study, a subject must meet all of the following criteria:
- ASA physical status 1-3.
- Age 18 years or older.
- A pulmonary lesion (i.e. a focal, rounded opacity mostly surrounded by aerated lung or a ground glass opacity or part- or sub-solid lesion) with an indication for diagnostic evaluation following current clinical guidelines and/or as decided by multi-disciplinary team consultation.
Exclusion Criteria:
A potential subject who meets any of the following criteria will be excluded from participation in this study:
- Bleeding disorders.
- Less than 18 years old.
- Contra-indication for temporary interruption of the use of anticoagulant therapy (acenocoumarol, warfarin, therapeutic dose of low molecular weight heparines, clopidrogel, analogs, or, NOAC's).
- Known allergy for lidocaine.
- Uncontrolled pulmonary hypertension.
- Recent and/or uncontrolled cardiac disease.
- Compromised upper airway (e.g. concomitant head and neck cancer or central airway stenosis for any reason such that endobronchial access is considered unsafe).
- ASA classification greater than or equal to 4 (unfit for performing non-surgical biopsy).
- Pregnancy.
- Inability to consent.
Study Plan
How is the study designed?
Design Details
- Observational Models: Cohort
- Time Perspectives: Prospective
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Suspected lung cancer
These will be subjected to a combined approach of modalities with the main intervention being augmented fluoroscopy guided virtual navigation.) |
Augmented fluoroscopy based virtual navigation combined with use of radial EBUS probe and Rapid On Site Evaluation of Histology for diagnosis of peripheral pulmonary nodules.Controlled by cone beam CT.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
number of patients with an adequate diagnosis (=diagnostic yield)
Time Frame: 0-12 months
|
diagnosis will consist of benign, malign or non-representative (=blood, anatomical lung tissue, unreachable)
|
0-12 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
number of patients with (S)AE's related to the procedure
Time Frame: 0-12 months
|
minor bleeding and pneumothoraces are reported
|
0-12 months
|
cost-effectiveness
Time Frame: 0-12 months
|
the study procedures will be compared against the conventional diagnostic TBB work-up
|
0-12 months
|
radiation exposure
Time Frame: 0-12 months
|
compared against conventional TBB and consecutive TTNA procedure
|
0-12 months
|
Collaborators and Investigators
Investigators
- Study Chair: Linda Garms, study coordinator
- Principal Investigator: Erik van der Heijden, MD PhD, Pulmonary diseases
- Study Chair: Roel Verhoeven, Msc, Pulmonary Diseases / Radiology
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- NL63109.091.17
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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