C2 CryoBalloon™ 180 Ablation System Dose De-escalation Study.

Clinical Trial To Evaluate Safety and Efficacy of the C2 CyroBalloon™ 180 Ablation System for the Treatment of Dysplastic Barrett's Esophagus: CBAS180 De-escalation Study

The primary objective is to determine the safety and efficacy of the C2 CryoBalloon 180 Ablation System ("CryoBalloon 180") used at decreasing doses in ablation naïve patients with low- or high-grade dysplastic Barrett's Esophagus (BE) or with residual BE after resection of dysplasia or early adenocarcinoma.

Study Overview

• Status: Active, not recruiting
• Conditions: Barrett Esophagus
• Intervention / Treatment: Device: C2 CryoBalloon 180° Ablation System

Detailed Description

The procedure will be performed on an outpatient basis, and the CryoBalloon 180 Ablation system will be used for all ablations following the instructions for use provided with the product.

Patients who meet the eligibility criteria will be assigned to one of the treatment groups and doses, depending on the order of their enrollment:

In phase I, the first 62 patients will be treated with Dose 1 (lowest), in one application to ablate 50% of the esophageal circumference.

All patients will undergo 10 week (±2 weeks) follow-up EGD to evaluate efficacy of the dose before the study continues.

If follow-up shows that Dose 1 eradicates ≤60% of the treated BE (by median percentage) and no SAE's are reported, the treatment phase will continue but at the next incremental higher dose (Second Dose) after approval from the IRB.

If the Dose 1 median BE surface regression percentage is ≥60%, the dose is defined as the therapeutic dose. In that case, the study will be prematurely terminated without the consecutive treatment of an additional 62 patients with a higher dose.

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Dose-related SAEs include pain in the treatment area greater than 6 (0-10 NRS score) at 24 hours AND seven (7) days post-treatment; symptomatic stricture requiring an additional EGD with endoscopic dilation before the first follow-up EGD; symptomatic stricture at follow-up EGD; or any stricture (symptomatic or asymptomatic) preventing passage of the therapeutic endoscope at follow-up EGD. Any other serious adverse events within 30 days after treatment will also be evaluated by the Data and Safety Monitoring Board (DSMB) for relationship to the dose and severity.

• Study Type: Interventional
• Enrollment (Actual): 62
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Netherlands
  • Nieuwegein, Netherlands
    • St. Antonius Hospital
  • Netherlands
    • Amsterdam, Netherlands, Netherlands
      • AMC Medical Research B.V.
    • Eindhoven, Netherlands, Netherlands
      • Catharina Hospital Eindhoven
    • Groningen, Netherlands, Netherlands
      • UMC Groningen
    • Rotterdam, Netherlands, Netherlands
      • Erasmus Medical Center
    • Utrecht, Netherlands, Netherlands
      • UMC Utrecht

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. Patients with flat- type BE esophagus, with an indication for ablation therapy, defined as:

   • Diagnosis of LGD or HGD in BE (confirmed by central pathology review), OR
   • Residual BE with any grade of dysplasia 6 weeks after endoscopic resection
2. Prague Classification Score C≤3 and ≥M1
3. Patients should be ablation-naïve (no previous ablation therapy of the esophagus)
4. Older than 18 years of age at time of consent
5. Operable per institution's standards
6. Patient provides written informed consent on the IRB-approved informed consent form
7. Patient is willing and able to comply with follow-up requirements.

Exclusion Criteria:

1. Esophageal stenosis preventing advancement of a therapeutic endoscope
2. Any endoscopically visualized lesion such as ulcers, masses or nodules. Neoplastic nodules must first be treated with ER ≥6 weeks prior to planned treatment under this protocol.
3. Prior ER of more than 2cm in length and/or >50% of the esophageal lumen circumference
4. History of locally advanced (>SM1) esophageal cancer
5. History of esophageal varices
6. Prior distal esophagectomy
7. Active esophagitis LA grade B or higher
8. Severe medical comorbidities precluding endoscopy
9. Uncontrolled coagulopathy
10. Pregnant or planning to become pregnant during period of study
11. Patient refuses or is unable to provide written informed consent
12. Participation in another study with investigational drug within the 30 days preceding or during the present study, interfering with participation in the current study
13. General poor health, multiple co-morbidities placing the patient at risk or otherwise unsuitable for trial participation

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

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: C2 CryoBalloon 180 Ablation System; C2 CryoBalloon 180 Ablation System will be used to ablate visible Barrett's esophagus	Device: C2 CryoBalloon 180° Ablation System; The C2 CryoBalloon 180° Ablation System is a cryosurgical device with a nitrous oxide cooled balloon probe that is compatible with upper gastrointestinal therapeutic endoscopes.; Other Names: CryoBalloon 180

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Safety: Incidence of Dose-related SAEs	Safety will be evaluated by the incidence of Dose-related SAEs. Dose-related SAEs include pain in the treatment area, or any stricture (symptomatic or asymptomatic) preventing passage of the diagnostic endoscope at follow-up EGD.	30 days
Efficacy: Dose response	Dose response (efficacy) is defined as eradication percentage of BE confirmed by histological evidence of eradication of BE, after treatment with the therapeutic dose.	10 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Incidence of AEs	Incidence of all serious and non-serious adverse events up to 30 days post-treatment	30 days
Efficacy: Percent Regression	Efficacy, defined as the regression percentage at the first follow-up endoscopy, after one (1) treatment covering 50% of circumference of the esophagus with the therapeutic dose.	10 weeks
Efficacy: Treatment	Efficacy of treatment with CryoBalloon 180 Ablation system, defined as the proportion of patients with ≥80% regression of BE after 1 hemi-circumferential and after full circumferential treatment.	10 weeks
Patient reported post-procedure pain	Post-procedure pain in the area of the cryoablation treatment (0-10 NRS score)	24hours, 7 days and 30 days post-procedure
Post procedure dysphagia score	Post procedure dysphagia score (scored 0-4 dysphagia score), described as median dysphagia score directly	24 hours, 7 days and 30 days post-procedure

Collaborators and Investigators

• Sponsor: Merit Medical Systems, Inc.
• Investigators: Principal Investigator: Bas LA Weusten, MD, PhD, St. Antonius Ziekenhuis, Niewegein The Netherlands

Study record dates

Study Major Dates

• Study Start (Actual): January 16, 2023
• Primary Completion (Estimated): June 18, 2026
• Study Completion (Estimated): December 18, 2026

Study Registration Dates

• First Submitted: October 10, 2017
• First Submitted That Met QC Criteria: October 13, 2017
• First Posted (Actual): October 17, 2017

Study Record Updates

• Last Update Posted (Actual): May 22, 2026
• Last Update Submitted That Met QC Criteria: May 19, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Neoplasms; Digestive System Diseases; Gastrointestinal Diseases; Esophageal Diseases; Precancerous Conditions; Barrett Esophagus
• Other Study ID Numbers: CP-0019

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Data will not be shared.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: Yes
• product manufactured in and exported from the U.S.: Yes