Evaluation of Healthcare Workers Safety During Pressurized Intraperitoneal Aerosol Chemotherapy (PIPAC-Secure)

July 9, 2019 updated by: Institut du Cancer de Montpellier - Val d'Aurelle

Evaluation of Oxaliplatin Exposure and Security of Healthcare Workers During Pressurized Intraperitoneal Aerosol Chemotherapy

Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a new treatment that applies chemotherapeutic drugs into the peritoneal cavity as an aerosol. It is used to treat patient with Peritoneal Carcinomatosis (PC). During this procedure, healthcare workers may be under risks of exposure to cytotoxic treatments.

The purpose of this study is to evaluate the safety of the heathcare workers and the risk of operation room Oxaliplatin's contamination during a PIPAC.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Peritoneal carcinomatosis (PC), which was long considered as a terminal stage, is now potentially curable. Nevertheless, in most cases, the surgical treatment of PC is limited by the disease extent which is commonly measured with the Peritoneal Carcinomatosis Index (PCI). For the patients that are not considered good candidates for resection, there are very few alternatives. Systemic chemotherapy may have limited or no effect therefore an alternative solution is needed for these patients.

Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is a new treatment that applies chemotherapeutic drugs into the peritoneal cavity as an aerosol under pressure through minimal laparoscopic surgery.

Nevertheless, as it is the case for most technologies, security is not always completely tested. The innovative team started by establishing a set of security rules that concern the operating room ventilation, distance monitoring of the patient during nebulization, evacuation of the aerosols in a closed system. In a work dedicated to occupational hazards, the authors followed the following steps: identification of hazardous substances and dose; identification of possible exposure ways; simulation of the PIPAC procedure with nontoxic aerosols and smoke; redaction of standard operating procedures (SOP); second simulation according to the SOP; informing and training the health care workers; and performance of the first two PIPAC procedures with chemotherapeutic substances and workplace measurements under real conditions. At the end of the study, there were no traces of doxorubicin or cisplatin (the two drugs used in the two consecutive test procedures) in the operating room air, neither to the position of the anesthesiologist, nor of the surgeon.

This study does not concern PIPAC with oxaliplatin, nor does it research the presence of the drugs in the health caregivers.

Therefore we considered mandatory to further investigate occupational hazards in the specific case of oxaliplatin by focusing more on the healthcare workers and partially applying the same protocols as in the case of Heated intraperitoneal chemotherapy (HIPEC).

Study Type

Interventional

Enrollment (Actual)

18

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • France
      • Montpellier, France, 34298
        • ICM - Val d'Aurelle

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

Male or female subjects ≥ 18 and ≤ 70 years old

  • Exposed subjects: The healthcarers involved in two different PIPAC using oxaliplatin (Surgeon, Anesthesiste, Block nurse …)
  • Non-exposed subjects: Healthy volunteers not exposed to oxaliplatin or other platin based chemotherapy (administrative function).
  • Must be affiliated to a social security system
  • Informed consent agreement and signature

Exclusion Criteria:

  • Legal incapacity or physical, psychological or mental status interfering with the subject's ability to sign the inform consent or to terminate the study

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Non-Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Other: Exposed
Healthcare workers participating at two PIPAC
Other: Blood sample

Exposed group:

  • 15 to 30 minutes before the start of the procedure: 1 EDTA tube of 6 ml for blood (T0)
  • 2hours after the end of the procedure: 1 EDTA tube of 6 ml (T1)

Non-exposed group:

- During the morning (8 to 10 a.m): 1 EDTA tube of 6 ml (T0)

Other: Urinary sample

Exposed group:

  • 15 to 30 min before the PIPAC procedure (T0)
  • 2hours after the end of the procedure (T1)
  • The next morning after the procedure (T2)

Non-exposed group:

- During the morning (8 to 10 a.m) (T0)
Other: Non-exposed
Healthy volunteers unexposed to chemotherapy
Other: Blood sample

Exposed group:

  • 15 to 30 minutes before the start of the procedure: 1 EDTA tube of 6 ml for blood (T0)
  • 2hours after the end of the procedure: 1 EDTA tube of 6 ml (T1)

Non-exposed group:

- During the morning (8 to 10 a.m): 1 EDTA tube of 6 ml (T0)

Other: Urinary sample

Exposed group:

  • 15 to 30 min before the PIPAC procedure (T0)
  • 2hours after the end of the procedure (T1)
  • The next morning after the procedure (T2)

Non-exposed group:

- During the morning (8 to 10 a.m) (T0)

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Blood levels of oxaliplatin - Exposed group
Time Frame: Change from before PIPAC and 2hours after PIPAC
Blood levels of oxaliplatin in healthcare workers in two PIPAC
Change from before PIPAC and 2hours after PIPAC
Blood levels of oxaliplatin - Non-exposed group
Time Frame: At baseline
Blood levels of oxaliplatin in heathy subject non-exposed to chemotherapy
At baseline
Urinary levels of oxaliplatin - Exposed group
Time Frame: Change from before PIPAC, 2hours after PIPAC and the next day after PIPAC
Urinary levels of oxaliplatin in healthcare workers in two PIPAC
Change from before PIPAC, 2hours after PIPAC and the next day after PIPAC
Urinary levels of oxaliplatin - Non-exposed group
Time Frame: At baseline
Urinary levels of oxaliplatin in heathy subject non-exposed to chemotherapy
At baseline

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Oxaliplatin contamination of the operating room
Time Frame: Before PIPAC and 10min after PIPAC
Oxaliplatin dosed on standardized gazes used to clear four different spots in the operating room: the ceiling lamp, the electroagulation device, the laparoscopy tower and the anesthesia monitoring screen
Before PIPAC and 10min after PIPAC

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Institut du Cancer de Montpellier - Val d'Aurelle

Investigators

  • Study Chair: Olivia SGARBURA, MD, ICM - Institut régional du Cancer Montpellier

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 2, 2018

Primary Completion (Actual)

July 4, 2018

Study Completion (Actual)

July 4, 2018

Study Registration Dates

First Submitted

July 1, 2019

First Submitted That Met QC Criteria

July 9, 2019

First Posted (Actual)

July 10, 2019

Study Record Updates

Last Update Posted (Actual)

July 10, 2019

Last Update Submitted That Met QC Criteria

July 9, 2019

Last Verified

June 1, 2019

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • ICM-URC 2017/36

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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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