- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04298242
Magnetic Resonance Guided High Intensity Focused Ultrasound in Advanced Pancreatic Adenocarcinoma Treatment
A Phase I Study of Magnetic Resonance Guided High Intensity Focused Ultrasound for Treatment of Advanced Pancreatic Adenocarcinoma
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Primary Objective: The primary endpoints for this study will be 1) feasibility of ablation and 2) safety of ablation.
Secondary Objective: 1.)Pain reduction after ablation. 2.) Evidence of inflammation at ablation site based on histology, or in blood after ablation
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
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California
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Stanford, California, United States, 94304
- Stanford Cancer Center
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Men and women ≥ 18 years of age
- Patients willing to sign a written informed consent document
- Patients with unresectable, locally advanced or metastatic pancreatic adenocarcinoma
- Patients with upper abdominal pain rating at least 4 out of 10 in severity on BPI
- Tumor must be visualized on CT or MRI, obtained within 30 days of enrollment
- Tumor must be accessible to the ExAblate MRgFUS device
- Life expectancy ≥ 3 months, as determined by oncologist and documented in chart
- ECOG performance status of 0, 1, or 2
- INR < 1.6, platelet count > 50,000 microL
- Serum urate, calcium, potassium, phosphate, creatinine < 1.5x upper limit of normal
- Patients can receive general anesthesia, as determined by anesthesiologist
Exclusion Criteria:
- Previous pancreatic surgery
- Patients with contraindication for MR imaging such as implanted metallic devices that are not MRI-safe, size limitations, claustrophobia, etc.
- Patients with known intolerance or allergy to MR contrast agent (gadolinium chelates) including advanced kidney disease (GFR <30 mL/min/1.73 m2) or on dialysis
- Pregnant and nursing patients will be excluded from the study because of a contraindication to administering MRI contrast agents to these patients
- Patients unable to receive general anesthesia
Target is:
- NOT visible by non-contrast MRI, OR
- NOT accessible to ExAblate device
- Individuals who are not able or willing to tolerate the required prolonged stationary position during treatment (can be up to 6 hrs of total table time)
- Patients with acute medical condition (e.g. pneumonia, sepsis) that is expected to hinder them from completing this study
Patients with unstable cardiac status including:
- Unstable angina pectoris on medication
- Patients with documented myocardial infarction within six months of protocol entry
- Congestive heart failure requiring medication (other than diuretic)
- Patients on anti-arrhythmic drugs
- Patients with severe hypertension (diastolic BP > 100 on medication)
- Patients with severe hematologic, neurologic, or other uncontrolled disease (e.g. platelets < 50,000/microL, INR > 1.5)
- Patients who are taking anti-thrombotic medication
- Severe cerebrovascular disease (multiple CVAs or CVA within 6 months)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Device Feasibility
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: MRgFUS Treatment
The pancreatic tumor will be ablated with magnetic resonance guided focused ultrasound (MRgFUS).
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A non-invasive thermal ablation device fully integrated with an MR imaging system
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Measure acceptable ablation percentage
Time Frame: Immediately after MRgFUS treatment
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Feasibility of ablation, as measured by the number of patients with acceptable ablation percentage.
Acceptable ablation percentage is defined as ≥50% of the targeted volume appearing ablated on post-treatment imaging.
Ablation will be deemed feasible if at least seven of the ten patients have an acceptable ablation percentage
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Immediately after MRgFUS treatment
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Total frequency and severity of adverse events
Time Frame: 24 months
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Safety of ablation, as measured by the total frequency and severity of adverse events.
Adverse events will be categorized and grade for severity according to the Common Terminology Criteria for Adverse Events, Version 5.0.
Ablation will be deemed safe if there are no treatment-related serious adverse events, and no more than five moderate or mild treatment-related adverse events, among the ten patients during follow up.
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24 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Assess Pain Response assessed by the Brief Pain Inventory (BPI)
Time Frame: Baseline, 1 week, and monthly for 24 months following treatment
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Reduction in pain level, as measured by: a. a decline in pain score after one week of at least 2 points, or a pain score < 4 out of 10, as assessed by the Brief Pain Inventory. Ablation will be deemed pain reducing if at least five of the ten patients have pain reduction. |
Baseline, 1 week, and monthly for 24 months following treatment
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Assess Pain Response assessed by morphine equivalent daily dose (MEDD)
Time Frame: Baseline, 1 week, and monthly for 24 months following treatment
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Reduction in pain level will be measured by a decline after one week in morphine equivalent daily dose (MEDD) of 25%.
Ablation will be deemed pain reducing if at least five of the ten patients have pain reduction.
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Baseline, 1 week, and monthly for 24 months following treatment
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Evidence of ablation-induced inflammation
Time Frame: 1week
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Evidence of ablation-induced inflammation, defined as post-ablation increases in histologic and/or blood measures of inflammation markers, as measured by either:
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1week
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Pejman Ghanouni, Stanford University
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
Additional Relevant MeSH Terms
Other Study ID Numbers
- IRB-52567
- PANC0034 (Other Identifier: OnCore)
- NCI-2020-13809 (Other Identifier: CTRP)
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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