- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05141513
Intraoperative Radiation Therapy After Stereotactic Body Radiation Therapy and Chemotherapy in Treatment of Pancreatic Adenocarcinoma
A Safety Study of Intraoperative Radiation Therapy Following Stereotactic Body Radiation Therapy and Multi-agent Chemotherapy in the Treatment of Localized Pancreatic Adenocarcinoma
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Standard of care treatment for patients with non-metastatic pancreatic adenocarcinoma (PDAC) includes chemotherapy and Stereotactic Body Radiation Treatment (SBRT) followed by surgical resection of the tumor with or without Intra-Operative Radiation Therapy (IORT).
There is some evidence from other research studies suggesting that adding radiation treatment during the surgical resection may improve local control of the cancer. The use of IORT plus surgical resection can be used to treat pancreatic cancer and is done on a case by case basis at Johns Hopkins.
The department of Radiation Oncology has developed a program using a High Dose Rate-IORT (HDR-IORT). The HDR-IORT makes it possible to deliver concentrated radiation dose at the surface of the tumor.
Our team has shown in previous studies that the majority of cancer cells that remain after treatment are located around the area of the pancreas called the "Triangle Volume" (TV). This region contains blood vessels, lymphatic vessels, and nerves, and is at high risk of containing cancer cells. This region is difficult to treat with SBRT alone because of being close to normal, healthy organs. Therefore, this study involves using IORT to treat the TV to a therapeutic radiation dose.
The part of the treatment that is considered research is:
- Giving one dose of 15 Gy during the surgery using IORT to deliver radiation, and
- Targeting the larger area around the pancreas called the TV
The goal of this study is to determine safety of this added treatment which will be assessed at 3 months after the surgery is completed.
Study Type
Enrollment (Estimated)
Phase
- Phase 1
Contacts and Locations
Study Contact
- Name: Amol Narang, MD
- Phone Number: 410-502-3828
- Email: anarang2@jh.edu
Study Contact Backup
- Name: Dana B Kaplin, MPH
- Phone Number: 410-502-3950
- Email: dkaplin1@jhmi.edu
Study Locations
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Maryland
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Baltimore, Maryland, United States, 21205
- Recruiting
- Johns Hopkins Hospital
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Contact:
- Amol Narang, MD
- Phone Number: 410-502-3828
- Email: anarang2@jhmi.edu
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age > 18 years old
- Resectable/BRPC/LAPC as defined by NCCN guidelines (Figure 1) as follows confirmed via CT, EUS, or other imaging modalities.
- ECOG performance status 0-2
- Subject or authorized representative, has been informed of the nature of the study and has provided written informed consent, approved by the appropriate Institutional Review Board (IRB) of the respective clinical site.
- Candidate for SBRT at JHU
- Upfront treatment with multi-agent chemotherapy
- Candidate for surgical exploration at JHU
Exclusion Criteria:
- Previous thoracic/abdominal radiation therapy
- Unable to receive SBRT at JHU
- Duodenal invasion detected on imaging which would exclude candidacy for SBRT
- Tumor located in pancreatic body or tail
- Unable to undergo Whipple procedure
- Evidence of disease not localized to the pancreas
- Any arterial reconstruction during surgery
- Currently enrolled in another investigational drug or device trial that clinically interferes with this study
- Unable to comply with study requirements or follow-up schedule
- Women of child bearing potential or sexually active fertile men with partners who are women of child bearing potenital who are unwilling or unable to use an acceptable method to avoid pregnancy for the entire study
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Other: Intra Operative Radiation Therapy (IORT) Group
The IORT group is the single arm of this study.
Enrolled patients who undergo standard of care treatment will also receive a study treatment of High Dose Rate (HDR) Intra Operative Radiation Therapy.
|
After the patient receives standard of care treatment, they will receive a single dose of radiation (15 Gy) at the time the tumor is surgically removed.
Surgeons will then place clips along the blood vessels around the surgical area.
These clips will be used to confirm (after surgery) that the expected dose of radiation was received during surgery.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Acute post-operative toxicity of targeted IORT
Time Frame: 3 months
|
To evaluate acute post-operative toxicity of IORT targeted to the TV in patients with non-metastatic PDAC undergoing surgical resection after neoadjuvant multi-agent chemotherapy and SBRT.
|
3 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Late post-operative toxicity of targeted IORT
Time Frame: 6 months
|
To evaluate late toxicity of IORT targeted to the TV in patients with non-metastatic PDAC undergoing surgical resection after neoadjuvant multi-agent chemotherapy and SBRT. To evaluate late toxicity (>90 days) of IORT targeted to the TV in patients with non-metastatic PDAC undergoing surgical resection after neoadjuvant multi-agent chemotherapy and SBRT. |
6 months
|
Late post-operative toxicity of targeted IORT
Time Frame: 12 months
|
To evaluate late toxicity of IORT targeted to the TV in patients with non-metastatic PDAC undergoing surgical resection after neoadjuvant multi-agent chemotherapy and SBRT. To evaluate late toxicity (>90 days) of IORT targeted to the TV in patients with non-metastatic PDAC undergoing surgical resection after neoadjuvant multi-agent chemotherapy and SBRT. |
12 months
|
Late post-operative toxicity of targeted IORT
Time Frame: 24 months
|
To evaluate late toxicity of IORT targeted to the TV in patients with non-metastatic PDAC undergoing surgical resection after neoadjuvant multi-agent chemotherapy and SBRT. To evaluate late toxicity (>90 days) of IORT targeted to the TV in patients with non-metastatic PDAC undergoing surgical resection after neoadjuvant multi-agent chemotherapy and SBRT. |
24 months
|
Late post-operative toxicity of targeted IORT
Time Frame: 36 months
|
To evaluate late toxicity of IORT targeted to the TV in patients with non-metastatic PDAC undergoing surgical resection after neoadjuvant multi-agent chemotherapy and SBRT. To evaluate late toxicity (>90 days) of IORT targeted to the TV in patients with non-metastatic PDAC undergoing surgical resection after neoadjuvant multi-agent chemotherapy and SBRT. |
36 months
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Median local-progression free survival (LPFS) from IORT
Time Frame: 6 months
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To determine the median local-progression free survival (LPFS) from time of IORT.
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6 months
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Median local-progression free survival (LPFS) from IORT
Time Frame: 12 months
|
To determine the median local-progression free survival (LPFS) from time of IORT.
|
12 months
|
Median local-progression free survival (LPFS) from IORT
Time Frame: 24 months
|
To determine the median local-progression free survival (LPFS) from time of IORT.
|
24 months
|
Median local-progression free survival (LPFS) from IORT
Time Frame: 36 months
|
To determine the median local-progression free survival (LPFS) from time of IORT.
|
36 months
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Median overall survival (OS) from IORT
Time Frame: 6 months
|
To determine the median overall survival (OS) from time of IORT.
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6 months
|
Median overall survival (OS) from IORT
Time Frame: 12 months
|
To determine the median overall survival (OS) from time of IORT.
|
12 months
|
Median overall survival (OS) from IORT
Time Frame: 24 months
|
To determine the median overall survival (OS) from time of IORT.
|
24 months
|
Median overall survival (OS) from IORT
Time Frame: 36 months
|
To determine the median overall survival (OS) from time of IORT.
|
36 months
|
Median progression free survival (PFS) from IORT
Time Frame: 6 months
|
To determine the median progression free survival (PFS) from time of IORT
|
6 months
|
Median progression free survival (PFS) from IORT
Time Frame: 12 months
|
To determine the median progression free survival (PFS) from time of IORT
|
12 months
|
Median progression free survival (PFS) from IORT
Time Frame: 24 months
|
To determine the median progression free survival (PFS) from time of IORT
|
24 months
|
Median progression free survival (PFS) from IORT
Time Frame: 36 months
|
To determine the median progression free survival (PFS) from time of IORT
|
36 months
|
Collaborators and Investigators
Investigators
- Principal Investigator: Amol Narang, MD, JHU, School of Medicine, SKCCC
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
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
- J21105
- IRB00294801 (Other Identifier: Johns Hopkins Medicine)
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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