CT-guided Percutaneous Radionuclide Therapy With 32P Microparticles in Patients With Non-progressive Locally Advanced Pancreatic Cancer (PANCOSIL)

May 19, 2026 updated by: M.R. Meijerink

Safety and Feasibility of CT-guided Percutaneous Radionuclide Therapy With 32P Microparticles in Patients With Non-progressive Locally Advanced Pancreatic Cancer (PANCOSIL): an Open-label, Single-arm Phase 1-2 Feasibility Study

Pancreatic ductal adenocarcinoma is a highly lethal cancer, and approximately 40% of patients present with non-metastatic locally advanced pancreatic cancer (LAPC) that is not suitable for surgical resection. To improve outcomes in this patient group, local ablative treatments are being explored. Radionuclide therapy (RNT) is a promising option that delivers high-dose internal radiation directly into the tumor, potentially achieving better local tumor control while sparing surrounding tissues compared with external-beam radiation therapy. The OncoSil™ device is a type of RNT containing Phosphorus-32-radiolabeled microparticles. The ³²P microparticles have been designed to deliver a localized distribution of beta-radiation within the target tumor up to 100 Gy, which causes direct damage to cancer cell DNA and renders them incapable of further cell division and proliferation. Favorable results have been reported by implanting ³²P microparticles intra-tumorally, which is typically administered via endoscopic ultrasound guidance. A percutaneous approach may allow for more precise and reproducible delivery, but prospective data on its safety and feasibility are lacking.

This prospective, single-arm phase 1-2 feasibility study aims to evaluate the safety and feasibility of percutaneous CT- guided RNT using ³²P microparticles in patients with non-progressive LAPC following induction chemotherapy. Twenty adult patients with pathology-confirmed LAPC, showing non-progressive disease according to RECIST, will be included after multidisciplinary tumor board review. Patients will undergo percutaneous, CT-guided implantation of ³²P microparticles under general anesthesia, sedation, or local analgesia depending on study phase and clinical judgment, followed by continuation of standard systemic chemotherapy and routine follow-up.

The primary endpoint is the rate of adverse events (CTCAE grade ≥3) occurring during the procedure and within 90 days afterward. Secondary endpoints include technical success, all adverse events, best overall respons, overall and progression-free survival, and changes in tumor markers.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

20

Phase

  • Phase 2
  • Phase 1

Contacts and Locations

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

Study Contact

Study Locations

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

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Age ≥18 years
  • Locally advanced pancreatic cancer, defined by the DPCG consensus criteria as: arterial involvement >90 degrees or venous involvement >270 degrees.
  • At least RECIST stable disease after a minimum two months of chemotherapy according to current clinical practice*
  • Capable of providing written and oral informed consent
  • Candidate for RNT, judged by a multidisciplinary tumor board
  • WHO 0-2

Exclusion Criteria:

  • Eligibility for resection
  • Participation in other trials focussing on different ablative treatment modalities such as radiofrequency ablation or irreversible electroporation for LAPC
  • Known hypersensitivity to silicon or phosphor
  • Bleeding disorders which cannot be corrected with medication
  • Inability/unwillingness to interrupt anticoagulation therapy
  • Pregnancy
  • Metastatic pancreatic cancer
  • Epilepsy episode(s) in the past six months
  • Longest tumor diameter >70 mm or total target tumor volume >110 ml
  • Presence of multiple collateral vessels surrounding or adjacent to the target tumor on radiologic imagining, prohibiting safe injection of the OncosilTM device
  • Presence (or significant risk) of varices near the target tumor on radiologic imaging
  • Recent clinically significant pancreatitis
  • Previous administration of radiotherapy to the pancreas

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: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: CT-guided percutaneous intratumoural implantation of ³²P microparticles for LAPC
CT-guided percutaneous intratumoural implantation of the OncoSil™ device, containing ³²P microparticles as a form of radionucleide therapy for 20 patients diagnosed with RECIST-stable LAPC after 2 months of systemic therapy.
Device: CT-guided percutaneous intratumoural implantation of the OncoSil™ device
CT-guided percutaneous intratumoural implantation of the OncoSil™ device, containing ³²P microparticles as a form of radionucleide therapy for 20 patients diagnosed with RECIST-stable LAPC after 2 months of systemic therapy.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Safety defined as the rate of procedure- or device-related CTCAE grade ≥3 adverse events (AEs) within 90 days after implantion.
Time Frame: From implantation to 90 days after implantation
From implantation to 90 days after implantation

Secondary Outcome Measures

Outcome Measure
Time Frame
Technical succes defined a the rate of adequate punctures and subsequent complete intratumoral delivery of the planned dose.
Time Frame: Periprocedural.
Periprocedural.
Overall safety defined as the rate of adverse events.
Time Frame: From implantation until 90 days after implantation.
From implantation until 90 days after implantation.
Duration of implantation procedure defined as the total time of punction.
Time Frame: Periprocedural.
Periprocedural.
Duration of overall procedure defined as the total time in the radiology suite.
Time Frame: Periprocedural.
Periprocedural.
Overall survival
Time Frame: Defined from diagnosis and from implantion untill death by any cause, assessed up to end of study or up to 1 year after implantation.
Defined from diagnosis and from implantion untill death by any cause, assessed up to end of study or up to 1 year after implantation.
Local, distant and overall progression free survival
Time Frame: Defined from diagnosis and from implantation until local and/or distant progression, or death, assessed up to end of study or up to 1 year after implantation.
Defined from diagnosis and from implantation until local and/or distant progression, or death, assessed up to end of study or up to 1 year after implantation.
Changes in serum CA19.9 during the first three months after implantation.
Time Frame: From implantation until three months after implantation.
From implantation until three months after implantation.
Visual confirmation of intra-tumoral delivery of ³²P microparticles or other off-target deposition.
Time Frame: SPECT-imaging at +4 hours and +7 days after implantation.
SPECT-imaging at +4 hours and +7 days after implantation.

Collaborators and Investigators

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

Sponsor

M.R. Meijerink

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)

June 4, 2023

Primary Completion (Estimated)

June 1, 2026

Study Completion (Estimated)

June 1, 2026

Study Registration Dates

First Submitted

January 26, 2026

First Submitted That Met QC Criteria

May 12, 2026

First Posted (Actual)

May 19, 2026

Study Record Updates

Last Update Posted (Actual)

May 22, 2026

Last Update Submitted That Met QC Criteria

May 19, 2026

Last Verified

February 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • NL78596.000.22

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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