- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT07791446
End Hole vs. Pressure-Modulated Delivery of Y-90 Resin Microspheres to Liver Metastases.
Pressure-Enabled Selective SIR-Sphere Uptake for Radiation Efficacy (PRESSURE): A Prospective Randomized Clinical Trial of End Hole vs. Pressure-Modulated Delivery of Y-90 Resin Microspheres to Liver Metastases.
Patients with liver metastases undergoing planning arteriography for Y-90 administration by interventional radiology will be screened for study enrollment. If there are at least 2 planned delivery sites with the same target mean dose to tumor and at least 1 tumor in each angiosome that is measurable by RECIST criteria, the patient is potentially eligible for this study (see full inclusion and exclusion criteria). On the day of Y-90 administration, one delivery site will be randomized to a standard end hole microcatheter while the other delivery site will be assigned to the TriNav Infusion System.
A standard of care post-Y-90 PET/CT will be performed and dosimetry analysis will be conducted. The patient will also undergo a standard of care MRI 3 months and 6 months following Y-90 administration and disease response will be graded according to RECIST/mRECIST criteria.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: David Marcellus
- Email: dmarcel2@stanford.edu
Study Contact Backup
- Name: Brittney Worley
- Phone Number: 650-736-3688
- Email: bw718@stanford.edu
Study Locations
-
-
California
-
Palo Alto, California, United States, 94305
- Stanford University
-
Contact:
- Brittney G Worley
- Phone Number: 650-736-3688
- Email: bw718@stanford.edu
-
Contact:
- David G Marcellus, MD
- Email: dmarcel2@stanford.edu
-
Principal Investigator:
- Matthew Hung
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Presence of multiple liver metastases
- Prior multidisciplinary clinical decision for treatment with radioembolization
- 18 years of age or older
- ECOG less than or equal to 2
- Life expectancy > 3 months
- Ability to understand and the willingness to provide written informed consent.
- At least 2 planned Y-90 delivery sites/vessels with the same target mean dose to tumor
- Angiosome for each delivery site has at least 1 measurable tumor per RECIST criteria
- At least 1 target tumor per delivery site is exclusively supplied by the angiosome of the delivery site.
- Vascular anatomy suitable for use with the TriNav Infusion System, including target vessel diameter 1.5-5 mm.
- The vessel level for each planned delivery site is no further distal than the segmental level.
Exclusion Criteria:
- Pregnant
- Breast-feeding
- Lung shunt fraction > 20% or calculated lung dose > 30 Gy
- Prior hepatic transarterial embolization in the hepatic lobe to be treated
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 |
|---|---|
|
Experimental: Single Group
Participants undergo Y-90 administration using both the TriNav Infusion System and a standard end hole microcatheter, with delivery sites randomized within the participant.
|
The Y-90 dose to be delivered by the TriNav Infusion System will be determined and recorded by the Investigator or Sub-Investigator, calculated using partition-based dosimetry software (i.e.
MIM SurePlan or Simplicit90y)
The comparator is a standard end hole microcatheter, defined as any commercially available microcatheter utilizing a single end hole without balloon occlusion or other tip modifications.
The Y-90 dose delivered by the standard end hole microcatheter will be determined and recorded by the Investigator or Sub-Investigator and calculated using partition-based dosimetry software (e.g., MIM SurePlan or Simplicit90Y).
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Tumor Absorbed Dose (Gy)
Time Frame: Within 1 day following intervention
|
Tumor absorbed dose (Gy) measured using post-radioembolization ^90Y PET/CT and Simplicit90Y dosimetry analysis software.
The endpoint will compare the absorbed dose delivered to tumors following Y-90 administration using the TriNav Infusion System versus a standard end-hole microcatheter.
|
Within 1 day following intervention
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Tumor-to-Normal Liver Ratio (T/N Ratio)
Time Frame: Within 1 day following intervention
|
T/N ratio measured on post-radioembolization ^90Y PET/CT using Simplicit90Y dosimetry analysis software.
This endpoint evaluates preferential microsphere deposition within tumor relative to normal liver tissue and compares results between treatment groups.
|
Within 1 day following intervention
|
|
Objective Response Rate (ORR) by RECIST 1.1
Time Frame: 3 months and 6 months after radioembolization
|
Proportion of target lesions achieving complete response (CR) or partial response (PR) according to RECIST 1.1 criteria on contrast-enhanced MRI of the abdomen at 3 and 6 months following radioembolization.
|
3 months and 6 months after radioembolization
|
|
Disease Control Rate (DCR) by RECIST 1.1
Time Frame: 3 months and 6 months after radioembolization
|
Proportion of target lesions achieving complete response (CR), partial response (PR), or stable disease (SD) according to RECIST 1.1 criteria on contrast-enhanced MRI of the abdomen at 3 and 6 months following radioembolization.
|
3 months and 6 months after radioembolization
|
|
Tumor Response by mRECIST for enhancing tumors
Time Frame: 3 months and 6 months after radioembolization
|
For tumors demonstrating arterial enhancement on pre-treatment imaging, treatment response will be assessed using mRECIST criteria on contrast-enhanced MRI of the abdomen at 3 and 6 months following radioembolization.
|
3 months and 6 months after radioembolization
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Matthew Hung, MD, Stanford University
Study record dates
Study Major Dates
Study Start (Estimated)
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
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- IRB-88560
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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.