Randomized Trial Comparing Stereotactic Body Radiation Therapy to Microwave Ablation for the Treatment of Localized Hepatocellular Carcinoma
A Phase II Randomized Trial Comparing Stereotactic Body Radiation Therapy to Microwave Ablation for the Treatment of Localized Hepatocellular Carcinoma
This is a randomized phase II study comparing microwave ablation (MWA) and stereotactic body radiation therapy (SBRT) for localized hepatocellular carcinoma (HCC).
This trial will be the first prospective comparison of these modalities for the treatment of HCC and will provide critical information regarding which local ablative modality is most appropriate for which patients. This study will also provide important information regarding quality of life and liver function changes following these two different treatment modalities.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiesteder
-
-
Michigan
-
Ann Arbor, Michigan, Forenede Stater, 48109
- The University of Michigan Comprehensive Cancer Center
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
Patients with hepatocellular carcinoma (HCC) are eligible for this trial. HCC is defined as having at least one of the following:
- HCC diagnosed either on biopsy or based on standard imaging criteria on contrast enhanced CT or MRI (arterial enhancement with washout and pseudocapsule); or
- A discrete hepatic tumor(s) as defined by the Barcelona criteria10 for cirrhotic patients, >1 cm with arterial hypervascularity and venous or delayed phase washout on CT or MRI
- Presentation at multidisciplinary liver tumor board to assess eligibility for either SBRT or MWA
- Patients must have 1-2 intrahepatic foci of HCC and may not be candidates for refuse hepatic resection. Patients who are on the organ wait list for (orthotopic liver transplantation) OLT will be considered for this trial as a "bridge" to transplant.
- Patients with 1 focus of HCC will be eligible if their tumor is 3.5 cm or less in greatest diameter. Patients with 2 foci of HCC will be eligible if each lesion is 3.5 cm in diameter or less and the combined diameter of both lesions is 5 cm or less.
- The foci of HCC must be in an anatomic location amendable to treatment by both MWA and SBRT.
- The patient must have an ECOG performance status of ≤ 2 (Eastern Cooperative Oncology Group Performance Status is an attempt to quantify cancer patients' general well-being and activities of daily life. The score ranges from 0 to 5 where 0 is asymptomatic and 5 is death).
- Patients must have recovered from the acute effects of prior liver-directed therapy (e.g., RT, RFA, MWA or TACE) and a minimum of 4 weeks must have passed since the last procedure and protocol therapy.
Patients must have:
- Platelets ≥ 50,000/mm3
- Child Pugh class A liver function or class B7 (Appendix II)
- INR (international normalized ratio (for anticoagulant monitoring)) < 1.5
- The patient must have a life expectancy of at least 12 weeks
- The patient must be at least 18 years old
- Patients must sign an IRB approved informed consent form for this purpose indicating that they are aware of the investigational aspects of the treatment and the potential risks. They also must be able to understand and the willing to sign a written informed consent.
Exclusion Criteria:
- Patients who have received prior abdominal radiation
- Patients with 3 or more foci of HCC
- Patients whose HCC involves the local vasculature, regional lymph nodes or distant metastatic sites
- Patients with Child Pugh liver function worse than B7
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
|
Eksperimentel: MWA
MWA will typically be administered in one ablation session during which time up to 2 tumors are treated.
|
MWA will typically be administered in one ablation session during which time up to 2 tumors are treated.
|
|
Eksperimentel: SBRT
SBRT will be administered in five fractions of up to 10 Gy per fraction.
SBRT will be administered 5-15 days per tumor.
|
SBRT will be administered in five fractions of up to 10 Gy per fraction.
SBRT will be administered 5-15 days per tumor.
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Time to local tumor progression
Tidsramme: Patients will be followed up to 2 years
|
The primary outcome of this trial is to prospectively determine local control rates in patients with HCC treated with MWA or SBRT.
Freedom From Local Progression (FFLP) is defined as the time from randomization to local tumor progression.
Tumors falling to group PD (progressive disease) would constitute local control failures.
Progressive disease will be defined as at least a 20% increase in the LD (longest diameter) of target lesion, taking as reference the smallest LD recorded.
Or at least a 20% increase in viable arterial enhancing disease, taking as reference the smallest LD of viable HCC since treatment started.
Increases of less than 3 mm compared to the smallest LD recorded will be considered stable disease rather than PD.
|
Patients will be followed up to 2 years
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Incidence of gastrointestinal (GI) and hepatobiliary toxicity
Tidsramme: Patients will be followed up to 2 years
|
The number of patients experiencing grade 3 or higher GI or hepatobiliary toxicity by Common Terminology Criteria for Adverse Events (CTCAE) v4.0.
|
Patients will be followed up to 2 years
|
|
Incidence of liver function worsening
Tidsramme: Patients will be followed up to 2 years
|
The number of patients experiencing a 2 point or more increase in Child-Pugh score and an increase in albumin-bilirubin score of at least 0.5.
|
Patients will be followed up to 2 years
|
|
Change in FACT- Hep questionnaire score
Tidsramme: Questionnaires will be administered pre-treatment, post-treatment, and at 1, 3 ,6, 9, 12, 15, 18, 21, and 24 months post-treatment
|
The FACT-Hep questionnaire is used to measure health-related quality of life (HRQoL) in patients with hepatobiliary cancers.
They are asked questions about their physical, social, emotional and functional well-being and asked to provide a score between 0 and 4 where 0 represents not at all and 4 represents very much.
|
Questionnaires will be administered pre-treatment, post-treatment, and at 1, 3 ,6, 9, 12, 15, 18, 21, and 24 months post-treatment
|
|
Overall survival time
Tidsramme: Patients will be followed up to 2 years
|
Overall survival (OS) is defined as the time from randomization to death from any cause.
Patients who are alive at last follow-up will be censored on that date.
|
Patients will be followed up to 2 years
|
|
Progression free survival time
Tidsramme: Patients will be followed up to 2 years
|
Progression Free Survival (PFS) is defined as the minimum time to death or any progression.
|
Patients will be followed up to 2 years
|
|
Metastasis free survival time
Tidsramme: Patients will be followed up to 2 years
|
Metastasis-free survival (MFS) is defined as the minimum time to development of metastases or death, whichever occurs first.
|
Patients will be followed up to 2 years
|
|
Incidence of intrahepatic failure
Tidsramme: Patients will be followed up to 2 years
|
Intrahepatic failure will include progression of the treated lesion(s) as well as development of other new liver lesions.
|
Patients will be followed up to 2 years
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Ledende efterforsker: Dawn Owen, M.D., Ph.D., University of Michigan Rogel Cancer Center
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Forventet)
Primær færdiggørelse
Studieafslutning (Forventet)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- UMCC 2017.001
- HUM00124501 (Anden identifikator: University of Michigan)
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .
Kliniske forsøg med Carcinom, hepatocellulært
-
NCT07482670Ikke rekrutterer endnu
-
NCT02567409AfsluttetMetastatisk blæreurothelial karcinom | Metastatisk Ureter Urothelial Carcinoma | Stadie IV Blære Urothelial Carcinoma AJCC v7 | Metastatisk nyrebækken og Ureter Urothelial Carcinoma
-
NCT07265947RekrutteringLow Grade Upper Tract Urothelial Carcinoma
-
NCT04637594Aktiv, ikke rekrutterendeMetastatisk blæreurothelial karcinom | Metastatisk nyrebækken Urothelial Carcinom | Metastatisk Ureter Urothelial Carcinoma | Metastatisk Urethral Urothelial Carcinoma | Metastatisk Urothelial Carcinom | Lokalt avanceret blæreurothelial karcinom | Lokalt avanceret nyrebækken Urothelial Carcinoma | Lokalt avanceret Ureter Urothelial Carcinoma | Lokalt avanceret Urethral Urothelial Carcinom | Lokalt avanceret Urothelial Carcinom
-
NCT01124409UkendtHOVED- OG NAKKEKRÆFT | CARCINOMA OROPHARYNX | CARCINOMA PYRIFORM SINUS | CARCINOMA LARYNX
-
NCT03935347Trukket tilbageMetastatisk blæreurothelial karcinom | Metastatisk nyrebækken Urothelial Carcinom | Metastatisk Ureter Urothelial Carcinoma | Metastatisk Urethral Urothelial Carcinoma | Uoperabelt nyrebækken Urothelial Carcinom | Uoperabelt Ureter Urothelial Carcinoma
-
NCT07430202Ikke rekrutterer endnuLeverkræft (Fibrolamellær Hepatocellular Kræft (FLC))
-
NCT07492225Aktiv, ikke rekrutterendeNeoadjuverende terapi | Urothelial Carcinoma Ureter | Øvre urinvejsurothelial karcinom
-
NCT03421652AfsluttetStadie III Blære Urothelial Carcinoma AJCC v6 og v7 | Stadie IV Blære Urothelial Carcinoma AJCC v7 | Stadie II Blære Urothelial Carcinoma AJCC v6 og v7
-
NCT07265076Ikke rekrutterer endnuCarcinoma, Hepatocellulært
Kliniske forsøg med Microwave Ablation (MWA)
-
NCT07235787Ikke rekrutterer endnuUterine Fibroids (Leiomyom) | Symptomatisk Uterin Leiomyom
-
NCT04081168RekrutteringKolorektal cancer metastatisk | Levermetastaser tyktarmskræft
-
NCT03088150RekrutteringKirurgi | Levermetastaser | ColoRektal Cancer | Levermetastaser tyktarmskræft
-
NCT03402607AfsluttetHepatocellulært karcinom
-
NCT02964260RekrutteringHepatocellulært karcinom, voksen
-
NCT06929390Ikke rekrutterer endnu
-
NCT02787954AfsluttetHepatocellulær kræft | Metastatisk leverkræft
-
NCT06506149RekrutteringGraves sygdom | Minimalt invasiv behandling | Ablationsbehandling