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Interstitiel fotodynamisk terapi efter palliativ strålebehandling til behandling af patienter med inoperabel malign central luftvejsobstruktion

4. november 2026 opdateret af: Roswell Park Cancer Institute

Et fase I/II-studie af interstitiel fotodynamisk terapi efter palliativ strålebehandling til patienter med inoperabel malign central luftvejsobstruktion

This phase I/II trial studies the side effects of interstitial photodynamic therapy following palliative radiotherapy and how well it works in treating patients with inoperable malignant central airway obstruction. Patients who have advanced stage cancer tumors in the lung can often have the breathing passages to the lung partially or completely blocked. These tumors could be due to lung cancer or other cancers (e.g., renal, breast, kidney, etc.) that spread to the lung. This blockage puts the patient at a higher risk for respiratory failure, post-obstructive pneumonia, and prolonged hospitalizations. Treatment for these patients may include bronchoscopic intervention (such as mechanical removal, stenting, laser cauterization, or ballooning), radiation therapy with and without chemotherapy. While palliative x-ray radiotherapy may help in shrinking the tumor, high dose curative radiotherapy that can ablate (a localized, nonsurgical destruction) the tumor also has high risk to cause significant toxicity, including bleeding, abnormal connections or passageways between organs or vessels and abnormal scar tissue that can also produce airway obstruction. Photodynamic therapy (PDT) is another possible treatment that can provide local control of the tumor. PDT consists of injecting a light sensitive drug (photosensitizer, PS) into the vein, waiting for the PS to accumulate in the tumor, and then activating it with a red laser light. Radiation therapy uses high energy x-rays, particles, or radioactive seeds to kill cancer cells and shrink tumors. Giving interstitial photodynamic therapy following palliative radiotherapy may improve tumor response and survival without the serious side effects that are associated with the typical high dose curative x-ray radiotherapy alone in patients with malignant central airway obstruction.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

PRIMARY OBJECTIVES:

I. To test the safety of our image-based treatment planning for image-guided interstitial photodynamic therapy (I PDT) with endobronchial ultrasound (EBUS) following standard of care palliative radiotherapy (p-XRT). (Phase I)

-To assess the efficacy of our image-based treatment planning for image-guided I-PDT following standard of care p-XRT. (Phase II)

SECONDARY OBJECTIVES:

  • To assess objective tumor response. (Phase I)
  • To evaluate changes in quality of life. (Phase I and II)
  • To measure changes in functional lung capacity. (Phase I and II)
  • To measure the relationship between the measured objective tumor response (at 12 +/- 2 weeks post I-PDT) and changes in therapeutic laser light transmission within the target tumor, as a future dosimetric marker for response. (Phase I and II)
  • To assess treatment effects on the immune contexture. (Phase I and II)
  • To monitor progression free survival. (Phase I and II)

OUTLINE: This is a phase I study, followed by a phase II.

PHASE I: Patients are assigned to 1 of 2 cohorts.

COHORT 1: Patients receive visudyne intravenously (IV) over 10 minutes and then undergo I-PDT with EBUS 60-90 minutes after visudyne for up to 3 treatment sessions. Patients undergo blood and tissue sample collection on study. Patients also undergo computed tomography (CT) throughout the trial.

COHORT 2: Patients undergo SOC p-XRT over a single fraction. Patients receive visudyne IV over 10 minutes and then undergo I-PDT with EBUS 60-90 minutes after visudyne for up to 2 treatment sessions at least 12 weeks apart. Patients undergo blood and tissue sample collection on study. Patients also undergo CT throughout the trial.

PHASE II: Patients undergo SOC p-XRT over a single fraction. Patients receive visudyne IV over 10 minutes and then undergo I-PDT with EBUS 60-90 minutes after visudyne for up to 2 treatment sessions at least 12 weeks apart. Patients undergo blood and tissue sample collection on study. Patients also undergo CT throughout the trial.

After completion of study treatment, patients are followed up at 30 days and 8, 12, and 24 weeks.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

42

Fase

  • Fase 2
  • Fase 1

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

    • New York
      • Buffalo, New York, Forenede Stater, 14263
        • Rekruttering
        • Roswell Park Cancer Institute
        • Kontakt:
        • Ledende efterforsker:
          • Nathaniel Ivanick
    • Pennsylvania
      • Philadelphia, Pennsylvania, Forenede Stater, 19104
        • Rekruttering
        • Abramson Cancer Center

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Age >= 18 years of age
  • Eligibility checklist before registration requires review of case by the interventional pulmonologist/s and radiation oncologist/s to approve anatomic feasibility of an airway intervention and palliative radiotherapy
  • Patients with pathologic diagnosis of inoperable solid malignancy involving extrabronchial tumor growth that causes airway obstruction and not amenable to curative radiotherapy. All patients will have tumors requiring bronchoscopic intervention with endobronchial ultrasound (EBUS) at the time of I-PDT
  • Participants have at least one measurable lesion which is also the target lesion for Response Evaluation Criteria in Solid Tumors (RECIST) measurement
  • Patients amenable to receive standard of care palliative radiotherapy to the target tumor, as determined by the radiation oncologist/s
  • Amenable to high resolution chest computed tomography (CT) scan (with or without contrast due to contraindication) with 0.625-1.25 mm slice thickness and slice interval 0.5-1 mm
  • Tumor is accessible and amenable to I-PDT, as determined by the interventional pulmonologist/s
  • Have an Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 3
  • Platelets ≥ 100,000 cells/mm^3 (International System of Units [SI] units 100 x 10^9/L)
  • International normalized ratio (INR) < 1.5 and activated partial thromboplastin time (aPTT) < 1.5 x ULN. PTT or aPTT per institutional standards for participating external sites
  • Participants of child-bearing potential must agree to use adequate contraceptive methods (e.g., hormonal or barrier method of birth control; abstinence) prior to study entry and for 3 months after receiving the study drug. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately
  • Participant must understand the investigational nature of this study and sign an Independent Ethics Committee/Institutional Review Board approved written informed consent form prior to receiving any study related procedure

Exclusion Criteria:

  • Pregnant or nursing female participants
  • Co-existing ophthalmic disease likely to require slit-lamp examination within the next 30 days following I-PDT treatment
  • Any condition which in the investigator's opinion deems the participant an unsuitable candidate to receive the I-PDT
  • CT imaging suggestive of target tumor invasion into a major blood vessel (typically proximal to segmental vessels)
  • Known hypersensitivity/allergy to porphyrin
  • Patients who are not cleared by the anesthesiologist to undergo an advanced bronchoscopy procedure under general anesthesia
  • Patients who have received 120 Gy total radiation dose delivered to a structure within 1 cm margin of tumor volume to be targeted by p-XRT and I-PDT
  • Patients diagnosed with porphyria
  • Patients with known allergy to eggs
  • Patients unwilling or unable to follow protocol requirements

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Ikke-randomiseret
  • Interventionel model: Sekventiel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Phase I cohort 1 (I-PDT, EBUS)

Patients receive visudyne IV over 10 minutes and then undergo I-PDT with EBUS 60-120 minutes after visudyne for up to 3 treatment sessions. Patients undergo blood and tissue sample collection on study. Patients also undergo CT throughout the trial.

Undergo CT

Andre navne:
  • CT
  • KAT
  • CAT-scanning
  • Beregnet aksial tomografi
  • Computerstyret aksial tomografi
  • Computerstyret tomografi
  • CT-scanning
  • tomografi
  • Computerstyret aksial tomografi (procedure)

Ancillary studies

Undergo blood and tissue sample collection

Andre navne:
  • Biologisk prøvesamling
  • Bioprøve indsamlet
  • Prøvesamling

Ancillary studies

Andre navne:
  • Fysisk konditionstest
  • Fysisk funktionstest

Undergo EBUS

Andre navne:
  • EBUS
  • Endobronchial ultralyd

Undergo I-PDT

Andre navne:
  • I-PDT
  • Interstitiel belysning fotodynamisk terapi

Given IV

Andre navne:
  • Visudyne
  • Benzoporphyrinderivat monosyrering A
  • BPD-MA
Eksperimentel: Phase I cohort 2 (I-PDT, EBUS, palliative radiation therapy)

Patients undergo SOC p-XRT over a single fraction. Patients receive visudyne IV over 10 minutes and then undergo I-PDT with EBUS 60-120 minutes after visudyne for up to 2 treatment sessions at least 12 weeks apart. Patients undergo blood and tissue sample collection on study. Patients also undergo CT throughout the trial.

Undergo CT

Andre navne:
  • CT
  • KAT
  • CAT-scanning
  • Beregnet aksial tomografi
  • Computerstyret aksial tomografi
  • Computerstyret tomografi
  • CT-scanning
  • tomografi
  • Computerstyret aksial tomografi (procedure)

Ancillary studies

Undergo blood and tissue sample collection

Andre navne:
  • Biologisk prøvesamling
  • Bioprøve indsamlet
  • Prøvesamling

Ancillary studies

Andre navne:
  • Fysisk konditionstest
  • Fysisk funktionstest

Undergo EBUS

Andre navne:
  • EBUS
  • Endobronchial ultralyd

Undergo I-PDT

Andre navne:
  • I-PDT
  • Interstitiel belysning fotodynamisk terapi

Given IV

Andre navne:
  • Visudyne
  • Benzoporphyrinderivat monosyrering A
  • BPD-MA

Undergo palliative radiation therapy

Andre navne:
  • Palliativ strålebehandling

Delivering the therapeutic 689+/-3 nm laser light during I-PDT. Measuring light transmission.

Andre navne:
  • Fiberkoblet diodelaser: ML7710-PDT
Eksperimentel: Phase II (I-PDT, EBUS, palliative radiation therapy)

Phase II: Patients undergo SOC p-XRT over a single fraction. Patients receive visudyne IV over 10 minutes and then undergo I-PDT with EBUS 60-120 minutes after visudyne for up to 2 treatment sessions at least 12 weeks apart. Patients undergo blood and tissue sample collection on study. Patients also undergo CT throughout the trial.

Undergo CT

Andre navne:
  • CT
  • KAT
  • CAT-scanning
  • Beregnet aksial tomografi
  • Computerstyret aksial tomografi
  • Computerstyret tomografi
  • CT-scanning
  • tomografi
  • Computerstyret aksial tomografi (procedure)

Ancillary studies

Undergo blood and tissue sample collection

Andre navne:
  • Biologisk prøvesamling
  • Bioprøve indsamlet
  • Prøvesamling

Ancillary studies

Andre navne:
  • Fysisk konditionstest
  • Fysisk funktionstest

Undergo EBUS

Andre navne:
  • EBUS
  • Endobronchial ultralyd

Undergo I-PDT

Andre navne:
  • I-PDT
  • Interstitiel belysning fotodynamisk terapi

Undergo palliative radiation therapy

Andre navne:
  • Palliativ strålebehandling

Delivering the therapeutic 689+/-3 nm laser light during I-PDT. Measuring light transmission.

Andre navne:
  • Fiberkoblet diodelaser: ML7710-PDT

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Incidence of >= grade 3 adverse events (Phase I)
Tidsramme: Within 30 days post interstitial photodynamic therapy (I-PDT)

Will will be associated with treatment related adverse events .grade 3 (with attribution of 'possible', 'probable' or 'definite'. Will be assessed using National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0 (NCI CTCAE v 5.0).

Within 30 days post interstitial photodynamic therapy (I-PDT)
Overall tumor response (Phase II)
Tidsramme: At 12 weeks post I-PDT

Will be assessed by complete response (CR) or partial response (PR) defined by the Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v 1.1) criteria.

At 12 weeks post I-PDT

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Overall tumor response (Phase I)
Tidsramme: At 12 weeks post I-PDT

Will be assessed by CR or PR defined by the RECIST v 1.1 criteria.

At 12 weeks post I-PDT
Quality of life (Phase I and II)
Tidsramme: At study enrollment, immediately prior to p-XRT and I-PDT, and at 4 and 12 weeks

Will be monitored using the Functional Assessment of Cancer Therapy-Lung. This 36 item self-reported quality of life questionnaire measures responses across six domains: physical well-being, social/family well-being, relationship with doctor, emotional well-being, functional well-being, and additional concerns. This scale was chosen because multiple studies support its validity and use in clinical trials of lung cancer.

At study enrollment, immediately prior to p-XRT and I-PDT, and at 4 and 12 weeks
Functional lung capacity (Phase I and II)
Tidsramme: At study entry (baseline), 30 days and 12 weeks

Will be measured with the six-minute walk test.

At study entry (baseline), 30 days and 12 weeks
Change in the therapeutic laser light transmission (Phase I and II)
Tidsramme: During the I-PDT

Will be measured with our light dosimetry system.

During the I-PDT
Association between immune markers and tumor response (Phase I and II)
Tidsramme: Prior and 7-10 days after the I-PDT

will be measured with flow cytometry in fresh blood samples collected prior and 7-10 days after the I-PDT.

Prior and 7-10 days after the I-PDT
Progression free survival (Phase I and II)
Tidsramme: Time from date of study treatment to the time of first observed disease progression (RECIST 1.1 criteria) at the treated tumor site or, death due to any cause, assessed up to 5 years

Will be summarized using standard Kaplan-Meier methods.

Time from date of study treatment to the time of first observed disease progression (RECIST 1.1 criteria) at the treated tumor site or, death due to any cause, assessed up to 5 years

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Samarbejdspartnere

Efterforskere

  • Ledende efterforsker: Nathaniel Ivanick, Roswell Park Cancer Institute

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. oktober 2024

Primær færdiggørelse (Anslået)

1. oktober 2029

Studieafslutning (Anslået)

1. oktober 2029

Datoer for studieregistrering

Først indsendt

27. februar 2024

Først indsendt, der opfyldte QC-kriterier

5. marts 2024

Først opslået (Faktiske)

12. marts 2024

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

5. november 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

4. november 2026

Sidst verificeret

1. november 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • I-3901323
  • I-3901323 (Anden identifikator: Roswell Park Cancer Institute)
  • NCI-2024-01239 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
  • R01CA283547 (U.S. NIH-bevilling/kontrakt)

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ja

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

produkt fremstillet i og eksporteret fra U.S.A.

Ja

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 .