Total pankreatektomi med autotransplantation af ø-celler (TPIAT) til højrisikopatienter med pancreastumorer
Total pankreatektomi med autotransplantation af ø-celler (TPIAT) til patienter med periampullære neoplasi med høj risiko for lækage fra pankreatikojejunostomi efter pankreatikoduodenektomi: et enkeltcenter, prospektivt, enkeltarms, observationsstudie
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Jin He, MD, PhD
- Telefonnummer: +1(410)614-7551
- E-mail: jhe11@jhmi.edu
Undersøgelse Kontakt Backup
- Navn: Thomas McPhaul, MS
- E-mail: tmcphau2@jhu.edu
Studiesteder
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Maryland
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Baltimore, Maryland, Forenede Stater, 21287
- Rekruttering
- Johns Hopkins Hospital
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Kontakt:
- Jin He, MD, PhD
- Telefonnummer: 410-614-7551
- E-mail: jhe11@jhmi.edu
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inklusionskriterier:
- Voksne i alderen 18 år og derover.
- Patienter med periampullære neoplasi, der kræver pankreatikoduodenektomi, herunder men ikke begrænset til:
- Distalt galdegangsadenokarcinom
- Duodenalt adenokarcinom
- Leiomyosarkom i duodenum
- Pankreatiske neuroendokrine neoplasi
- Ampullært adenom
- Duodenal gastrointestinal stromal tumor (GIST)
- Højrisiko Intraduktal Papillær Mucinøs Neoplasi (IPMN) ifølge Fukuoka-kriterierne
- Mucinøs cystisk neoplasi
- Serøst cystadenom
- Tilstedeværelse af blødt pankreasvæv og en hovedpankreasgang ≤ 2 mm baseret på præoperativ billeddiagnostik.
- Tilstrekkelig ø-cellefunktion med målbar C-peptid præoperativt til at retfærdiggøre ø-celleisolering og transplantation.
Eksklusionskriterier:
- Graviditet
- Aktiv alkohol- eller ulovligt stofmisbrug
- Dårligt kontrolleret psykisk sygdom, der begrænser overholdelse af behandling
- Eksisterende insulinafhængig diabetes med fravær af C-peptid
- Portvenetrombose eller signifikant portal hypertension
- Kontraindikationer for større kirurgi
- Body Mass Index (BMI) > 35 kg/m².
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: N/A
- Interventionel model: Enkelt gruppeopgave
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
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Eksperimentel: Total Pancreatectomy With Islet Autotransplantation
Participants with periampullary neoplasms who are considered at high risk for postoperative pancreatic fistula after pancreaticoduodenectomy will undergo total pancreatectomy with islet autotransplantation using either an open or robotic surgical approach.
Outcomes will be assessed prospectively through 12 months after surgery.
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Participants will undergo total pancreatectomy with islet autotransplantation using either an open or robotic surgical approach.
After removal of the pancreas, islets will be isolated from nontumorous pancreatic tissue and infused into the portal venous system according to established institutional protocols.
The study will prospectively assess feasibility, perioperative safety, metabolic outcomes, and early oncologic outcomes through 12 months after surgery.
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Annual accrual rate of participants who consent to and undergo planned TPIAT
Tidsramme: From study opening through completion of enrollment, up to 36 months
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Annual accrual rate, defined as the number of eligible participants per year who provide informed consent and proceed with the planned total pancreatectomy with islet autotransplantation procedure.
The feasibility threshold is accrual of at least 3 participants per year.
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From study opening through completion of enrollment, up to 36 months
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Consent yield among eligible patients approached for participation
Tidsramme: From study opening through completion of enrollment, up to 36 months
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Consent yield, defined as the proportion of approached, eligible patients who provide informed consent and undergo planned total pancreatectomy with islet autotransplantation.
The feasibility threshold is at least 5%, defined as at least 1 of the first 20 eligible patients approached consenting to and undergoing TPIAT.
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From study opening through completion of enrollment, up to 36 months
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Incidence of major postoperative complications within 90 days after surgery
Tidsramme: Up to 90 days post surgery
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Number and proportion of participants experiencing at least one major postoperative complication within 90 days after TPIAT.
Complications will be graded according to the Clavien-Dindo classification.
Major complications are defined as Clavien-Dindo Grade III-V.
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Up to 90 days post surgery
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Unplanned readmission within 90 days after surgery
Tidsramme: Up to 90 days post surgery
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Number and percentage of participants with at least one unplanned hospital readmission within 90 days after TPIAT.
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Up to 90 days post surgery
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Length of hospital stay
Tidsramme: From date of surgery to date of discharge, assessed up to 90 days
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Number of days from the date of TPIAT to hospital discharge.
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From date of surgery to date of discharge, assessed up to 90 days
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Incidence of hypoglycemic events requiring hospitalization
Tidsramme: Up to 12 months post surgery
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Number and percentage of participants experiencing hypoglycemic events requiring hospitalization after TPIAT.
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Up to 12 months post surgery
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Incidence of endocrine pancreatic insufficiency
Tidsramme: At 3, 6, and 12 months post surgery
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Number and percentage of participants with endocrine pancreatic insufficiency after TPIAT, assessed using insulin requirement, fasting glucose, fasting C-peptide, and hemoglobin A1c.
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At 3, 6, and 12 months post surgery
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Average Daily Insulin requirement (IU/kg/day) after TPIAT
Tidsramme: At 3, 6, and 12 months post surgery
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Average daily insulin requirement after TPIAT, assessed at postoperative months 3, 6, and 12.
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At 3, 6, and 12 months post surgery
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Fasting glucose (percentage) after TPIAT
Tidsramme: At 3, 6, and 12 months post surgery
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Fasting glucose level measured after TPIAT
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At 3, 6, and 12 months post surgery
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Fasting C-peptide (ng/mL) after TPIAT
Tidsramme: At 3, 6, and 12 months after surgery
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Fasting C-peptide level measured after TPIAT.
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At 3, 6, and 12 months after surgery
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Hemoglobin A1c (percentage) after TPIAT
Tidsramme: At 3, 6, and 12 months after surgery
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Hemoglobin A1c measured after TPIAT.
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At 3, 6, and 12 months after surgery
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Tumor recurrence within 1 year after surgery
Tidsramme: Within 12 months after surgery
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Number and proportion of participants with clinical, radiographic, or pathologic evidence of tumor recurrence within 1 year after TPIAT.
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Within 12 months after surgery
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Ledende efterforsker: Jin He, MD, SKCCC Johns Hopkins Medical Institution
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
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
Nøgleord
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- J2605
- IRB00543437 (Anden identifikator: JHM IRB)
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
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