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.
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: David Marcellus
- E-mail: dmarcel2@stanford.edu
Undersøgelse Kontakt Backup
- Navn: Brittney Worley
- Telefonnummer: 650-736-3688
- E-mail: bw718@stanford.edu
Studiesteder
-
-
California
-
Palo Alto, California, Forenede Stater, 94305
- Stanford University
-
Kontakt:
- Brittney G Worley
- Telefonnummer: 650-736-3688
- E-mail: bw718@stanford.edu
-
Kontakt:
- David G Marcellus, MD
- E-mail: dmarcel2@stanford.edu
-
Ledende efterforsker:
- Matthew Hung
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
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
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 |
|---|---|
|
Eksperimentel: 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).
|
Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Tumor Absorbed Dose (Gy)
Tidsramme: 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
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Tumor-to-Normal Liver Ratio (T/N Ratio)
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Samarbejdspartnere
Samarbejdspartnere
Efterforskere
Efterforskere
- Ledende efterforsker: Matthew Hung, MD, Stanford University
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
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
- IRB-88560
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
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