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Additional Chemotherapy Administered Directly Into the Liver Using a Chemo Pump in Patients With Bile Duct Cancer Inside the Liver Treatable by Surgery (PUMP IV)

21. September 2026 aktualisiert von: Bas Groot Koerkamp, MD, PhD, Erasmus Medical Center

Verhinderung des Wiederauftretens von Leber nach partieller Hepatektomie für intrahepatisches Cholangiokarzinom unter Verwendung der chemotherapie adjuvanten Leber -Arterieninfusionspumpe - Pumpe IV -Studie

The goal of this clinical trial is to learn if additional chemotherapy by means of a chemo pump can prevent return of disease in adult patients with bile duct cancer in the liver that can be treated with surgery. The main questions it aims to answer are:

  • Does addition of chemotherapy by means of a chemo pump lead to less return of disease within the liver two years after surgery?
  • Does addition of chemotherapy by means of a chemo pump lead to longer survival of patients?
  • Does addition of chemotherapy by means of a chemo pump lead to an increase in quality of life?

Participants will receive an implanted chemo pump, through which additional chemotherapy will be given to the liver in addition to surgery.

Studienübersicht

Status

Rekrutierung

Bedingungen

Intervention / Behandlung

Studientyp

Interventionell

Einschreibung (Geschätzt)

40

Phase

  • Phase 2

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienkontakt

Studieren Sie die Kontaktsicherung

Studienorte

    • South Holland
      • Rotterdam, South Holland, Niederlande, 3015GD
        • Rekrutierung
        • Erasmus Medical Center
        • Kontakt:
        • Kontakt:
        • Hauptermittler:
          • Bas Groot Koerkamp, MD, PhD

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

18 Jahre und älter (Erwachsene, Älterer Erwachsener)

Akzeptiert gesunde Freiwillige

Nein

Studienberechtigte Geschlechter

Alle

Beschreibung

Inclusion Criteria:

  • 18 years or older
  • ECOG or WHO performance status 0 or 1
  • Diagnosis of resectable iCCA on imaging. No histological confirmation is needed before surgery, according to standard of care.
  • Patient is able to undergo a laparotomy.
  • Positioning of a catheter for HAIP chemotherapy is technically feasible based on a CT-scan with early arterial phase with 1mm cuts. The default site for the catheter insertion is the GDA. Accessory or aberrant hepatic arteries are no contraindication for catheter placement.
  • Adequate bone marrow, liver, and renal function before inclusion (values may be max. 30 days old)
  • Absolute neutrophil count (ANC) ≥ 1.5 x 10^ 9/L
  • White blood cell count (WBC) ≥ 2.5 x 10^9/L
  • Platelets ≥ 100 x 10^9/L
  • Glomerular filtration rate (GFR) ≥ 30 ml/min
  • Haemoglobin (Hb) ≥ 5.5 mmol/L
  • Total bilirubin ≤ 25 µmol/L
  • Written informed consent must be given according to ICH/good clinical practice (GCP), and national/local regulations.

Exclusion Criteria:

  • Presence of extrahepatic disease at the time of first presentation. Patients with locoregional lymph node disease or with small (≤ 1 cm) extrahepatic lesions that are too small to characterize or biopsy are eligible.
  • Second primary malignancy, except for adequately treated non-melanoma skin cancer, or other malignancy treated at least 3 years previously without evidence of recurrence or with a life expectancy longer than 5 years.
  • Known homozygous dihydropyrimidine dehydrogenase (DPYD) deficiency
  • Prior hepatic radiation, ablation, or resection for iCCA.
  • Clinical evidence of portal hypertension (ascites, gastroesophageal varices, or portal vein thrombosis). Some postoperative ascites is allowed.
  • (Partial) portal vein thrombosis in future liver remnant.
  • Pregnant or lactating women.
  • History of psychiatric disability judged by the investigator to be clinically significant, precluding informed consent or interfering with compliance for HAIP chemotherapy.
  • Serious concomitant systemic disorders that would compromise the safety of the patient or his/her ability to complete the study, at the discretion of the investigator.
  • Organ allografts requiring immunosuppressive therapy.
  • Serious infections (uncontrolled or requiring treatment).
  • Participation in another interventional study for iCCA with survival as outcome.
  • Participation in another prospective study with an interventional medical product.
  • Any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be discussed with the patient before registration in the trial

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Behandlung
  • Zuteilung: N / A
  • Interventionsmodell: Einzelgruppenzuweisung
  • Maskierung: Keine (Offenes Etikett)

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Experimental: Surgery + chemo pump (Hepatic Arterial Infusion Pump chemotherapy)

Surgery + chemo pump

Participants in this arm will receive in addition to standard care (surgery) a chemo pump. This pump will provide participants with 4 cycles of treatment with chemotherapy (Floxuridin), each lasting 4 weeks. Total treatment with chemotherapy will last 16 weeks (approx. 4 months)

Andere Namen:
  • Haip
  • Haic mit Floxuridin
  • Pumpenchemotherapie

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Two-year hepatic recurrence free survival (hRFS)
Zeitfenster: From pump implantation until 2 years after that surgery

The percentage of patients who do not have return of disease in the liver two years after surgery. The time frame is defined as the period between pump implantation and return of disease in the liver. A recurrence is defined as a biopsy-proven recurrent lesion or radiological evidence with cross-sectional imaging in combination with an elevated CA19.9 or CEA level in the blood samples.

From pump implantation until 2 years after that surgery

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Overall recurrence free survival (RFS)
Zeitfenster: From pump implantation until the earliest return of disease in the body during the study (up to 5 years after inclusion)

The percentage of patients who do not have return of disease in the given time frame. A recurrence is defined as a biopsy-proven recurrent lesion or radiological evidence with cross-sectional imaging in combination with an elevated CA19.9 or CEA level in the blood samples.

From pump implantation until the earliest return of disease in the body during the study (up to 5 years after inclusion)
Overall survival (OS)
Zeitfenster: From pump implantation until death or lost to follow-up during the study (up to 5 years after inclusion)

OS is defined as the interval between pump implantation and the date of death (by any cause) or date of last follow-up

From pump implantation until death or lost to follow-up during the study (up to 5 years after inclusion)
Post-operative complications
Zeitfenster: From pump implantation until 90 days after surgery

All complications rated Clavien-Dindo grade 3 or higher are recorded for the first 90 days after surgery.

From pump implantation until 90 days after surgery
Chemotherapy related adverse events (AEs)
Zeitfenster: From inclusion until 4 weeks after the end of treatment with chemotherapy

Chemotherapy related adverse events (AEs) will be collected if they are grade III or higher according to CTCAE version 5.0

From inclusion until 4 weeks after the end of treatment with chemotherapy
Proportion of patients started with HAIP chemotherapy
Zeitfenster: From pump implantation until the first cycle of HAIP chemotherapy, on average between 4 and 16 weeks after implantation of the HAIP chemopump

The number of patients that could receive at least 1 cycle of HAIP chemotherapy with floxuridin

From pump implantation until the first cycle of HAIP chemotherapy, on average between 4 and 16 weeks after implantation of the HAIP chemopump
Quality of life: EORTC QLQ-30
Zeitfenster: From inclusion until 5 years after surgery

After study inclusion and every 3 months (+/- 30 days) thereafter patients will be asked to complete the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). This validated instrument includes 30 items covering functional domains, symptom scales, and global health status. Scores range from 0 to 100, with higher scores on the global health and functional scales indicating better quality of life.

After 1 year of follow-up, the questionnaires will be taken annually until a maximum of 5 years.

From inclusion until 5 years after surgery
Quality of life: EQ-5D
Zeitfenster: From inclusion until 5 years after surgery

After study inclusion and every 3 months (+/- 30 days) thereafter patients will be asked to complete the EuroQol 5-Dimension (EQ-5D) questionnaire, a standardized measure of health-related quality of life. The EQ-5D includes five dimensions-mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. The resulting health state is converted into an index score ranging from 0 (equivalent to death) to 1 (perfect health), though negative scores are possible.

After 1 year of follow-up, the questionnaires will be taken annually until a maximum of 5 years.

From inclusion until 5 years after surgery
Cost-effectiveness
Zeitfenster: From implantation of the chemo pump until 2 years after (=timeframe of the primary outcome)

An assessment of the cost-effectiveness of HAIP chemotherapy for patients with iCCA will be made

From implantation of the chemo pump until 2 years after (=timeframe of the primary outcome)
Predictive biomarkers in the blood for efficacy of HAIP chemotherapy
Zeitfenster: From implantation of the chemo pump until 1 year after surgery or return of disease (whichever comes first)

A total of five additional blood samples will be collected. These samples will be collected:

  • On the day of surgery before the incision is made.
  • During surgery (directly from the hepatic vein).
  • Before the start of HAIP chemotherapy.
  • After the last cycle of HAIP chemotherapy.
  • At one year after surgery or at recurrence
From implantation of the chemo pump until 1 year after surgery or return of disease (whichever comes first)
Predictive biomarkers from liver tissue for efficacy of HAIP chemotherapy
Zeitfenster: From resection until 25 years after (conform applicable laws)

Additionally, tumor tissue will be collected from the removed part of the liver during the surgery. These tissue samples will be stored for further research into biomarkers.

From resection until 25 years after (conform applicable laws)

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

Mitarbeiter

Ermittler

  • Hauptermittler: Bas Groot Koerkamp, MD, PhD, Erasmus Medical Center

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Tatsächlich)

20. November 2024

Primärer Abschluss (Geschätzt)

1. September 2028

Studienabschluss (Geschätzt)

1. September 2033

Studienanmeldedaten

Zuerst eingereicht

5. Februar 2025

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

14. März 2025

Zuerst gepostet (Tatsächlich)

21. März 2025

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

23. September 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

21. September 2026

Zuletzt verifiziert

1. September 2026

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Andere Studien-ID-Nummern

  • MEC-2024-0324
  • 2024-513726-33-00 (Ctis)

Plan für individuelle Teilnehmerdaten (IPD)

Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?

UNENTSCHIEDEN

Beschreibung des IPD-Plans

The decision on sharing IPD has not been made within the trial team. Once this decision is made, we will update this part.

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Ja

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

Nein

Produkt, das in den USA hergestellt und aus den USA exportiert wird

Ja

Diese Informationen wurden ohne Änderungen direkt von der Website clinicaltrials.gov abgerufen. Wenn Sie Ihre Studiendaten ändern, entfernen oder aktualisieren möchten, wenden Sie sich bitte an register@clinicaltrials.gov. Sobald eine Änderung auf clinicaltrials.gov implementiert wird, wird diese automatisch auch auf unserer Website aktualisiert .