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Robotic Systems Evaluation for Peripheral Pulmonary Lesions (RISE Trial)

29. Juli 2026 aktualisiert von: Case Comprehensive Cancer Center

Robotic Systems Evaluation for Peripheral Pulmonary Lesions: A Randomized Trial (RISE Trial)

This is an investigator-initiated cluster randomized control trial. The primary objective is to compare the diagnostic yield of two Food and Drug Administration (FDA) cleared national robotic assisted bronchoscopy platforms - the Monarch™ Platform and the ION™ Endoluminal System - in participants undergoing bronchoscopy to evaluate peripheral pulmonary lesions (PPLs). Participants will undergo their scheduled robotic assisted bronchoscopy (RAB) using one of these platforms.

Studienübersicht

Status

Noch keine Rekrutierung

Bedingungen

Intervention / Behandlung

Detaillierte Beschreibung

Roughly 1.6 million lung nodules are identified every year in the United States. When tissue sampling is required, robotic-assisted bronchoscopy (RAB) systems are increasingly used to reach peripheral targets inaccessible to standard bronchoscopy.

Robotic-assisted bronchoscopy (RAB) has rapidly evolved as a promising modality for sampling PPLs. Two FDA-cleared robotic platforms are currently in clinical use: the ION™ Endoluminal System (Intuitive Surgical, Inc., Sunnyvale, CA) and the Monarch™ Platform (Johnson & Johnson MedTech / Auris Health, Redwood City, CA). Both platforms were cleared through the FDA 510(k) pathway, which requires demonstration of substantial equivalence to predicate devices but does not mandate comparative effectiveness data prior to commercialization.

The ION™ system uses shape-sensing fiber-optic technology to track catheter position with high precision throughout the bronchial tree. It has been shown in multiple studies to achieve diagnostic yields ranging from 67-85%, with enhanced performance when combined with intraprocedural cone-beam computed tomography (CBCT). The recent RELIANT trial (the first cluster-randomized controlled trial in interventional pulmonology) demonstrated that ION™ was non-inferior to electromagnetic navigation bronchoscopy (ENB) with integrated digital tomosynthesis, with diagnostic yields of 77.8% and 75.5% respectively (P for non-inferiority = 0.007).

The Monarch™ platform uses a hybrid approach combining electromagnetic tracking and robotic catheter control with a continuously visualizing bronchoscope (4-way articulation). A key feature of the Monarch™ is direct bronchoscopic vision throughout navigation, enabling real-time assessment of the airways and the target lesion. The Monarch™ has received additional FDA clearance for bronchoscopic transparenchymal nodule access (BTPNA), allowing access to lesions without a direct airway path. Published studies report diagnostic yields of 66-81% for the Monarch™ platform, though most are single-center, non-randomized studies with varying definitions of diagnostic yield, co-intervention use, and did not fully use integrated intraprocedural imaging (including fluoroscopy and CBCT, as available and integrated).

Critically, no randomized or high-quality comparative study has directly compared the ION™ and Monarch™ platforms head-to-head with integrated intraprocedural imaging. As both systems are now available at University Hospitals Cleveland Medical Center and represent substantial capital expenditures, high-quality prospective comparative data are urgently needed to guide clinical decision-making and resource allocation. This trial leverages the existing dual-platform clinical infrastructure at UHCMC to conduct a pragmatic, cluster-randomized, non-inferiority trial embedded within routine clinical care

Studientyp

Interventionell

Einschreibung (Geschätzt)

398

Phase

  • Unzutreffend

Kontakte und Standorte

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

Studienkontakt

Studienorte

    • Ohio
      • Cleveland, Ohio, Vereinigte Staaten, 44106
        • University Hospitals Cleveland Medical Center, Case Comprehensive Cancer Center
        • Kontakt:
        • Hauptermittler:
          • Sameer K Avasarala, MD

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

  • Erwachsene
  • Älterer Erwachsener

Akzeptiert gesunde Freiwillige

Nein

Beschreibung

Inclusion Criteria:

  • Age ≥ 18 years at the time of bronchoscopy.
  • Scheduled to undergo navigational bronchoscopy (either ION™ or Monarch™) for the evaluation of a pulmonary lesion at University Hospitals Cleveland Medical Center (UHCMC).
  • Able and willing to provide written informed consent.

Exclusion Criteria:

  • Enrolled in another clinical trial that requires the use of a specific navigational/robotic bronchoscopy platform.
  • Enrolled in another bronchoscopy-related clinical trial.
  • Participant or legally authorized representative declines participation.

Studienplan

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

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Diagnose
  • Zuteilung: Zufällig
  • Interventionsmodell: Parallele Zuordnung
  • Maskierung: Keine (Offenes Etikett)

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Sonstiges: Monarch Platform
This study is being conducted at a hospital that has two bronchoscopy procedure rooms (BPRs). The unit of the randomization is the BPR day. Each day, one BPR will be randomized to the Monarch platform and the other to the ION platform. Participants in this arm will have undergone their RAB via the Monarch platform.
The Monarch™ (Monarch) platform is one of two FDA-cleared robotic platforms currently in clinical use for robotic-assisted bronchoscopy (RAB). It uses a hybrid approach combining electromagnetic tracking and robotic catheter control with a continuously visualizing bronchoscope (4-way articulation). A key feature of the Monarch platform is direct bronchoscopic vision throughout navigation, enabling real-time assessment of the airways and the target lesion.
Andere Namen:
  • Monarch™
Sonstiges: ION Platform
This study is being conducted at a hospital that has two bronchoscopy procedure rooms (BPRs). The unit of the randomization is the BPR day. Each day, one BPR will be randomized to the Monarch platform and the other to the ION platform. Participants in this arm will have undergone their RAB via the ION platform.
The ION™ Endoluminal System (ION) platform is one of two FDA-cleared robotic platforms currently in clinical use for robotic-assisted bronchoscopy (RAB). It uses shape-sensing fiber-optic technology to track catheter position with high precision throughout the bronchial tree.
Andere Namen:
  • ION™ Endoluminal System

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Diagnostic yield defined as the proportion of procedures that result in the acquisition of lesional tissue
Zeitfenster: Up to Day 14
Diagnostic yield is defined as the proportion of procedures that result in the acquisition of lesional tissue. This will be measured for both procedures conducted via the Monarch platform and the ION platform.
Up to Day 14

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Duration of the robotic bronchoscopy procedures
Zeitfenster: Day 0
The duration of the robotic bronchoscopy procedure will be measured in minutes for both the Monarch platform and the ION platform.
Day 0
Safety, measured by the number of complications
Zeitfenster: Up to Day 7
Safety will be measured by the number of complications that occur within 7 days of the procedure for both the Monarch platform group and the ION platform group.
Up to Day 7
Radiation exposure
Zeitfenster: Day 0
Radiation exposure is defined as the radiation dose delivered to the participant during the study bronchoscopy and is recorded as a dose area product in milligray per centimeters squared (mGy/cm2). Radiation exposure is measured for both the Monarch platform group and the ION platform group.
Day 0
Rate of additional diagnostic procedures required within 12 months
Zeitfenster: Up to 12 months
The rate of additional diagnostic procedures required within 12 months of the study bronchoscopy will be assess for both the Monarch platform group and the ION group.
Up to 12 months
Diagnostic accuracy at 12 months post-biopsy
Zeitfenster: Up to 12 months
Diagnostic accuracy at 12 months post-biopsy is defined as the number of true positive lesions (malignant) plus true negative lesions (specific benign diagnosis) with no evidence of malignancy at 12-month follow-up (no interval biopsy diagnostic of malignancy, regression on CT or stable size with no plan for repeat diagnostic procedure), divided by the total number of biopsied lesions. This will be assessed for both the Monarch platform group and the ION platform group.
Up to 12 months

Mitarbeiter und Ermittler

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

Sponsor

Ermittler

  • Hauptermittler: Sameer K Avasarala, MD, Case Comprehensive Cancer Center, University Hospitals

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 (Geschätzt)

1. August 2026

Primärer Abschluss (Geschätzt)

1. August 2027

Studienabschluss (Geschätzt)

1. August 2027

Studienanmeldedaten

Zuerst eingereicht

23. Juli 2026

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

29. Juli 2026

Zuerst gepostet (Tatsächlich)

30. Juli 2026

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

30. Juli 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

29. Juli 2026

Zuletzt verifiziert

1. Juli 2026

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Andere Studien-ID-Nummern

  • CASE3526

Plan für individuelle Teilnehmerdaten (IPD)

Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?

JA

IPD-Sharing-Zeitrahmen

The data will become available 3 months following publication of outcomes and will remain available for at least 5 years.

IPD-Sharing-Zugriffskriterien

Data will be made available to researchers who provide a methodologically sound proposal that has been approved by University Hospitals Institutional Review Board and the study executive committee.

Art der unterstützenden IPD-Freigabeinformationen

  • STUDIENPROTOKOLL
  • SAFT

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Nein

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

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 .