Feasibility of HISA During TURBT for NMIBC
A Pilot Study Using Hyperthermic Irrigation Followed by Intravesical Chemotherapy in Patients With Low- to Intermediate-Risk Non-Muscle Invasive Bladder Cancer
The goal of this prospective pilot study is to evaluate the safety and feasibility of using heated saline during bladder tumor surgery in patients with non-muscle invasive bladder cancer.
The main questions it aims to answer are:
Can heated saline be given during bladder tumor removal surgery safely?
Does using heated saline keep the bladder tumor from coming back?
Researchers will compare the heated saline to room temperature saline to see if the heated saline works to prevent the bladder tumor from coming back.
Participants will:
- Have heated saline or room temperature saline during bladder tumor surgery
- Visit the clinic at 2 weeks, 3 and 6 months after bladder tumor surgery
- Complete questionnaires about quality of their life and symptoms before and after surgery
- Provide urine samples to test your urine at each visit before and after surgery
- To have a cystoscopy to check your bladder for tumors
Studienübersicht
Status
Status
Bedingungen
Bedingungen
- Blasenkrebs
- Nicht muskelinvasiver Blasenkrebs
- Transurethrale Resektion der Blase
- Nicht-muskelinvasiver Blasenkrebs (NMIBC)
- Transurethrale Resektion von Blasentumoren
- Blasenkrebs (Urothel, Übergangszelle), resektabler Krebs (Präzystektomie)
- Nicht-muskelinvasive Blasenneoplasien
- Nicht-muskelinvasives Blasenkarzinom
- Blasenkrebs (BC)
Intervention / Behandlung
Intervention / Behandlung
Detaillierte Beschreibung
Non-muscle invasive bladder cancer (NMIBC) represents 75% of bladder cancer cases and recurs in up to 79% of patients. West Virginia carries disproportionately high bladder cancer incidence due to smoking, aging population, and occupational exposures. High recurrence requires frequent cystoscopy and intravesical therapy, creating a burden for rural Appalachian patients. New strategies to reduce recurrence and treatment are urgently needed.
Hyperthermic intravesical chemotherapy improves drug penetration and tumor cell sensitivity. However, the benefit of applying hyperthermic saline intraoperatively during resection of the bladder tumor is unknown. In this randomized, two-arm study, we will randomize 40 patients with low-risk appearing NMIBC to normothermic and hyperthermic saline irrigation during bladder tumor resection. Hyperthermic irrigation will be delivered at 42 ± 2° Celsius using the Stryker Thermaclear FluidSmart system. All patients will receive standard postoperative gemcitabine instillation. Follow-up visits will occur at 2 weeks, 3 and 6 months. The primary goal is feasibility, defined as 80% protocol adherence to hyperthermic irrigation. Secondary goals include safety, logistics, and patient retention. Additional outcomes include recurrence, adverse events, and patient-reported quality-of-life scores.
Studientyp
Studientyp
Einschreibung (Geschätzt)
Einschreibung
Phase
Phase
- Unzutreffend
Kontakte und Standorte
Studienkontakt
Studienkontakt
- Name: Michael G Stencel, DO
- Telefonnummer: 1-304-388-5280
- E-Mail: michael.stencel@vandaliahealth.org
Studieren Sie die Kontaktsicherung
- Name: Jacqueline C Fannin, PhD
- Telefonnummer: 1-304-388-9923
- E-Mail: jacqueline.fannin@vandaliahealth.org
Studienorte
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West Virginia
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Charleston, West Virginia, Vereinigte Staaten, 25304
- Charleston Area Medical Center Memorial Hospital
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Kontakt:
- Jacqueline C Fannin, PhD
- Telefonnummer: 6062250344
- E-Mail: jacqueline.fannin@vandaliahealth.org
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Kontakt:
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Hauptermittler:
- Michael G Stencel, DO
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Unterermittler:
- Jacqueline C Fannin, PhD
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Teilnahmekriterien
Zulassungskriterien
Zulassungskriterien
Studienberechtigtes Alter
- Erwachsene
- Älterer Erwachsener
Akzeptiert gesunde Freiwillige
Beschreibung
Inclusion Criteria:
- Male or female patients
- Age from 18 to 89 years old
- Visual diagnosis of a papillary tumor(s) ≤ 3 cm
- Transurethral resection of bladder tumor (TURBT)
- Eastern Cooperative Oncology Group (ECOG) performance status grade 0-2
- Glomerular filtration rate (GFR) ≥ 30 mL/min
Exclusion Criteria:
- Ages less than 18 years of age
- Pregnant women
- Prisoners
- Patients with evidence of distant metastasis
- Patients with histologically confirmed high-risk NMIBC prior to and after TURBT
- Patients with prior carcinoma is situ diagnosis
- Patients with an active infection defined as documented urinary tract infection based on preoperative urine analysis or urine culture
- Immunosuppression defined as a patient with leukopenia or taking any active immunosuppressive medication
- Patients that had an intraoperative perforation during TURBT
- Patients participating in another clinical trial with this urologic cancer diagnosis
- Postoperative bladder instillation failure defined as the inability to deliver and maintain the planned volume of instilled fluid within the bladder for at least 30 minutes
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Single
Anzahl der Arme
Waffen und Interventionen
Teilnehmergruppe / ArmTeilnehmergruppe / Arm |
Intervention / BehandlungIntervention / Behandlung |
|---|---|
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Kein Eingriff: No HISA
The control arm (no HISA) will consist of standard intraoperative care including bladder irrigation with normothermic saline during TURBT.
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|
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Experimental: HISA
The intervention arm (HISA) will be treated in the same way as the control arm with the addition of administering hyperthermic (42.0 ± 2°C) intravesical saline during the TURBT.
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The intervention arm (HISA) will be treated in the same way as the control arm with the addition of administering hyperthermic (42.0 ± 2°C) intravesical saline during the TURBT.
Bladder irrigation with 1g of gemcitabine will be delivered in the immediate postoperative setting.
The Thermaclear FluidSmart Fluid management system (Stryker, MI) will be used to administer and irrigate the bladder with normothermic or hyperthermic intravesical saline during the TURBT.
|
Was misst die Studie?
Primäre Ergebnismessungen
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
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Patient Recruitment
Zeitfenster: one year
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The primary outcome will be patient recruitment.
Patient recruitment will be the number of patients recruited divided by the total number of eligible patients.
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one year
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Protocol Adherence for HISA Treatment
Zeitfenster: one year
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Protocol adherence will be assessed per case.
Full adherence is defined as: (1) assigned saline used; (2) temperature maintained at 42.0 ± 2.0°C for ≥80% of intended exposure; (3) delivery of hyperthermic saline occurred during the specified operative window, and (4) postoperative instillation of 1g gemcitabine for 60 minutes.
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one year
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Sekundäre Ergebnismessungen
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Incidence of HISA Treatment-related Complicatons, Adverse Events, and Readmission Rates
Zeitfenster: Three years
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To assess postoperative complications, adverse events, and readmission rates at 30- and 90-days.
Adverse events will be monitored during the study for up to 90 days for each patient, assessed and graded using the Common Terminology Criteria for Adverse Events (CTCAE) version 5.
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Three years
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Andere Ergebnismessungen
Andere Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
|
Overall Cancer-related Quality of Life and General Treatment Effects
Zeitfenster: From TURBT to 6 months after TURBT
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Quality of life will be assessed at the preoperative visit and follow-up visits at 2-weeks, 3 months, and 6 months using the EORTC QLQ Core Questionnaire (EORTC QLQ-C30, version 3.0).
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From TURBT to 6 months after TURBT
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Recurrence of NMIBC
Zeitfenster: From time of TURBT to 6 months after TURBT
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The proportion of patients with recurrence of NMIBC will be determined.
Recurrence will be defined as the percentage of patients with the reappearance of NMIBC tumor(s) within the bladder following transurethral resection of bladder tumor (TURBT).
The event will be defined as the earliest date of recurrence as determined using the date of cystoscopy, biopsy, or cytology, whichever occurs first.
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From time of TURBT to 6 months after TURBT
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Survival of NMIBC Patients
Zeitfenster: From time of TURBT to 6 months after TURBT
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Survival will be defined as the percentage of patients who have survived after TURBT without any recurrence or death from any cause.
The event will be defined as the length of time until cancer recurrence or death from any cause using the date of cystoscopy, biopsy, or death certificate date whichever occurs first.
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From time of TURBT to 6 months after TURBT
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Patient Quality of Life Concerns and Symptoms of HISA Treatment of NMIBC
Zeitfenster: From TURBT to 6 months after TURBT
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Quality of life will be assessed at the preoperative visit and follow-up visits at 2weeks, 3 months, and 6 months using the EORTC QLQ-NMIBC 24.
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From TURBT to 6 months after TURBT
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Mitarbeiter und Ermittler
Sponsor
Sponsor
Mitarbeiter
Mitarbeiter
Ermittler
Ermittler
- Hauptermittler: Michael G Stencel, DO, CAMC Health System
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Geschätzt)
Studienbeginn
Primärer Abschluss (Geschätzt)
Primärer Abschluss
Studienabschluss (Geschätzt)
Studienabschluss
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Zuerst gepostet
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes Update gepostet
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Zusätzliche relevante MeSH-Bedingungen
- Urogenitale Erkrankungen
- Urogenitale Neoplasmen
- Neubildungen nach Standort
- Neubildungen
- Männliche Urogenitalerkrankungen
- Urologische Erkrankungen
- Weibliche Urogenitalerkrankungen
- Weibliche Urogenitalerkrankungen und Schwangerschaftskomplikationen
- Neubildungen nach histologischem Typ
- Neubildungen, Drüsen und Epithelien
- Urologische Neubildungen
- Karzinom
- Erkrankungen der Harnblase
- Nicht-muskelinvasive Blasenneoplasien
- Neoplasien der Harnblase
Andere Studien-ID-Nummern
Andere Studien-ID-Nummern
- 25-1357
- U54GM104942 (US NIH Stipendium/Vertrag)
Plan für individuelle Teilnehmerdaten (IPD)
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Beschreibung des IPD-Plans
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