- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT00661622
Halt Growth of Liver Tumors From Uveal Melanoma With Closure of Liver Artery Following Injection of GM-CSF
Immuno-embolization of Hepatic Artery With Granulocyte-macrophage Colony Stimulating Factor (GM-CSF)
Patients with uveal melanoma metastatic to the liver will be treated with embolization of the hepatic artery every 4 weeks. GM-CSF (granulocyte-macrophage colony simulating factor) or normal saline will be injected into one of the liver arteries with an oily contrast dye, Ethiodol. This is followed by blockage of the artery with small pieces of gelatin sponge (embolization). It is hoped with this novel approach that:
- tumor cells will die due to a loss of their blood supply,
- local inflammatory reactions induced by GM-CSF will kill remaining tumor cells, and
- a systemic immune response against tumor cells may develop.
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
Type d'étude
Inscription (Réel)
Phase
- Phase 2
Contacts et emplacements
Lieux d'étude
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Pennsylvania
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Philadelphia, Pennsylvania, États-Unis, 19317
- Thomas Jefferson University
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
Inclusion Criteria:
- Metastatic uveal melanoma in the liver with histological confirmation
- Ability/willingness to give informed consent
- ECOG performance status of 0 or 1
- Adequate renal, liver and bone marrow function
Exclusion Criteria:
- Solitary liver metastasis that is amenable to surgical removal
- Presence of symptomatic liver failure including ascites and hepatic encephalopathy
- Presence of extra-hepatic metastases
- Untreated brain metastases
- Uncontrolled hypertension or congestive heart failure or acute myocardial infarction within 6 months of entry
- Presence of any other medical complication that imply survival of less than six months
- Uncontrolled sever bleeding tendency or active GI bleeding
- Significant allergic reaction to contrast dye or GM-CSF
- Immunosuppressive treatments such as systemic steroids, radiation to pelvis or systemic chemotherapy within 4 weeks
- Previous embolization of the hepatic artery or intrahepatic arterial chemotherapy of liver metastasis
- Active hepatitis with serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT) greater than 5 x normal
- HIV infection positive by ELISA
- Pregnancy or breast feeding women
- Biliary obstruction, biliary stent or prior biliary surgery except cholecystectomy
- Significant arteriovenous shunt identified on angiography of the hepatic artery
- Occlusion of main portal vein or inadequate collateral flow around an occluded portal vein
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Quadruple
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
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Expérimental: Immunoembolization
Liver embolization treatment with injection of GM-CSF.
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2,000 mcg injected into the liver every 4 weeks alternating between right or left lobe when tumors present throughout liver.
Autres noms:
A catheter will be introduced to one of the hepatic arteries by way of the femoral artery (groin) to allow injection of GM-CSF in combination with ethiodized oil and gelatin sponge providing a temporary blockage of the blood supply from the hepatic (liver) artery
Autres noms:
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Comparateur actif: Plain embolization
Liver embolization with normal saline injected in place of GM-CSF
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A catheter will be introduced to one of the hepatic arteries by way of the femoral artery (groin) to allow injection of GM-CSF in combination with ethiodized oil and gelatin sponge providing a temporary blockage of the blood supply from the hepatic (liver) artery
Autres noms:
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
---|---|---|
Response of Liver Metastases
Délai: Every 8 weeks
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Complete response: Disappearance of all target and non-target liver lesions Partial response: >= 30% decrease in the sum of the longest diameters (LD) relative to baseline sum LD with at least stable non-target liver lesions Stable disease: Absence of change which would qualify as response or progression Progression: >= 20% increase in the sum LD in target liver lesions or unequivocal progression of non-target liver lesions in the treated lobe(s) or appearance of one or more new liver lesions >= 10mm in the treated lobe(s) |
Every 8 weeks
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Overall Response Rate
Délai: Baseline then 3 to 4 weeks after every 2 treatments
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Clinical response in the liver metastases will be evaluated after every two embolizations using CT scans or MRI of the abdomen.
The sum of the longest diameter (LD) of up to 6 target lesions will be used to determine response.
Target indicator lesions will be identified and measured as baseline prior to the first embolization.
The same target lesions will then be measured 3 to 4 weeks after every two treatments.
The sum of the baseline LDs will be compared to the sum of the LDs after every two treatments.
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Baseline then 3 to 4 weeks after every 2 treatments
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
---|---|---|
Overall Survival
Délai: Baseline to death
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Measured from the start of the treatment to death of patients
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Baseline to death
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Median Progression Free Survival
Délai: Baseline to time of progression
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Measured from the start of the treatment to confirmation of progression of disease by either imaging tests or physical examination. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of one or more new liver lesions >= 10mm in the treated lobe(s). |
Baseline to time of progression
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Systemic Progression Free Survival
Délai: Baseline to time of progression
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Measured from the start of the treatment to confirmation of progression of disease by either imaging tests or physical examination. Progression is defined using Response Evaluation Criteria In Solid Tumors Criteria (RECIST v1.0), as a 20% increase in the sum of the longest diameter of target lesions, or a measurable increase in a non-target lesion, or the appearance of one or more new liver lesions >= 10mm in the treated lobe(s). |
Baseline to time of progression
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Collaborateurs et enquêteurs
Collaborateurs
Les enquêteurs
- Chercheur principal: Takami Sato, M.D., Ph.D., Thomas Jefferson University
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Estimation)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Estimation)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- 04F.445
- R21CA103250 (Subvention/contrat des NIH des États-Unis)
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