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Terapia fotodinamica interstiziale dopo radioterapia palliativa nel trattamento di pazienti con ostruzione maligna centrale inoperabile delle vie aeree

4 novembre 2026 aggiornato da: Roswell Park Cancer Institute

Uno studio di fase I/II sulla terapia fotodinamica interstiziale successiva alla radioterapia palliativa per pazienti con ostruzione maligna centrale delle vie aeree

This phase I/II trial studies the side effects of interstitial photodynamic therapy following palliative radiotherapy and how well it works in treating patients with inoperable malignant central airway obstruction. Patients who have advanced stage cancer tumors in the lung can often have the breathing passages to the lung partially or completely blocked. These tumors could be due to lung cancer or other cancers (e.g., renal, breast, kidney, etc.) that spread to the lung. This blockage puts the patient at a higher risk for respiratory failure, post-obstructive pneumonia, and prolonged hospitalizations. Treatment for these patients may include bronchoscopic intervention (such as mechanical removal, stenting, laser cauterization, or ballooning), radiation therapy with and without chemotherapy. While palliative x-ray radiotherapy may help in shrinking the tumor, high dose curative radiotherapy that can ablate (a localized, nonsurgical destruction) the tumor also has high risk to cause significant toxicity, including bleeding, abnormal connections or passageways between organs or vessels and abnormal scar tissue that can also produce airway obstruction. Photodynamic therapy (PDT) is another possible treatment that can provide local control of the tumor. PDT consists of injecting a light sensitive drug (photosensitizer, PS) into the vein, waiting for the PS to accumulate in the tumor, and then activating it with a red laser light. Radiation therapy uses high energy x-rays, particles, or radioactive seeds to kill cancer cells and shrink tumors. Giving interstitial photodynamic therapy following palliative radiotherapy may improve tumor response and survival without the serious side effects that are associated with the typical high dose curative x-ray radiotherapy alone in patients with malignant central airway obstruction.

Panoramica dello studio

Stato

Reclutamento

Condizioni

Intervento / Trattamento

Descrizione dettagliata

PRIMARY OBJECTIVES:

I. To test the safety of our image-based treatment planning for image-guided interstitial photodynamic therapy (I PDT) with endobronchial ultrasound (EBUS) following standard of care palliative radiotherapy (p-XRT). (Phase I)

-To assess the efficacy of our image-based treatment planning for image-guided I-PDT following standard of care p-XRT. (Phase II)

SECONDARY OBJECTIVES:

  • To assess objective tumor response. (Phase I)
  • To evaluate changes in quality of life. (Phase I and II)
  • To measure changes in functional lung capacity. (Phase I and II)
  • To measure the relationship between the measured objective tumor response (at 12 +/- 2 weeks post I-PDT) and changes in therapeutic laser light transmission within the target tumor, as a future dosimetric marker for response. (Phase I and II)
  • To assess treatment effects on the immune contexture. (Phase I and II)
  • To monitor progression free survival. (Phase I and II)

OUTLINE: This is a phase I study, followed by a phase II.

PHASE I: Patients are assigned to 1 of 2 cohorts.

COHORT 1: Patients receive visudyne intravenously (IV) over 10 minutes and then undergo I-PDT with EBUS 60-90 minutes after visudyne for up to 3 treatment sessions. Patients undergo blood and tissue sample collection on study. Patients also undergo computed tomography (CT) throughout the trial.

COHORT 2: Patients undergo SOC p-XRT over a single fraction. Patients receive visudyne IV over 10 minutes and then undergo I-PDT with EBUS 60-90 minutes after visudyne for up to 2 treatment sessions at least 12 weeks apart. Patients undergo blood and tissue sample collection on study. Patients also undergo CT throughout the trial.

PHASE II: Patients undergo SOC p-XRT over a single fraction. Patients receive visudyne IV over 10 minutes and then undergo I-PDT with EBUS 60-90 minutes after visudyne for up to 2 treatment sessions at least 12 weeks apart. Patients undergo blood and tissue sample collection on study. Patients also undergo CT throughout the trial.

After completion of study treatment, patients are followed up at 30 days and 8, 12, and 24 weeks.

Tipo di studio

Interventistico

Iscrizione (Stimato)

42

Fase

  • Fase 2
  • Fase 1

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Contatto studio

Luoghi di studio

    • New York
      • Buffalo, New York, Stati Uniti, 14263
        • Reclutamento
        • Roswell Park Cancer Institute
        • Contatto:
        • Investigatore principale:
          • Nathaniel Ivanick
    • Pennsylvania
      • Philadelphia, Pennsylvania, Stati Uniti, 19104
        • Reclutamento
        • Abramson Cancer Center

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

18 anni e precedenti (Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Descrizione

Inclusion Criteria:

  • Age >= 18 years of age
  • Eligibility checklist before registration requires review of case by the interventional pulmonologist/s and radiation oncologist/s to approve anatomic feasibility of an airway intervention and palliative radiotherapy
  • Patients with pathologic diagnosis of inoperable solid malignancy involving extrabronchial tumor growth that causes airway obstruction and not amenable to curative radiotherapy. All patients will have tumors requiring bronchoscopic intervention with endobronchial ultrasound (EBUS) at the time of I-PDT
  • Participants have at least one measurable lesion which is also the target lesion for Response Evaluation Criteria in Solid Tumors (RECIST) measurement
  • Patients amenable to receive standard of care palliative radiotherapy to the target tumor, as determined by the radiation oncologist/s
  • Amenable to high resolution chest computed tomography (CT) scan (with or without contrast due to contraindication) with 0.625-1.25 mm slice thickness and slice interval 0.5-1 mm
  • Tumor is accessible and amenable to I-PDT, as determined by the interventional pulmonologist/s
  • Have an Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 3
  • Platelets ≥ 100,000 cells/mm^3 (International System of Units [SI] units 100 x 10^9/L)
  • International normalized ratio (INR) < 1.5 and activated partial thromboplastin time (aPTT) < 1.5 x ULN. PTT or aPTT per institutional standards for participating external sites
  • Participants of child-bearing potential must agree to use adequate contraceptive methods (e.g., hormonal or barrier method of birth control; abstinence) prior to study entry and for 3 months after receiving the study drug. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately
  • Participant must understand the investigational nature of this study and sign an Independent Ethics Committee/Institutional Review Board approved written informed consent form prior to receiving any study related procedure

Exclusion Criteria:

  • Pregnant or nursing female participants
  • Co-existing ophthalmic disease likely to require slit-lamp examination within the next 30 days following I-PDT treatment
  • Any condition which in the investigator's opinion deems the participant an unsuitable candidate to receive the I-PDT
  • CT imaging suggestive of target tumor invasion into a major blood vessel (typically proximal to segmental vessels)
  • Known hypersensitivity/allergy to porphyrin
  • Patients who are not cleared by the anesthesiologist to undergo an advanced bronchoscopy procedure under general anesthesia
  • Patients who have received 120 Gy total radiation dose delivered to a structure within 1 cm margin of tumor volume to be targeted by p-XRT and I-PDT
  • Patients diagnosed with porphyria
  • Patients with known allergy to eggs
  • Patients unwilling or unable to follow protocol requirements

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Non randomizzato
  • Modello interventistico: Assegnazione sequenziale
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: Phase I cohort 1 (I-PDT, EBUS)

Patients receive visudyne IV over 10 minutes and then undergo I-PDT with EBUS 60-120 minutes after visudyne for up to 3 treatment sessions. Patients undergo blood and tissue sample collection on study. Patients also undergo CT throughout the trial.

Undergo CT

Altri nomi:
  • CT
  • GATTO
  • TAC
  • Tomografia assiale computerizzata
  • Tomografia computerizzata
  • tomografia
  • Tomografia assiale computerizzata (procedura)

Ancillary studies

Undergo blood and tissue sample collection

Altri nomi:
  • Raccolta di campioni biologici
  • Biocampione raccolto
  • Raccolta di campioni

Ancillary studies

Altri nomi:
  • Test di idoneità fisica
  • Test di funzionalità fisica

Undergo EBUS

Altri nomi:
  • EBUS
  • Ecografia endobronchiale

Undergo I-PDT

Altri nomi:
  • I-PDT
  • Terapia fotodinamica con illuminazione interstiziale

Given IV

Altri nomi:
  • Visudine
  • Anello monoacido derivato dalla benzoporfirina A
  • BPD-MA
Sperimentale: Phase I cohort 2 (I-PDT, EBUS, palliative radiation therapy)

Patients undergo SOC p-XRT over a single fraction. Patients receive visudyne IV over 10 minutes and then undergo I-PDT with EBUS 60-120 minutes after visudyne for up to 2 treatment sessions at least 12 weeks apart. Patients undergo blood and tissue sample collection on study. Patients also undergo CT throughout the trial.

Undergo CT

Altri nomi:
  • CT
  • GATTO
  • TAC
  • Tomografia assiale computerizzata
  • Tomografia computerizzata
  • tomografia
  • Tomografia assiale computerizzata (procedura)

Ancillary studies

Undergo blood and tissue sample collection

Altri nomi:
  • Raccolta di campioni biologici
  • Biocampione raccolto
  • Raccolta di campioni

Ancillary studies

Altri nomi:
  • Test di idoneità fisica
  • Test di funzionalità fisica

Undergo EBUS

Altri nomi:
  • EBUS
  • Ecografia endobronchiale

Undergo I-PDT

Altri nomi:
  • I-PDT
  • Terapia fotodinamica con illuminazione interstiziale

Given IV

Altri nomi:
  • Visudine
  • Anello monoacido derivato dalla benzoporfirina A
  • BPD-MA

Undergo palliative radiation therapy

Altri nomi:
  • Radioterapia palliativa

Delivering the therapeutic 689+/-3 nm laser light during I-PDT. Measuring light transmission.

Altri nomi:
  • Laser a diodi accoppiati a fibra: ML7710-PDT
Sperimentale: Phase II (I-PDT, EBUS, palliative radiation therapy)

Phase II: Patients undergo SOC p-XRT over a single fraction. Patients receive visudyne IV over 10 minutes and then undergo I-PDT with EBUS 60-120 minutes after visudyne for up to 2 treatment sessions at least 12 weeks apart. Patients undergo blood and tissue sample collection on study. Patients also undergo CT throughout the trial.

Undergo CT

Altri nomi:
  • CT
  • GATTO
  • TAC
  • Tomografia assiale computerizzata
  • Tomografia computerizzata
  • tomografia
  • Tomografia assiale computerizzata (procedura)

Ancillary studies

Undergo blood and tissue sample collection

Altri nomi:
  • Raccolta di campioni biologici
  • Biocampione raccolto
  • Raccolta di campioni

Ancillary studies

Altri nomi:
  • Test di idoneità fisica
  • Test di funzionalità fisica

Undergo EBUS

Altri nomi:
  • EBUS
  • Ecografia endobronchiale

Undergo I-PDT

Altri nomi:
  • I-PDT
  • Terapia fotodinamica con illuminazione interstiziale

Undergo palliative radiation therapy

Altri nomi:
  • Radioterapia palliativa

Delivering the therapeutic 689+/-3 nm laser light during I-PDT. Measuring light transmission.

Altri nomi:
  • Laser a diodi accoppiati a fibra: ML7710-PDT

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Incidence of >= grade 3 adverse events (Phase I)
Lasso di tempo: Within 30 days post interstitial photodynamic therapy (I-PDT)

Will will be associated with treatment related adverse events .grade 3 (with attribution of 'possible', 'probable' or 'definite'. Will be assessed using National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0 (NCI CTCAE v 5.0).

Within 30 days post interstitial photodynamic therapy (I-PDT)
Overall tumor response (Phase II)
Lasso di tempo: At 12 weeks post I-PDT

Will be assessed by complete response (CR) or partial response (PR) defined by the Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v 1.1) criteria.

At 12 weeks post I-PDT

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Overall tumor response (Phase I)
Lasso di tempo: At 12 weeks post I-PDT

Will be assessed by CR or PR defined by the RECIST v 1.1 criteria.

At 12 weeks post I-PDT
Quality of life (Phase I and II)
Lasso di tempo: At study enrollment, immediately prior to p-XRT and I-PDT, and at 4 and 12 weeks

Will be monitored using the Functional Assessment of Cancer Therapy-Lung. This 36 item self-reported quality of life questionnaire measures responses across six domains: physical well-being, social/family well-being, relationship with doctor, emotional well-being, functional well-being, and additional concerns. This scale was chosen because multiple studies support its validity and use in clinical trials of lung cancer.

At study enrollment, immediately prior to p-XRT and I-PDT, and at 4 and 12 weeks
Functional lung capacity (Phase I and II)
Lasso di tempo: At study entry (baseline), 30 days and 12 weeks

Will be measured with the six-minute walk test.

At study entry (baseline), 30 days and 12 weeks
Change in the therapeutic laser light transmission (Phase I and II)
Lasso di tempo: During the I-PDT

Will be measured with our light dosimetry system.

During the I-PDT
Association between immune markers and tumor response (Phase I and II)
Lasso di tempo: Prior and 7-10 days after the I-PDT

will be measured with flow cytometry in fresh blood samples collected prior and 7-10 days after the I-PDT.

Prior and 7-10 days after the I-PDT
Progression free survival (Phase I and II)
Lasso di tempo: Time from date of study treatment to the time of first observed disease progression (RECIST 1.1 criteria) at the treated tumor site or, death due to any cause, assessed up to 5 years

Will be summarized using standard Kaplan-Meier methods.

Time from date of study treatment to the time of first observed disease progression (RECIST 1.1 criteria) at the treated tumor site or, death due to any cause, assessed up to 5 years

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Collaboratori

Investigatori

  • Investigatore principale: Nathaniel Ivanick, Roswell Park Cancer Institute

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Effettivo)

1 ottobre 2024

Completamento primario (Stimato)

1 ottobre 2029

Completamento dello studio (Stimato)

1 ottobre 2029

Date di iscrizione allo studio

Primo inviato

27 febbraio 2024

Primo inviato che soddisfa i criteri di controllo qualità

5 marzo 2024

Primo Inserito (Effettivo)

12 marzo 2024

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

5 novembre 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

4 novembre 2026

Ultimo verificato

1 novembre 2026

Maggiori informazioni

Termini relativi a questo studio

Altri numeri di identificazione dello studio

  • I-3901323
  • I-3901323 (Altro identificatore: Roswell Park Cancer Institute)
  • NCI-2024-01239 (Identificatore di registro: CTRP (Clinical Trial Reporting Program))
  • R01CA283547 (Sovvenzione/contratto NIH degli Stati Uniti)

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

Sì

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

prodotto fabbricato ed esportato dagli Stati Uniti

Sì

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .