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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)

2026年9月21日 更新者：Bas Groot Koerkamp, MD, PhD、Erasmus Medical Center

使用辅助肝动脉输液泵化疗，预防部分肝切除术后肝切除术后肝脏复发 - 泵IV试验

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.

研究概览

地位

招聘中

条件

干预/治疗

研究类型

介入性

注册 (估计的)

40

阶段

  • 阶段2

联系人和位置

本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。

学习联系方式

研究联系人备份

学习地点

  • 荷兰
    • South Holland
      • Rotterdam、South Holland、荷兰、3015GD
        • 招聘中
        • Erasmus Medical Center
        • 接触：
        • 接触：
        • 首席研究员：
          • Bas Groot Koerkamp, MD, PhD

参与标准

研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

18年 及以上 (成人、年长者)

接受健康志愿者

不

有资格学习的性别

全部

描述

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

学习计划

本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。

研究是如何设计的？

设计细节

  • 主要用途：治疗
  • 分配：不适用
  • 介入模型：单组作业
  • 屏蔽：无（打开标签）

武器和干预

参与者组/臂
干预/治疗
实验性的：Surgery + chemo pump (Hepatic Arterial Infusion Pump chemotherapy)

Surgery + chemo pump
组合产品：Hepatic Arterial Infusion Pump chemotherapy with floxuridin

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)

其他名称：
  • Haip
  • HAIC与氟苷素
  • 泵化疗

研究衡量的是什么？

主要结果指标

结果测量
措施说明
大体时间
Two-year hepatic recurrence free survival (hRFS)
大体时间：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

次要结果测量

结果测量
措施说明
大体时间
Overall recurrence free survival (RFS)
大体时间：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)
大体时间：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
大体时间：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)
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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
大体时间：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)

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

Erasmus Medical Center

合作者

Koningin Wilhelmina Fonds

调查人员

  • 首席研究员：Bas Groot Koerkamp, MD, PhD、Erasmus Medical Center

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始 (实际的)

2024年11月20日

初级完成 (估计的)

2028年9月1日

研究完成 (估计的)

2033年9月1日

研究注册日期

首次提交

2025年2月5日

首先提交符合 QC 标准的

2025年3月14日

首次发布 (实际的)

2025年3月21日

研究记录更新

最后更新发布 (实际的)

2026年9月23日

上次提交的符合 QC 标准的更新

2026年9月21日

最后验证

2026年9月1日

更多信息

与本研究相关的术语

关键字

其他相关的 MeSH 术语

其他研究编号

  • MEC-2024-0324
  • 2024-513726-33-00 (克蒂斯)

计划个人参与者数据 (IPD)

计划共享个人参与者数据 (IPD)？

未定

IPD 计划说明

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

药物和器械信息、研究文件

研究美国 FDA 监管的药品

是的

研究美国 FDA 监管的设备产品

不

在美国制造并从美国出口的产品

是的

此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.

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