Ignite Creation Date:
2024-05-06 @ 8:28 AM
Last Modification Date:
2024-10-26 @ 12:00 PM
Study NCT ID:
NCT02748161
Status:
TERMINATED
Last Update Posted:
2018-06-21
First Post:
2016-04-18
Brief Title:
DEB-TACE for Hepatocellular Carcinoma
Sponsor:
Surefire Medical Inc
Organization:
SurefireMedical
Study Overview
Official Title:
Surefire vs Endhole for DEB-TACE Quantifying Hepatic Artery Embolization to Improve Outcomes by Comparing Two Different Catheter Systems for DEB-TACE QED Study
Status:
TERMINATED
Status Verified Date:
2018-06
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Low enrollment
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
QED
Brief Summary:
Patients enrolled in this study have been diagnosed with hepatocellular carcinoma HCC and are scheduled to have a procedure called drug-eluting bead trans-arterial chemoembolization DEB-TACE During the DEB-TACE procedure very small beads are mixed in with a chemotherapy drug doxorubicin and delivered to the tumor through an arterial catheter
The DEB-TACE procedure allows the treatment to be delivered directly into the liver It also causes arterial embolization the process in which a blood vessel is blocked Treatment of HCC using DEB-TACE may help delay tumor progression and can downstage decrease the size the cancer in order to meet the criteria which may allow patients to become candidates for liver transplantation The purpose of this study is to compare tumor response and medical outcomes for patients who undergo DEB-TACE with standard endhole catheter versus Surefire Infusion System
The DEB-TACE procedure allows the treatment to be delivered directly into the liver It also causes arterial embolization the process in which a blood vessel is blocked Treatment of HCC using DEB-TACE may help delay tumor progression and can downstage decrease the size the cancer in order to meet the criteria which may allow patients to become candidates for liver transplantation The purpose of this study is to compare tumor response and medical outcomes for patients who undergo DEB-TACE with standard endhole catheter versus Surefire Infusion System
Detailed Description:
Conventional transarterial chemoembolization with lipiodoldoxorubicin cTACE is known to prolong survival compared to supportive therapy in certain patients with unresectable HCC including patients with unilateral portal vein invasion PVI TACE with doxorubicin-eluting beads DEB-TACE is a relatively new modality associated with favorable systemic doxorubicin exposuretoxicity and liver-specific toxicity compared to cTACE and studies have documented its safety and efficacy DEB-TACE is currently utilized for 1 patients who have unresectable HCC and 2 patients who meet the Milan Criteria and currently on liver transplantation lists
The biggest challenge for these procedures has been the inability to actually quantify embolization in a real-time setting to provide immediate feedback to the operator Although various methods such as perfusion analysis with CT or MRI have been described these require advanced imaging equipmentcapabilities extensive post processing analysis and can create challenging workflows
Currently the best results occur when the dose is delivered in a highly targeted manner into the tumor Dense accumulation of embolic spheres or lipiodol into the tumor as documented by CT has been shown to have improved outcomes However with standard endhole catheters achieving maximum delivery of embolic agents is limited by the development of stasis and subsequent non-target injury
As DEB-TACE is performed through an endhole catheter with either stasis or substasis as an endpoint The current methodology is extremely subjective lacks a quantifiable endpoint and results in various degrees of embolization on patients Often this can result in repeat procedures or the progression of tumor
Recently there has been FDA clearance of a new anti-reflux catheter Surefire Infusion System SIS Westminster CO The current design has an expandable tip which collapses during forward flow and then dynamically seal off the vessel with reversal of flow analogous to a valve SIS with its expandable tip microcatheter has been demonstrated clinically to cause a slight decrease in intra-arterial pressure in the antegrade or downstream vascular compartment Although this device was designed primarily to prevent retrograde reflux of embolic agents the downstream blood pressure reduction may serve as a biomarker on quantifying embolization
The goal is to develop a method that 1 allows maximum delivery of embolic spheres into the tumor tissue to stasis without reflux 2 enables direct real time numerical quantification on the degree of embolization and 3 provides an intra-procedural functional parameter which could be used to guide the optimal therapeutic endpoints at the time of treatment
The biggest challenge for these procedures has been the inability to actually quantify embolization in a real-time setting to provide immediate feedback to the operator Although various methods such as perfusion analysis with CT or MRI have been described these require advanced imaging equipmentcapabilities extensive post processing analysis and can create challenging workflows
Currently the best results occur when the dose is delivered in a highly targeted manner into the tumor Dense accumulation of embolic spheres or lipiodol into the tumor as documented by CT has been shown to have improved outcomes However with standard endhole catheters achieving maximum delivery of embolic agents is limited by the development of stasis and subsequent non-target injury
As DEB-TACE is performed through an endhole catheter with either stasis or substasis as an endpoint The current methodology is extremely subjective lacks a quantifiable endpoint and results in various degrees of embolization on patients Often this can result in repeat procedures or the progression of tumor
Recently there has been FDA clearance of a new anti-reflux catheter Surefire Infusion System SIS Westminster CO The current design has an expandable tip which collapses during forward flow and then dynamically seal off the vessel with reversal of flow analogous to a valve SIS with its expandable tip microcatheter has been demonstrated clinically to cause a slight decrease in intra-arterial pressure in the antegrade or downstream vascular compartment Although this device was designed primarily to prevent retrograde reflux of embolic agents the downstream blood pressure reduction may serve as a biomarker on quantifying embolization
The goal is to develop a method that 1 allows maximum delivery of embolic spheres into the tumor tissue to stasis without reflux 2 enables direct real time numerical quantification on the degree of embolization and 3 provides an intra-procedural functional parameter which could be used to guide the optimal therapeutic endpoints at the time of treatment
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
None
Is a FDA Regulated Device?:
None
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None