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Completed

NCT Number: NCT03998566

Radiopaque Hydrogel Spacer in Patients Undergoing Radiotherapy for Pancreatic Cancer

An early feasibility study to evaluate feasibility, radiotherapy benefits and safety when using TraceIT tissue spacer to create space between pancreas and duodenum in patients with localized Pancreatic Cancer.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Johns Hopkins Medicine, Baltimore, Maryland, United States

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Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Age ≥18 years old
  • Biopsy-confirmed localized pancreatic cancer in the head or neck of the pancreas as defined by the NCCN guidelines
  • Tumor is clearly delineable from duodenum and no clear evidence of invasion of the duodenum is seen at time of EUS performed for either diagnosis or fiducial placement.
  • Subject is able to comply with motion management guidelines.
  • Radiotherapy or chemoradiotherapy for treatment of the disease is indicated.
  • In Investigator's opinion, medically fit to undergo endoscopy for fiducial marker implantation and TraceIT administration.
  • Subjects Screening/Baseline laboratory testing must meet the following laboratory value criteria:
  • White blood cell count: ≥ 3.0 x 109/L
  • Absolute neutrophil count (ANC): ≥ 1.5 x 109/L
  • Platelets: ≥ 100 x 109/L
  • Total bilirubin: ≤ 2.0 times upper limit of normal (ULN)
  • AST and ALT: ≤ 3.0 times institutional upper normal limit
  • Serum creatinine: < 1.5 times ULN e
  • INR: < 1.5
  • Serum pregnancy: Negative
  • Hemoglobin: ≥ 8.0 g/dl
  • Zubrod Performance Status 0-2
  • Subject or authorized representative, has been informed of the nature of the study and has provided written informed consent, approved by the appropriate Institutional Review Board (IRB) of the respective clinical site.
  • Life expectancy of at least 9 months

Exclusion criteria

  • Patients for whom radiotherapy is contraindicated
  • Previous thoracic or abdominal radiotherapy
  • Any GI abnormality that would interfere with the ability to access the injection site
  • Presence of tumor invasion of the duodenum detected on EUS at time of biopsy
  • Previous Whipple procedure or other resection of pancreatic tumor prior to screening
  • Active gastroduodenal ulcer or uncontrolled watery diarrhea
  • History of Chronic Renal Failure.
  • Documented history of uncontrolled diabetes (i.e., symptomatic hyperglycemia that cannot be medically managed, fasting blood glucose level above 300 mg/dL, and/or frequent swings between hyperglycemia and hypoglycemia)
  • Currently enrolled in another investigational drug or device trial that clinically interferes with this study.
  • Unable to comply with the study requirements or follow-up schedule.
  • Any condition or comorbidity that the Investigator believes would interfere with the intent of the study or would make participation not in the best interest of the subject.
  • Women who are pregnant or breast-feeding; women of child-bearing age must use contraceptives.

Treatment and study plan

TraceIT Tissue Spacer implantation

Device

The TraceIT Tissue Spacer will be implanted between duodenum and pancreas using endoscopic procedure. After implantation patient will have radiotherapy treatment per standard of care.

Primary outcomes

  1. Safety Endpoint

    Time frame: 2-6 week assessment post-procedure

    Number of subjects with TraceIT procedure-related event which resulted in a delay in initiation for RT (radio-therapy).

Secondary outcomes

  1. Radio-Therapy Benefits of TraceIT

    Time frame: 2-6 week assessment

    Number of subjects who were able to maintain safe duodenal dose constraints. RT benefits were assessed via comparison of pre- and post-TraceIT administration RT plans with consideration of the following: ability to maintain safe duodenal dose constraints, percent/volume of gross tumor volume/planning target volume (GTV/PTV) receiving prescription dose and overall duodenal dose/dose distribution.

  2. Feasibility of TraceIT

    Time frame: 2-6 week assessment post-procedure

    Number of subjects who achieved Technical Success (the ability to place TraceIT and create space between the duodenum and head of pancreas (HOP).

  3. TraceIT Persistence (at 6-months Post-treatment)

    Time frame: 2-6 weeks and 6 month post procedure

    Characteristics of TraceIT persistence and migration were measured at 2 to 6 weeks and 6 months following injection. Persistence was measured at the 2 to 6 week and 6 month follow-ups by assessing whether a cohesive mass of water density fluid was present in the periduodenal space following the last radio therapy appointment. Migration of the TraceIT post Radiation was measured by CT scan taken at 2-6 weeks follow-up.

  4. Theoretical Dose Escalation From Post-TraceIT Treatment Plan

    Time frame: 2-6 week assessment Post-procedure

    Maximum dose to the GTV while maintaining duodenal dose constraints

  5. Incidence of Acute (Within 3 Months) and Late (>3 Months) Duodenal Toxicity Summarized by CTCAE Grade and Timing

    Time frame: 18 months post procedure

    Number of subject with Duodenal AE summarized by CTCAE grade and timing

  6. Incidence of Resection Following the Completion of Radiation Therapy (RT)

    Time frame: 2-6 weeks post procedure

    Number of subjects with resection following the completion of radiation therapy (RT). Within 2-6 weeks after completion of therapy, subjects were restaged to determine whether they may progress for surgery (resection).

  7. Progression Free and Overall Survival

    Time frame: 18 months post procedure

    Progression-free survival is the interval between the start of induction chemotherapy (prior to Radiation Therapy) to the earliest treatment failure onset date, or death, in months. Overall survival is the interval between the start of induction chemotherapy (prior to radiation therapy) to death in month.

  8. Changes From Baseline at the Final RT Appointment, 3 Month, 6 Month, 12 Month and 18 Month in EORTC QoL (QLQ-C30)

    Time frame: Changes in baseline at the Final RT appointment, 3 month, 6 month, 12 month and 18 month

    The EORTC QOL QLQ-C30 is a questionnaire used to assess patient-reported symptoms and outcomes during cancer treatment. The survey contains 28 questions scored on a 4-point Likert scale (1 = 'Not at all' to 4 'Very much') and 2 questions on a 7-point numerical scale (1 = 'Very poor' to 7 = 'Excellent').Questions are grouped into 15 categories containing 1 to 5 different questions per category. All scores were transformed to a 0-100 scale following instructions in the scoring manual. Raw scores calculated as the average of component items are then standardized using linear transformation to a score ranging from 0-100. Higher score for a functional scale represents a high/healthy level of functioning. A high score for the global health status/QoL represents a high QoL. A high score for a symptom scale/item represents a high level of symptomatology/problems.

Other outcomes

  1. Comparability of Visualization of the Fiducial Marker and TraceIT Hydrogel

    Time frame: 2-5 weeks assessment post procedure

    Scores for the visualization of the fiducial marker and TraceIT hydrogel.

  2. TraceIT Stability and Space Measurements

    Time frame: Pre-TraceIT and Post-TraceIT procedure, up to 2-6 weeks follow-up post radiation therapy

    The stability of TraceIT was measured as the minimum distance from the fiducial marker to TraceIT gel. Space measurements were taken before and after TraceIT was injected, which measured the preduodenal space using the axial view along the head of the HOP.

  3. Changes From Baseline Final RT Appointment, 3 Months, 6 Months, 12 Months, and 18 Months in QLQ-PAN26

    Time frame: Changes from baseline final RT appointment, 3 months, 6 months, 12 months, and 18 months in QLQ-PAN26

    The QLQ-PAN26 questionnaire is a survey designed to assess patient-reported symptoms of patients undergoing treatment for pancreatic cancer. All of the scales and single item measures range in score from 0-100. A high score for the symptom scales and/or single items represents a high level of symptomatology or problems, whereas a high score for the functional scales represents a high level of functioning.

Sponsors and collaborators

Lead sponsor

Boston Scientific Corporation

Industry

Registry information

Official study title

Early Feasibility Study For Evaluation Of The TraceIT® Tissue Spacer For Creating Space Between The Duodenum And Pancreas In Patients With Localized Pancreatic Cancer Undergoing Radiation Therapy

Important dates

Study start
2019
Primary completion
2021
Study completion
2021
First posted
Jun 26, 2019
Registry last updated
Feb 27, 2023

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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