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Y90 Radioembolization Prior to Surgical Resection or Radiofrequency for Hepatocellular Carcinoma in Cirrhotic Liver (TRYPHON)

Primary Purpose

Hepatocellular Carcinoma, Liver Cirrhosis

Status
Terminated
Phase
Phase 2
Locations
Belgium
Study Type
Interventional
Intervention
Sirsphere trans-arterial radioembolization
Sponsored by
Jules Bordet Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hepatocellular Carcinoma focused on measuring Hepatocellular Carcinoma, Liver Cirrhosis, radioembolization, SIRT, TARE, Sirspheres, neoadjuvant, liver cancer

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Age ≥18 years.
  • Cirrhotic liver demonstrated by typical liver dysmorphy on imaging and/or liver biopsy.
  • HCC with at least one lesion measuring more than 1 cm in diameter with a single dynamic imaging technique (CT or MRI), showing intense arterial uptake followed by washout of contrast in the venous-delayed phases, or diagnosed by biopsy.
  • Borderline resectable disease eligible for surgical resection or radiofrequency destruction.
  • No extra-hepatic dissemination.
  • ECOG Performance status < 2.
  • Women of child-bearing potential must agree to use adequate contraception (hormonal or barrier method of birth control, abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately.
  • Signed written informed consent (approved by an Independent Ethics Committee) obtained prior to any study specific baseline procedures.

Exclusion Criteria:

  • Decompensated cirrhosis (Child Pugh B, C).
  • Extra-hepatic tumour spread.
  • Previous or concomitant malignancies within five years other than basal cell carcinoma of the skin.
  • Pregnancy, lactation or refusal to use adequate contraceptive measures (hormonal or barrier method of birth control, abstinence).
  • Pre-existing other hepatic disease (liver abscess, hepatic sarcoidosis or tuberculosis, sclerosing cholangitis, …).
  • Previous trans-arterial radioembolization (TARE).
  • History of allergic reactions attributed to compounds of similar chemical or biologic composition of the administered materials.
  • Bleeding diathesis, history of cardiovascular ischemic disease or cerebrovascular incident within the last six months.
  • Major surgery within four weeks.
  • Uncontrolled concurrent illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
  • Uncontrolled Diabetes.

Sites / Locations

  • Institut Jules Bordet
  • Erasme Hosptial

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Preoperative aTARE

Arm Description

The patients in this arm will receive Sirsphere trans-arterial radioembolization before surgery

Outcomes

Primary Outcome Measures

Peri-operative morbidity
peri-operative morbidity of supraselective ablative transarterial radioembolization prior to surgical resection or radiofrequency in cirrhotic patients with HCC (starting from date of inclusion till 90 days after surgery or hospital discharge if more than 90 days)

Secondary Outcome Measures

Survival
Assessment of the overall disease free survival and Overall Survival
One and three years survival
Estimation of disease free survival and overall survival rates after 1 and 3 years
Tumor regression
Assessment of tumour size regression after Trans-arterial radioembolization by MRI
Functional Imaging
Assessment of imaging parameters changes (DW-MRI, FDG-PET/CT) and MAA-SPECT-CT in relation to the outcome measured by tumour regression after TARE, disease free and overall survival.
Contra-lateral Lobe Hypertrophy
Assessment of TARE induced liver contralateral lobe hypertrophy (volumetric measurement by MRI).

Full Information

First Posted
September 11, 2012
Last Updated
June 30, 2015
Sponsor
Jules Bordet Institute
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1. Study Identification

Unique Protocol Identification Number
NCT01686880
Brief Title
Y90 Radioembolization Prior to Surgical Resection or Radiofrequency for Hepatocellular Carcinoma in Cirrhotic Liver
Acronym
TRYPHON
Official Title
Treatment With Yttrium90 Radioembolization Prior to Surgical Resection or Radiofrequency for Hepatocellular Carcinoma in Cirrhotic Liver
Study Type
Interventional

2. Study Status

Record Verification Date
June 2015
Overall Recruitment Status
Terminated
Why Stopped
poor recruitment and an unexpected low treatment rate
Study Start Date
September 2012 (undefined)
Primary Completion Date
January 2015 (Actual)
Study Completion Date
January 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Jules Bordet Institute

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to assess the safety of transarterial radioembolization prior to surgical resection or radiofrequency in cirrhotic patients with hepatocellular carcinoma
Detailed Description
The purpose of this study is to assess the peri-operative morbidity and mortality of supraselective ablative transarterial radioembolization prior to surgical resection or radiofrequency in cirrhotic patients with HCC

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hepatocellular Carcinoma, Liver Cirrhosis
Keywords
Hepatocellular Carcinoma, Liver Cirrhosis, radioembolization, SIRT, TARE, Sirspheres, neoadjuvant, liver cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
10 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Preoperative aTARE
Arm Type
Experimental
Arm Description
The patients in this arm will receive Sirsphere trans-arterial radioembolization before surgery
Intervention Type
Device
Intervention Name(s)
Sirsphere trans-arterial radioembolization
Other Intervention Name(s)
TARE, SIRT
Intervention Description
Patients will receive Sirsphere trans-arterial radioembolization before surgery
Primary Outcome Measure Information:
Title
Peri-operative morbidity
Description
peri-operative morbidity of supraselective ablative transarterial radioembolization prior to surgical resection or radiofrequency in cirrhotic patients with HCC (starting from date of inclusion till 90 days after surgery or hospital discharge if more than 90 days)
Time Frame
3 months after surgery
Secondary Outcome Measure Information:
Title
Survival
Description
Assessment of the overall disease free survival and Overall Survival
Time Frame
3 years
Title
One and three years survival
Description
Estimation of disease free survival and overall survival rates after 1 and 3 years
Time Frame
one and three years
Title
Tumor regression
Description
Assessment of tumour size regression after Trans-arterial radioembolization by MRI
Time Frame
8 weeks after Trans-arterial radioembolization
Title
Functional Imaging
Description
Assessment of imaging parameters changes (DW-MRI, FDG-PET/CT) and MAA-SPECT-CT in relation to the outcome measured by tumour regression after TARE, disease free and overall survival.
Time Frame
3 years
Title
Contra-lateral Lobe Hypertrophy
Description
Assessment of TARE induced liver contralateral lobe hypertrophy (volumetric measurement by MRI).
Time Frame
3 Years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥18 years. Cirrhotic liver demonstrated by typical liver dysmorphy on imaging and/or liver biopsy. HCC with at least one lesion measuring more than 1 cm in diameter with a single dynamic imaging technique (CT or MRI), showing intense arterial uptake followed by washout of contrast in the venous-delayed phases, or diagnosed by biopsy. Borderline resectable disease eligible for surgical resection or radiofrequency destruction. No extra-hepatic dissemination. ECOG Performance status < 2. Women of child-bearing potential must agree to use adequate contraception (hormonal or barrier method of birth control, abstinence) prior to study entry and for the duration of study participation. Should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately. Signed written informed consent (approved by an Independent Ethics Committee) obtained prior to any study specific baseline procedures. Exclusion Criteria: Decompensated cirrhosis (Child Pugh B, C). Extra-hepatic tumour spread. Previous or concomitant malignancies within five years other than basal cell carcinoma of the skin. Pregnancy, lactation or refusal to use adequate contraceptive measures (hormonal or barrier method of birth control, abstinence). Pre-existing other hepatic disease (liver abscess, hepatic sarcoidosis or tuberculosis, sclerosing cholangitis, …). Previous trans-arterial radioembolization (TARE). History of allergic reactions attributed to compounds of similar chemical or biologic composition of the administered materials. Bleeding diathesis, history of cardiovascular ischemic disease or cerebrovascular incident within the last six months. Major surgery within four weeks. Uncontrolled concurrent illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements. Uncontrolled Diabetes.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Alain Hendlisz, MD
Organizational Affiliation
Jules Bordet Institute
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Vincent Donckier, MD, PHD
Organizational Affiliation
Erasme University Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Institut Jules Bordet
City
Brussels
ZIP/Postal Code
1000
Country
Belgium
Facility Name
Erasme Hosptial
City
Brussels
ZIP/Postal Code
1070
Country
Belgium

12. IPD Sharing Statement

Citations:
PubMed Identifier
29486918
Citation
Lemaire M, Lucidi V, Bouazza F, Katsanos G, Vanderlinden B, Levillain H, Delatte P, Garcia CA, Vouche M, Galdon MG, Demetter P, Deleporte A, Hendlisz A, Flamen P, Donckier V. Selective internal radiation therapy (SIRT) before partial hepatectomy or radiofrequency destruction for treatment of hepatocellular carcinoma in cirrhotic patients: a feasibility and safety pilot study. HPB (Oxford). 2018 Jul;20(7):641-648. doi: 10.1016/j.hpb.2018.01.006. Epub 2018 Feb 24.
Results Reference
derived
Links:
URL
http://www.bordet.be/
Description
Jules Bordet Institute
URL
http://www.erasme.ulb.ac.be/
Description
Erasme Hospital

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Y90 Radioembolization Prior to Surgical Resection or Radiofrequency for Hepatocellular Carcinoma in Cirrhotic Liver

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