Efficacy Study of Intra-hepatic Administration of Therasphere® in Association With Intravenous Chemotherapy to Treat Cholangiocarcinoma (MispheC)
Primary Purpose
Cholangiocarcinoma
Status
Completed
Phase
Phase 2
Locations
France
Study Type
Interventional
Intervention
Therasphere® in association with Gemcitabine and Cisplatin
Sponsored by
About this trial
This is an interventional treatment trial for Cholangiocarcinoma focused on measuring Intra-hepatic Cholangiocarcinoma treatment
Eligibility Criteria
Inclusion Criteria:
- Histologically confirmed intra-hepatic cholangiocarcinoma.
- Measurable target of at least 2 cm diameter.
- Healthy liver or cirrhosis CHILD < B8.
- WHO-PS: 0-1.
- Age ≥ 18 years.
- Non-Metastatic disease in extra-hepatic (are permitted: local lymph nodes < 3 cm, less than 5 lung nodes < 11 mm).
- Creatinine clearance (calculated with Cockcroft and Gault formula) ≥ 55 ml/min, polymorphonuclear neutrophils ≥ 1500 G/L, platelets ≥ 80 G/L, prothrombin ≥ 40% (INR ≤ 2.3), serum albumin ≥ 28 g/l, serum bilirubin ≤ 3 x LSN.
- Pregnancy test: negative for women of childbearing potential.
- Reliable contraception for a childbearing couple, men and woman must have an reliable contraception during the treatment and until 6 months following the end of the treatment by chemotherapy
- Signed informed consent form.
- Patient with national health insurance.
Exclusion Criteria:
- Pancreas cancer or duodenum cancer invading the bile duct or ampullary cancer. Cholangiocarcinoma of the bile ducts: hilar, main duct, gallbladder.
- Extra-hepatic metastasis (including local lymph nodes measuring > 30 mm).
- Primary sclerosing cholangitis.
- History of chemoembolization or radioembolization.
- Cirrhose CHILD > B7
- Portal vein trunk tumoral thrombosis
- History of hepato-biliary neo adjuvant or palliative chemotherapy and/or radiotherapy.
- Contra indication of Gemcitabine and/or Cisplatin.
- Other invasive active cancer, excepting in situ cervical cancer and basocellular or spino cellular skin cancer treated adequately. Any history of cancer not considered as completely cured for at least one year.
- Technical failure of the diagnostic arteriography.
- Extra hepatic uptake on the pre-therapeutic scintigraphy not manageable with an arteriography.
- Dosimetry study predicting lung exposure > 30 Gy.
- Any unstable medical history (diabetes, hypertension …).
- History of organ transplant.
- Symptomatic grade 1 angina pectoris or grade ≥ 2 angina pectoris.
- An evolutive neuropathy.
- Patient who already has been involved in a clinical trial with drug intake, whether this drug was experimental or not, within 30 days before.
- Pregnant patient or patient with breastfeeding.
- Patient under administrative supervision.
- Regular follow-up impossible for various reasons (psychological, familial, economical, and social).
Sites / Locations
- Hôpital Beaujon - Service de Chirurgie
- Hôpital Henri Mondor
- Hôpital saint-Eloi
- CHU Nancy - Hôpital Brabois
- CHU- Hotel Dieu
- CHU Poitiers
- Centre Eugene Marquis
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Therasphere®
Arm Description
Therasphere® in association with Gemcitabine and Cisplatin
Outcomes
Primary Outcome Measures
Radiological response rate to the treatment with the association of chemotherapy and radioembolization
Evaluation according RECIST 1.1 criteria. Rate will be reassessed every 8 weeks
Secondary Outcome Measures
Tolerance of intra-hepatic administration of Yttrium 90-labelled microspheres in association with intravenous chemotherapy with Gemcitabine and Cisplatin assessed according NCI/CTC AE version 4.
Grade 3-4 toxicity appearance.Time between 1st treatment administration and date of 1st appearance of a grade 3-4 toxicity or date of last toxicities assessment in case no grade 3-4 toxicity
Tumor markers changes (CA19.9, CEA and AFP)
Markers will be analysed every 8 weeks during treatment period and if applicable every 12 weeks after surgery
Radiological response rate by the CHOI criteria
every 8 weeks and every 12 weeks after surgery if applicable
Change in metabolic activity measured by TEP
Changes of liver volume
Every 8 weeks during treatment and every 12 weeks after surgery if applicable
Tumoral and non-tumoral dosimetric assessment of the liver
Data obtained from SPECT/CT performed at each hepatic scintigraphy
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT01912053
Brief Title
Efficacy Study of Intra-hepatic Administration of Therasphere® in Association With Intravenous Chemotherapy to Treat Cholangiocarcinoma
Acronym
MispheC
Official Title
An Open-label, Multicenter, Phase II Trial, to Evaluate the Efficacy of Intra-hepatic Administration of Yttrium 90-labelled Microspheres (Therasphere®, Nordion) in Association With Intravenous Chemotherapy With Gemcitabine and Cisplatin for the Treatment of Intra-hepatic Cholangiocarcinoma, First Line.
Study Type
Interventional
2. Study Status
Record Verification Date
January 2018
Overall Recruitment Status
Completed
Study Start Date
September 2013 (Actual)
Primary Completion Date
December 2016 (Actual)
Study Completion Date
November 2017 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Center Eugene Marquis
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of this study is to assess efficacy and tolerance of intra-hepatic administration of Yttrium 90-labelled microsphere (Theraspheres®, Nordion) in association with intravenous chemotherapy with Gemcitabin and Cisplatin for the treatment of intra-hepatic cholangiocarcinoma.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cholangiocarcinoma
Keywords
Intra-hepatic Cholangiocarcinoma treatment
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
41 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Therasphere®
Arm Type
Experimental
Arm Description
Therasphere® in association with Gemcitabine and Cisplatin
Intervention Type
Radiation
Intervention Name(s)
Therasphere® in association with Gemcitabine and Cisplatin
Other Intervention Name(s)
90-Yttrium theraspheres
Intervention Description
Therasphere® is a radioelement
Primary Outcome Measure Information:
Title
Radiological response rate to the treatment with the association of chemotherapy and radioembolization
Description
Evaluation according RECIST 1.1 criteria. Rate will be reassessed every 8 weeks
Time Frame
3 months after radioembolization
Secondary Outcome Measure Information:
Title
Tolerance of intra-hepatic administration of Yttrium 90-labelled microspheres in association with intravenous chemotherapy with Gemcitabine and Cisplatin assessed according NCI/CTC AE version 4.
Description
Grade 3-4 toxicity appearance.Time between 1st treatment administration and date of 1st appearance of a grade 3-4 toxicity or date of last toxicities assessment in case no grade 3-4 toxicity
Time Frame
Up to 24 months
Title
Tumor markers changes (CA19.9, CEA and AFP)
Description
Markers will be analysed every 8 weeks during treatment period and if applicable every 12 weeks after surgery
Time Frame
Up to 24 months
Title
Radiological response rate by the CHOI criteria
Description
every 8 weeks and every 12 weeks after surgery if applicable
Time Frame
Up to 24 months
Title
Change in metabolic activity measured by TEP
Time Frame
Change from baseline in metabolic activity 15 and 24 weeks after last treatment by microspheres
Title
Changes of liver volume
Description
Every 8 weeks during treatment and every 12 weeks after surgery if applicable
Time Frame
Up to 24 months
Title
Tumoral and non-tumoral dosimetric assessment of the liver
Description
Data obtained from SPECT/CT performed at each hepatic scintigraphy
Time Frame
Up to 6 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Histologically confirmed intra-hepatic cholangiocarcinoma.
Measurable target of at least 2 cm diameter.
Healthy liver or cirrhosis CHILD < B8.
WHO-PS: 0-1.
Age ≥ 18 years.
Non-Metastatic disease in extra-hepatic (are permitted: local lymph nodes < 3 cm, less than 5 lung nodes < 11 mm).
Creatinine clearance (calculated with Cockcroft and Gault formula) ≥ 55 ml/min, polymorphonuclear neutrophils ≥ 1500 G/L, platelets ≥ 80 G/L, prothrombin ≥ 40% (INR ≤ 2.3), serum albumin ≥ 28 g/l, serum bilirubin ≤ 3 x LSN.
Pregnancy test: negative for women of childbearing potential.
Reliable contraception for a childbearing couple, men and woman must have an reliable contraception during the treatment and until 6 months following the end of the treatment by chemotherapy
Signed informed consent form.
Patient with national health insurance.
Exclusion Criteria:
Pancreas cancer or duodenum cancer invading the bile duct or ampullary cancer. Cholangiocarcinoma of the bile ducts: hilar, main duct, gallbladder.
Extra-hepatic metastasis (including local lymph nodes measuring > 30 mm).
Primary sclerosing cholangitis.
History of chemoembolization or radioembolization.
Cirrhose CHILD > B7
Portal vein trunk tumoral thrombosis
History of hepato-biliary neo adjuvant or palliative chemotherapy and/or radiotherapy.
Contra indication of Gemcitabine and/or Cisplatin.
Other invasive active cancer, excepting in situ cervical cancer and basocellular or spino cellular skin cancer treated adequately. Any history of cancer not considered as completely cured for at least one year.
Technical failure of the diagnostic arteriography.
Extra hepatic uptake on the pre-therapeutic scintigraphy not manageable with an arteriography.
Dosimetry study predicting lung exposure > 30 Gy.
Any unstable medical history (diabetes, hypertension …).
History of organ transplant.
Symptomatic grade 1 angina pectoris or grade ≥ 2 angina pectoris.
An evolutive neuropathy.
Patient who already has been involved in a clinical trial with drug intake, whether this drug was experimental or not, within 30 days before.
Pregnant patient or patient with breastfeeding.
Patient under administrative supervision.
Regular follow-up impossible for various reasons (psychological, familial, economical, and social).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Eveline Boucher, MD
Organizational Affiliation
Centre Eugene Marquis
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hôpital Beaujon - Service de Chirurgie
City
Clichy
ZIP/Postal Code
92118
Country
France
Facility Name
Hôpital Henri Mondor
City
Créteil
ZIP/Postal Code
94010
Country
France
Facility Name
Hôpital saint-Eloi
City
Montpellier
ZIP/Postal Code
34295
Country
France
Facility Name
CHU Nancy - Hôpital Brabois
City
Nancy
ZIP/Postal Code
54000
Country
France
Facility Name
CHU- Hotel Dieu
City
Nantes
ZIP/Postal Code
44093
Country
France
Facility Name
CHU Poitiers
City
Poitiers
Country
France
Facility Name
Centre Eugene Marquis
City
Rennes
ZIP/Postal Code
35042
Country
France
12. IPD Sharing Statement
Learn more about this trial
Efficacy Study of Intra-hepatic Administration of Therasphere® in Association With Intravenous Chemotherapy to Treat Cholangiocarcinoma
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