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Safety Study of SIC 8000 in Subjects Undergoing Endoscopic Mucosal Resection (EMR) of Colonic Lesions Equal to or Larger Than 2 cm

Primary Purpose

Adenomas

Status
Completed
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Endoscopic Mucosal Resection of large colon polyps (greater than or equal to 20 mm in size)
Sponsored by
Cosmo Technologies Ltd
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Adenomas focused on measuring colonic polyps ≥20 mm,, adenomas, polyps

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Presence of treatment naïve, laterally spreading sessile, flat polyps or adenomas of the colon equal to or greater than 20 mm in largest dimension, assessed by the investigator to be suitable for EMR.
  2. The base of the lesion should measure at least 20mm in at least one dimension.
  3. A photograph demonstrating the lesion size ≥20 mm against a stiff Boston Scientific Captivator snare of 20 mm must be recorded for each patient prior to randomization.
  4. ASA status: limited anesthesiology risk, with ASA score 1, 2 or 3.
  5. Contraception: women of childbearing potential must use at least one reliable method of contraception or be abstinent. Women of non-child-bearing potential or in post-menopausal status must have been in that status for at least 1 year. For all women of child-bearing potential, serum pregnancy test result must be negative at screening.
  6. Full comprehension: ability to comprehend the full nature and purpose of the study, including possible risks and side effects; ability to co-operate with the investigator and to comply with the requirements of the entire study.
  7. Informed consent: signed written informed consent must be completed before inclusion in the study.

Exclusion Criteria:

  1. Age: Subjects under 18 years old are excluded
  2. Consent: Subjects who refuse or who are unable to consent, vulnerable subjects are excluded.
  3. Pregnancy: Pregnant or breastfeeding women
  4. ASA status: High anesthetic risk (ASA score > 3)
  5. Physical findings: clinically significant abnormal physical findings which could interfere with the objectives of the study
  6. Study participation: Subjects currently enrolled in any other clinical study or previous enrollment in a clinical study in the last 30 days
  7. Subjects with Lesions less than 20 mm in largest dimension
  8. Subjects with Lesions involving the muscularis propria (T2 lesions) on other staging modalities such as endoscopic ultrasonography (EUS)
  9. Subjects with ulcerated depressed lesions (Paris type III) or biopsy proven invasive carcinoma
  10. Presence of other malignant disease locally advanced or with metastasis
  11. Presence of other lesions of the digestive tract as active Inflammatory colonic conditions (inflammatory bowel disease , e.g ulcerative colitis, Crohn's disease)
  12. Endoscopic appearance of invasive malignancy
  13. Previous treatment of the lesion (radiotherapy, endoscopy, surgery, chemotherapy) is exclusionary. Previous cold biopsy of the target lesion is not an exclusion criteria.
  14. Previous partial resection or attempted resection of the target lesion is exclusionary.
  15. Allergy: ascertained or presumptive hypersensitivity to study products; history of anaphylaxis to drugs or allergic reactions in general, which the investigator considers may affect the outcome of the study.
  16. known or suspected gastrointestinal obstruction or perforation, toxic megacolon, active diverticulitis.
  17. inflammatory bowel disease e.g ulcerative colitis or Crohn's 's disease
  18. Hemostasis disorders (eg Von Willebran disease, haemophilia or factor V Leiden thrombophilia), known clotting disorder (INR>1.5 that cannot be corrected).
  19. Other medical condition that in the investigator's opinion would make the administration of the study IMD or procedures hazardous to the subject.
  20. Medical treatments (i.e.: radiotherapy, surgical endoscopic treatments) before the intervention.

Sites / Locations

  • Mayo Clinic
  • Indiana University Hospital
  • Kansas City VA Hospital
  • Humanitas Research Hospital & Humanitas University
  • Queen Alexandra Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

SIC 8000, 10 mL ampoules

reference comparator

Arm Description

Procedure/Surgery: Endoscopic Mucosal Resection of large colon polyps (greater than or equal to 20 mm in size) with SIC 8000 injectate solution.

Procedure/Surgery: Endoscopic Mucosal Resection of large colon polyps (greater than or equal to 20 mm in size) with Reference Comparator Injectate solution (site standard of care injectate solution).

Outcomes

Primary Outcome Measures

Sydney Resection Quotient (size of polyp in mm divided by number of resection pieces).
Proportion of subjects with en bloc resection of all endoscopically visible lesion

Secondary Outcome Measures

Effectiveness compared to the reference comparator in terms of injected volume to provide initial polyp lift
Injected volume required to complete the procedure
Number of re-injections required to complete the procedure
Number of resection pieces
Ease of use rated on 5-point scale
Time to resect the lesion completely
Number of single session complete removal of lesions
Need for additional treatment modalities (eg coagulation, ablation, avulsion)
Pathology negative report for lateral and/or deep margins
Number of deep resections containing muscularis propria
Histologically positive or negative Free margin confirmed in en-bloc resections
Histologist will assess if removed lesions have a free margin or not.
Recurrent or residual neoplasia confirmed by repeat standard endoscopy and biopsy (if applicable) at the follow up visit

Full Information

First Posted
January 7, 2016
Last Updated
September 1, 2017
Sponsor
Cosmo Technologies Ltd
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1. Study Identification

Unique Protocol Identification Number
NCT02654418
Brief Title
Safety Study of SIC 8000 in Subjects Undergoing Endoscopic Mucosal Resection (EMR) of Colonic Lesions Equal to or Larger Than 2 cm
Official Title
A Randomized, Double-blind, Comparative, Effectiveness and Safety Study of SIC 8000 in Subjects Undergoing Endoscopic Mucosal Resection (EMR) of Colonic Lesions Equal to or Larger Than 2 cm
Study Type
Interventional

2. Study Status

Record Verification Date
February 2017
Overall Recruitment Status
Completed
Study Start Date
February 2016 (undefined)
Primary Completion Date
May 2017 (Actual)
Study Completion Date
July 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Cosmo Technologies Ltd

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
SIC 8000 is indicated for use in gastrointestinal endoscopic procedures for submucosal lift of polyps, adenomas, early-stage cancers or other gastrointestinal mucosal lesions, prior to excision with a snare.
Detailed Description
SIC 8000 is indicated for use in gastrointestinal endoscopic procedures for submucosal lift of polyps, adenomas, early-stage cancers or other gastrointestinal mucosal lesions, prior to excision with a snare. The current trial will focus on only colonic polyps ≥20 mm removed by snare EMR technique. Patients with lesions not suitable for EMR because of features strongly suggestive of sub-mucosal invasion will not be included.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Adenomas
Keywords
colonic polyps ≥20 mm,, adenomas, polyps

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantOutcomes Assessor
Allocation
Randomized
Enrollment
226 (Actual)

8. Arms, Groups, and Interventions

Arm Title
SIC 8000, 10 mL ampoules
Arm Type
Experimental
Arm Description
Procedure/Surgery: Endoscopic Mucosal Resection of large colon polyps (greater than or equal to 20 mm in size) with SIC 8000 injectate solution.
Arm Title
reference comparator
Arm Type
Active Comparator
Arm Description
Procedure/Surgery: Endoscopic Mucosal Resection of large colon polyps (greater than or equal to 20 mm in size) with Reference Comparator Injectate solution (site standard of care injectate solution).
Intervention Type
Procedure
Intervention Name(s)
Endoscopic Mucosal Resection of large colon polyps (greater than or equal to 20 mm in size)
Primary Outcome Measure Information:
Title
Sydney Resection Quotient (size of polyp in mm divided by number of resection pieces).
Time Frame
At V2 day of Endoscopic Mucosal resection of polyp (Day 1)
Title
Proportion of subjects with en bloc resection of all endoscopically visible lesion
Time Frame
At V2 day of endoscopy (Day 1)
Secondary Outcome Measure Information:
Title
Effectiveness compared to the reference comparator in terms of injected volume to provide initial polyp lift
Time Frame
At V2 day of Endoscopic Mucosal Reseaction (Day 1)
Title
Injected volume required to complete the procedure
Time Frame
At V2 day of Endoscopic Mucosal Reseaction (Day 1)
Title
Number of re-injections required to complete the procedure
Time Frame
At V2 day of Endoscopic Mucosal Resection (Day 1)
Title
Number of resection pieces
Time Frame
At V2 day of Endoscopic Mucosal Reseaction (Day 1)
Title
Ease of use rated on 5-point scale
Time Frame
At V2 day of Endoscopic Mucosal Reseaction (Day 1)
Title
Time to resect the lesion completely
Time Frame
At V2 day of Endoscopic Mucosal Reseaction (Day 1)
Title
Number of single session complete removal of lesions
Time Frame
At V2 day of Endoscopic Mucosal Reseaction (day 1)
Title
Need for additional treatment modalities (eg coagulation, ablation, avulsion)
Time Frame
At V2 day of Endoscopic Mucosal Reseaction (Day 1)
Title
Pathology negative report for lateral and/or deep margins
Time Frame
At V2 day of Endoscopic Mucosal Reseaction (Day 1)
Title
Number of deep resections containing muscularis propria
Time Frame
At V2 day of Endoscopic Mucosal Reseaction (Day 1)
Title
Histologically positive or negative Free margin confirmed in en-bloc resections
Description
Histologist will assess if removed lesions have a free margin or not.
Time Frame
At V2 day of Endoscopic Mucosal Reseaction (Day 1)
Title
Recurrent or residual neoplasia confirmed by repeat standard endoscopy and biopsy (if applicable) at the follow up visit
Time Frame
Day 60 follow up visit

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Presence of treatment naïve, laterally spreading sessile, flat polyps or adenomas of the colon equal to or greater than 20 mm in largest dimension, assessed by the investigator to be suitable for EMR. The base of the lesion should measure at least 20mm in at least one dimension. A photograph demonstrating the lesion size ≥20 mm against a stiff Boston Scientific Captivator snare of 20 mm must be recorded for each patient prior to randomization. ASA status: limited anesthesiology risk, with ASA score 1, 2 or 3. Contraception: women of childbearing potential must use at least one reliable method of contraception or be abstinent. Women of non-child-bearing potential or in post-menopausal status must have been in that status for at least 1 year. For all women of child-bearing potential, serum pregnancy test result must be negative at screening. Full comprehension: ability to comprehend the full nature and purpose of the study, including possible risks and side effects; ability to co-operate with the investigator and to comply with the requirements of the entire study. Informed consent: signed written informed consent must be completed before inclusion in the study. Exclusion Criteria: Age: Subjects under 18 years old are excluded Consent: Subjects who refuse or who are unable to consent, vulnerable subjects are excluded. Pregnancy: Pregnant or breastfeeding women ASA status: High anesthetic risk (ASA score > 3) Physical findings: clinically significant abnormal physical findings which could interfere with the objectives of the study Study participation: Subjects currently enrolled in any other clinical study or previous enrollment in a clinical study in the last 30 days Subjects with Lesions less than 20 mm in largest dimension Subjects with Lesions involving the muscularis propria (T2 lesions) on other staging modalities such as endoscopic ultrasonography (EUS) Subjects with ulcerated depressed lesions (Paris type III) or biopsy proven invasive carcinoma Presence of other malignant disease locally advanced or with metastasis Presence of other lesions of the digestive tract as active Inflammatory colonic conditions (inflammatory bowel disease , e.g ulcerative colitis, Crohn's disease) Endoscopic appearance of invasive malignancy Previous treatment of the lesion (radiotherapy, endoscopy, surgery, chemotherapy) is exclusionary. Previous cold biopsy of the target lesion is not an exclusion criteria. Previous partial resection or attempted resection of the target lesion is exclusionary. Allergy: ascertained or presumptive hypersensitivity to study products; history of anaphylaxis to drugs or allergic reactions in general, which the investigator considers may affect the outcome of the study. known or suspected gastrointestinal obstruction or perforation, toxic megacolon, active diverticulitis. inflammatory bowel disease e.g ulcerative colitis or Crohn's 's disease Hemostasis disorders (eg Von Willebran disease, haemophilia or factor V Leiden thrombophilia), known clotting disorder (INR>1.5 that cannot be corrected). Other medical condition that in the investigator's opinion would make the administration of the study IMD or procedures hazardous to the subject. Medical treatments (i.e.: radiotherapy, surgical endoscopic treatments) before the intervention.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Dr Douglas Rex
Organizational Affiliation
Co-ordinating Investigator
Official's Role
Principal Investigator
Facility Information:
Facility Name
Mayo Clinic
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
FL 32224
Country
United States
Facility Name
Indiana University Hospital
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
IN 46290
Country
United States
Facility Name
Kansas City VA Hospital
City
Kansas City
State/Province
Missouri
ZIP/Postal Code
MO 64128
Country
United States
Facility Name
Humanitas Research Hospital & Humanitas University
City
Milan
Country
Italy
Facility Name
Queen Alexandra Hospital
City
Portsmouth
ZIP/Postal Code
PO6 3LY
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
29750983
Citation
Repici A, Wallace M, Sharma P, Bhandari P, Lollo G, Maselli R, Hassan C, Rex DK. A novel submucosal injection solution for endoscopic resection of large colorectal lesions: a randomized, double-blind trial. Gastrointest Endosc. 2018 Sep;88(3):527-535.e5. doi: 10.1016/j.gie.2018.04.2363. Epub 2018 May 8.
Results Reference
derived

Learn more about this trial

Safety Study of SIC 8000 in Subjects Undergoing Endoscopic Mucosal Resection (EMR) of Colonic Lesions Equal to or Larger Than 2 cm

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