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A Prospective, Multicenter Clinical Trial of Safety and Effectiveness of Nanosecond Knife Ablation for Liver Cancer

Primary Purpose

Liver Cancer

Status
Unknown status
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
nanosecond knife liver cancer ablation
Sponsored by
First Affiliated Hospital of Zhejiang University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Liver Cancer focused on measuring nanosecond knife, liver cancer

Eligibility Criteria

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

Inclusion Criteria:

  1. Liver malignant tumors with clear histopathology and cytology, or liver malignant tumors that meet clinical diagnosis and staging criteria.
  2. Age: 18-75 years old, regardless of gender.
  3. Liver function: Child-Pugh A or B, or Child C will reach B.
  4. No serious heart, lung, brain and other organ dysfunction. Normal or nearly normal blood coagulation function. Prothrombin time does not exceed 50% of the normal control, and platelets are more than 50 × 109 / L.
  5. It is usually suitable for single tumor with a maximum diameter of ≤5cm, or the number of tumors of ≤3 and a maximum diameter of ≤3cm.
  6. For single tumors > 5 cm in diameter that cannot be surgically removed, or multiple tumors with a maximum diameter > 3 cm, local ablation can be used as p palliative comprehensive treatment.
  7. According to CT and MRI, there are no macrovascular and bile duct invasions visible by the naked eye.
  8. Patients signed informed consent to participate in the trial.

Exclusion Criteria:

  1. The lesion of liver cancer is huge or diffuse ;
  2. Merged portal vein to secondary branch tumor thrombus or hepatic vein tumor thrombus, invasion of nearby organs or distant metastasis;
  3. tumors located on the surface of the liver, of which more than 1/3 tumor size are bare;
  4. liver function: Child-pugh C, those could not improve after liver protective treatment;
  5. Esophageal (bottom of stomach) varices rupture and bleeding within 1 month before treatment;
  6. Uncorrectable coagulation dysfunction and severe haematological abnormalities, who tend to severe bleeding;
  7. Refractory large amount of ascites and cachexia;
  8. active infection, especially inflammation of the biliary system;
  9. Severe failure of major organs such as liver, kidney, heart, lung and brain;
  10. Patients with unconsciousness or unable to cooperate with treatment;
  11. Subjects could not be followed up and fell off;
  12. Those who discontinued treatment, or the case records were incomplete for various reasons, and were determined by researchers to be unable to be evaluated.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    nanosecond knife group

    Arm Description

    This trial is a prospective, multi-center, single-arm clinical trial. Four hospitals with national medical clinical trial institution qualifications are selected as clinical trial centers. Qualified participants will receive nanosecond pulse ablation therapy according to the routine procedures. The results will be recorded according to the requirements of the primary and secondary efficacy indicators. After then, statistical comparisons of effectiveness and safety of the product will be made according to groups.

    Outcomes

    Primary Outcome Measures

    Effectiveness analysis
    The effective rate of nanosecond knife ablation for liver cancer

    Secondary Outcome Measures

    Secondary validity analysis
    partial response rate of nanosecond knife ablation for liver cancer
    Secondary validity analysis
    secondary ablation rate of nanosecond knife ablation for liver cancer
    Secondary validity analysis
    progression-free survival of nanosecond knife ablation for liver cancer
    Secondary validity analysis
    overall survival rate of nanosecond knife ablation for liver cancer
    Secondary validity analysis
    quality of life score of nanosecond knife ablation for liver cancer
    Secondary validity analysis
    alpha-fetoprotein levels
    Secondary validity analysis
    technical success rate of nanosecond knife ablation for liver cancer
    Secondary validity analysis
    local control rate of nanosecond knife ablation for liver cancer
    Secondary validity analysis
    complication rate of nanosecond knife ablation for liver cancer
    Secondary validity analysis
    device Use satisfaction of nanosecond knife ablation for liver cancer

    Full Information

    First Posted
    March 10, 2020
    Last Updated
    March 15, 2020
    Sponsor
    First Affiliated Hospital of Zhejiang University
    Collaborators
    Shulan (Hangzhou) Hospital, The First Affiliated Hospital of Zhengzhou University, First Affiliated Hospital of Xinjiang Medical University
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    1. Study Identification

    Unique Protocol Identification Number
    NCT04309747
    Brief Title
    A Prospective, Multicenter Clinical Trial of Safety and Effectiveness of Nanosecond Knife Ablation for Liver Cancer
    Official Title
    A Prospective, Multicenter Clinical Trial of Safety and Effectiveness of Nanosecond Knife Ablation for Liver Cancer
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    March 2020
    Overall Recruitment Status
    Unknown status
    Study Start Date
    April 1, 2020 (Anticipated)
    Primary Completion Date
    April 1, 2022 (Anticipated)
    Study Completion Date
    December 1, 2022 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    First Affiliated Hospital of Zhejiang University
    Collaborators
    Shulan (Hangzhou) Hospital, The First Affiliated Hospital of Zhengzhou University, First Affiliated Hospital of Xinjiang Medical University

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    No
    Studies a U.S. FDA-regulated Device Product
    No

    5. Study Description

    Brief Summary
    This is a prospective, multi-center, single-arm clinical trial. Four hospitals with national medical clinical trial institution qualifications are selected as clinical trial centers. Qualified participants will receive nanosecond pulse ablation therapy according to the routine procedures. The results will be recorded according to the requirements of the primary and secondary efficacy indicators. After then, statistical comparisons of effectiveness and safety of the product will be made according to groups.
    Detailed Description
    The prospective, multi-center, single-arm clinical trial is to evaluate whether the nanosecond knife can achieve the effectiveness and safety of liver cancer ablation treatment. Four hospitals with national medical clinical trial institution qualifications are selected as clinical trial centers. This clinical trial requires 190 subjects. Qualified participants will receive nanosecond pulse ablation therapy according to the routine procedures. The results will be recorded according to the requirements of the primary outcome (the effective rate of nanosecond knife ablation for liver cancer) and secondary outcomes (partial response rate, secondary ablation rate, progression-free survival, overall survival rate, quality of life score, alpha-fetoprotein levels, technical success rate, local control rate, complication rate, device Use satisfaction of nanosecond knife ablation for liver cancer). The first 2-month follow-up after the operation, CT, MR, CEUS, liver function, tumor markers were reviewed monthly to observe the lesion necrosis and tumor marker changes. After that, tumor markers, CEUS, or three-phase CT/MRI of liver were examined every 2 to 3 months. After two years, tumor markers, CEUS, or three-phase CT/MRI of liver were examined every 3 to 6 months. After then, statistical comparisons of effectiveness and safety of the product will be made according to groups.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Liver Cancer
    Keywords
    nanosecond knife, liver cancer

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Not Applicable
    Interventional Study Model
    Single Group Assignment
    Model Description
    To evaluate whether the nanosecond knife can achieve the effectiveness and safety of liver cancer ablation treatment.
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    190 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    nanosecond knife group
    Arm Type
    Experimental
    Arm Description
    This trial is a prospective, multi-center, single-arm clinical trial. Four hospitals with national medical clinical trial institution qualifications are selected as clinical trial centers. Qualified participants will receive nanosecond pulse ablation therapy according to the routine procedures. The results will be recorded according to the requirements of the primary and secondary efficacy indicators. After then, statistical comparisons of effectiveness and safety of the product will be made according to groups.
    Intervention Type
    Procedure
    Intervention Name(s)
    nanosecond knife liver cancer ablation
    Intervention Description
    This trial is a prospective, multi-center, single-arm clinical trial. Four hospitals with national medical clinical trial institution qualifications are selected as clinical trial centers. Qualified participants will receive nanosecond pulse ablation therapy according to the routine procedures. The results will be recorded according to the requirements of the primary and secondary efficacy indicators. After then, statistical comparisons of effectiveness and safety of the product will be made according to groups.
    Primary Outcome Measure Information:
    Title
    Effectiveness analysis
    Description
    The effective rate of nanosecond knife ablation for liver cancer
    Time Frame
    12 months
    Secondary Outcome Measure Information:
    Title
    Secondary validity analysis
    Description
    partial response rate of nanosecond knife ablation for liver cancer
    Time Frame
    12 months
    Title
    Secondary validity analysis
    Description
    secondary ablation rate of nanosecond knife ablation for liver cancer
    Time Frame
    12 months
    Title
    Secondary validity analysis
    Description
    progression-free survival of nanosecond knife ablation for liver cancer
    Time Frame
    12 months
    Title
    Secondary validity analysis
    Description
    overall survival rate of nanosecond knife ablation for liver cancer
    Time Frame
    12 months
    Title
    Secondary validity analysis
    Description
    quality of life score of nanosecond knife ablation for liver cancer
    Time Frame
    12 months
    Title
    Secondary validity analysis
    Description
    alpha-fetoprotein levels
    Time Frame
    12 months
    Title
    Secondary validity analysis
    Description
    technical success rate of nanosecond knife ablation for liver cancer
    Time Frame
    12 months
    Title
    Secondary validity analysis
    Description
    local control rate of nanosecond knife ablation for liver cancer
    Time Frame
    12 months
    Title
    Secondary validity analysis
    Description
    complication rate of nanosecond knife ablation for liver cancer
    Time Frame
    12 months
    Title
    Secondary validity analysis
    Description
    device Use satisfaction of nanosecond knife ablation for liver cancer
    Time Frame
    12 months

    10. Eligibility

    Sex
    All
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Liver malignant tumors with clear histopathology and cytology, or liver malignant tumors that meet clinical diagnosis and staging criteria. Age: 18-75 years old, regardless of gender. Liver function: Child-Pugh A or B, or Child C will reach B. No serious heart, lung, brain and other organ dysfunction. Normal or nearly normal blood coagulation function. Prothrombin time does not exceed 50% of the normal control, and platelets are more than 50 × 109 / L. It is usually suitable for single tumor with a maximum diameter of ≤5cm, or the number of tumors of ≤3 and a maximum diameter of ≤3cm. For single tumors > 5 cm in diameter that cannot be surgically removed, or multiple tumors with a maximum diameter > 3 cm, local ablation can be used as p palliative comprehensive treatment. According to CT and MRI, there are no macrovascular and bile duct invasions visible by the naked eye. Patients signed informed consent to participate in the trial. Exclusion Criteria: The lesion of liver cancer is huge or diffuse ; Merged portal vein to secondary branch tumor thrombus or hepatic vein tumor thrombus, invasion of nearby organs or distant metastasis; tumors located on the surface of the liver, of which more than 1/3 tumor size are bare; liver function: Child-pugh C, those could not improve after liver protective treatment; Esophageal (bottom of stomach) varices rupture and bleeding within 1 month before treatment; Uncorrectable coagulation dysfunction and severe haematological abnormalities, who tend to severe bleeding; Refractory large amount of ascites and cachexia; active infection, especially inflammation of the biliary system; Severe failure of major organs such as liver, kidney, heart, lung and brain; Patients with unconsciousness or unable to cooperate with treatment; Subjects could not be followed up and fell off; Those who discontinued treatment, or the case records were incomplete for various reasons, and were determined by researchers to be unable to be evaluated.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Tian'an Jiang, PhD
    Phone
    18857127666
    Email
    tiananjiang@zju.edu.cn

    12. IPD Sharing Statement

    Plan to Share IPD
    Yes
    IPD Sharing Plan Description
    This trial is a prospective, multi-center, single-arm clinical trial. Four hospitals with national medical clinical trial institution qualifications are selected as clinical trial centers. Qualified participants will receive nanosecond pulse ablation therapy according to the routine procedures. The results will be recorded according to the requirements of the primary and secondary efficacy indicators. After then, statistical comparisons of effectiveness and safety of the product will be made according to groups.
    Citations:
    PubMed Identifier
    18477802
    Citation
    Llovet JM, Di Bisceglie AM, Bruix J, Kramer BS, Lencioni R, Zhu AX, Sherman M, Schwartz M, Lotze M, Talwalkar J, Gores GJ; Panel of Experts in HCC-Design Clinical Trials. Design and endpoints of clinical trials in hepatocellular carcinoma. J Natl Cancer Inst. 2008 May 21;100(10):698-711. doi: 10.1093/jnci/djn134. Epub 2008 May 13.
    Results Reference
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    PubMed Identifier
    21128329
    Citation
    Gu YK, Luo RG, Huang JH, Si Tu QJ, Li XX, Gao F. Transarterial embolization ablation of hepatocellular carcinoma with a lipiodol-ethanol mixture. World J Gastroenterol. 2010 Dec 7;16(45):5766-72. doi: 10.3748/wjg.v16.i45.5766.
    Results Reference
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    PubMed Identifier
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    Citation
    Bargellini I, Vignali C, Cioni R, Petruzzi P, Cicorelli A, Campani D, De Simone P, Filipponi F, Bartolozzi C. Hepatocellular carcinoma: CT for tumor response after transarterial chemoembolization in patients exceeding Milan criteria--selection parameter for liver transplantation. Radiology. 2010 Apr;255(1):289-300. doi: 10.1148/radiol.09090927.
    Results Reference
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    PubMed Identifier
    28109674
    Citation
    Fruhling P, Nilsson A, Duraj F, Haglund U, Noren A. Single-center nonrandomized clinical trial to assess the safety and efficacy of irreversible electroporation (IRE) ablation of liver tumors in humans: Short to mid-term results. Eur J Surg Oncol. 2017 Apr;43(4):751-757. doi: 10.1016/j.ejso.2016.12.004. Epub 2017 Jan 11.
    Results Reference
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    PubMed Identifier
    28799842
    Citation
    Distelmaier M, Barabasch A, Heil P, Kraemer NA, Isfort P, Keil S, Kuhl CK, Bruners P. Midterm Safety and Efficacy of Irreversible Electroporation of Malignant Liver Tumors Located Close to Major Portal or Hepatic Veins. Radiology. 2017 Dec;285(3):1023-1031. doi: 10.1148/radiol.2017161561. Epub 2017 Aug 11.
    Results Reference
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    PubMed Identifier
    11592607
    Citation
    Bruix J, Sherman M, Llovet JM, Beaugrand M, Lencioni R, Burroughs AK, Christensen E, Pagliaro L, Colombo M, Rodes J; EASL Panel of Experts on HCC. Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona-2000 EASL conference. European Association for the Study of the Liver. J Hepatol. 2001 Sep;35(3):421-30. doi: 10.1016/s0168-8278(01)00130-1. No abstract available.
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    Xu M, Xu D, Dong G, Ren Z, Zhang W, Aji T, Zhao Q, Chen X, Jiang T. The Safety and Efficacy of Nanosecond Pulsed Electric Field in Patients With Hepatocellular Carcinoma: A Prospective Phase 1 Clinical Study Protocol. Front Oncol. 2022 Jul 13;12:869316. doi: 10.3389/fonc.2022.869316. eCollection 2022.
    Results Reference
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    A Prospective, Multicenter Clinical Trial of Safety and Effectiveness of Nanosecond Knife Ablation for Liver Cancer

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