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A Study of the Use of the Medtronic Pump and Codman Catheter to Give Chemotherapy to Patients With Colorectal Carcinoma or Cholangiocarcinoma

Primary Purpose

Colorectal Cancer, Cholangiocarcinoma

Status
Recruiting
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Medtronic pump and Codman catheter
Floxuridine (FUDR)
Gemcitabine
Oxaliplatin
Irinotecan (CPT-11)
Fluorouracil
Anti-EGFR (Panitumumab or Cetuximab)
Sponsored by
Benaroya Research Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Colorectal Cancer focused on measuring Medtronic Pump, Codman Catheter, Hepatic Arterial Infusion (HAI), Floxuridine (FUDR), Gemcitabine, Oxaliplatin, Irinotecan (CPT-11), Fluorouracil, Leucovorin Calcium (Folinic Acid), Dexamethasone

Eligibility Criteria

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

Inclusion Criteria:

  1. History of histologically confirmed colorectal adenocarcinoma metastatic to the liver with no clinically or radiographically confirmed extrahepatic disease (or) Histologically confirmed cholangiocarcinoma (Clinical or radiographic evidence of metastatic disease that has been resected is allowed, provided there is no recurrence in that area prior to protocol consent)
  2. Confirmation of diagnosis must be performed at VMMC
  3. Participant may have completely resected hepatic metastases without current evidence of other metastatic disease
  4. Lab values ≤14 days prior to registration:

    ANC ≥ 1.0(9)/L Platelet count ≥ 75 (9)/L Creatinine ≤1.8 mg/dL AST 0 to 2x reference value ALK PHOS 0 to < 1.2 x reference value Tot Bili 0 to < 1.2 x reference value

  5. Prior chemotherapy is acceptable if last dose of oxaliplatin or irinotecan is given ≥3 weeks prior to planned first dosing on this protocol. 5-FU or 5-FU leucovorin may be given ≥2 weeks prior to planned first dosing on this protocol. [Note: no chemotherapy to be given after resection of liver lesions prior to treatment on this study]
  6. Any investigation agent is acceptable if administered ≥3 months before planned first dose on this protocol
  7. ECOG <=1
  8. Participants ≥18 years of age

Exclusion Criteria:

  1. Prior radiation to the liver (prior radiation therapy to the pelvis is acceptable if competed at least 4 weeks prior to the planned first dose of treatment on protocol)
  2. Colorectal cancer that is BRAF mutant or defective in mismatch repair.
  3. Active infection, ascites, hepatic encephalopathy
  4. Female participants who are pregnant or lactating - or planning to become pregnant within 6 months after the end of the treatment (female participants of child-bearing potential must have negative pregnancy test ≤72 hours before treatment start)
  5. If in the opinion of the treating investigator a participant has any serious medical problems which may preclude receiving this type of treatment
  6. Participants with current evidence of hepatitis A, B, C (i.e., active hepatitis)
  7. Participants with history or known presence of primary CNS tumors, seizures not well- controlled with standard medical therapy, or history of stroke will also be excluded
  8. Serious or non-healing active wound, ulcer, or bone fracture
  9. History of other malignancy, except:

    1. Malignancy treated with curative intent and with no known active disease present for ≥3 years prior to registration and felt to be at low risk for recurrence by the treating physician
    2. Adequately treated non-melanomatous skin cancer or lentigo malignant without evidence of disease
    3. Adequately treated cervical carcinoma in situ without evidence of disease

Sites / Locations

  • Virginia mason medical CenterRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Pump Therapy

Arm Description

All patients will undergo surgery to have the Medtronic pump and Codman catheter placed appropriately before HAI therapy can begin.

Outcomes

Primary Outcome Measures

Number of patients requiring stent replacements
Percent frequency liver toxicity
Alkaline phosphatase percent toxicity, Serum bilirubin percent toxicity

Secondary Outcome Measures

Overall survival
Overall survival is defined as the time from treatment initiation till the day of death or last follow-up whichever occurs first.
Progression free survival
Progression free survival is defined as the time from treatment initiation till the day of progression or death whichever occurs first. Patients that are alive without progression at the end of the study will be censored.

Full Information

First Posted
December 6, 2020
Last Updated
December 17, 2020
Sponsor
Benaroya Research Institute
Collaborators
Virginia Mason Hospital/Medical Center
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1. Study Identification

Unique Protocol Identification Number
NCT04668976
Brief Title
A Study of the Use of the Medtronic Pump and Codman Catheter to Give Chemotherapy to Patients With Colorectal Carcinoma or Cholangiocarcinoma
Official Title
A Pilot Protocol Evaluating Safety of the Medtronic Pump and Codman Catheter for the Delivery of Hepatic Arterial Infusion (HAI) Chemotherapy in Patients With Advanced Colorectal Carcinoma or Cholangiocarcinoma
Study Type
Interventional

2. Study Status

Record Verification Date
December 2020
Overall Recruitment Status
Recruiting
Study Start Date
November 25, 2020 (Actual)
Primary Completion Date
December 2023 (Anticipated)
Study Completion Date
December 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Benaroya Research Institute
Collaborators
Virginia Mason Hospital/Medical Center

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
Yes
Data Monitoring Committee
No

5. Study Description

Brief Summary
This study is being done to answer the following question: Is the combination of the Medtronic pump and the Codman catheter device a safe alternative to the C3000 Codman pump for delivering chemotherapy directly into the liver of patients with metastatic colorectal cancer or cholangiocarcinoma?
Detailed Description
Group 1 unresectable liver metastases from colorectal cancer - Patients will receive either FOLFIRI, FOLFOX, Irinotecan or Irinotecan/oxaliplatin (anti- EGFR agent may be added to any of the systemic treatments) on Days 1 and 15 of each cycle, however initiation with systemic chemotherapy will not take place until 4 weeks post-surgery for pump placement. Group 2 resectable liver metastases from colorectal cancer - Patients will receive either FOLFIRI, FOLFOX, Irinotecan or Irinotecan/oxaliplatin on Days 1 and 15 of each cycle, however initiation with systemic chemotherapy will not take place until 4 weeks post-surgery for pump placement. Group 3 unresectable cholangiocarcinoma - Patients will receive Gemcitabine (800 mg/m2 IV over 30 minutes) and Oxaliplatin (85 mg/ m2 IV over 120 minutes) or Gemcitabine (1000 mg/m2 IV over 30 minutes) alone on Days 1 and 15 of each cycle, however initiation with systemic chemotherapy will not take place until 4 weeks post-surgery for pump placement.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Colorectal Cancer, Cholangiocarcinoma
Keywords
Medtronic Pump, Codman Catheter, Hepatic Arterial Infusion (HAI), Floxuridine (FUDR), Gemcitabine, Oxaliplatin, Irinotecan (CPT-11), Fluorouracil, Leucovorin Calcium (Folinic Acid), Dexamethasone

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Model Description
Pilot non- randomized safety study
Masking
None (Open Label)
Allocation
N/A
Enrollment
100 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Pump Therapy
Arm Type
Experimental
Arm Description
All patients will undergo surgery to have the Medtronic pump and Codman catheter placed appropriately before HAI therapy can begin.
Intervention Type
Device
Intervention Name(s)
Medtronic pump and Codman catheter
Intervention Description
All patients will undergo surgery to have the Medtronic pump and Codman catheter placed appropriately before HAI therapy can begin.
Intervention Type
Drug
Intervention Name(s)
Floxuridine (FUDR)
Intervention Description
Please see Detailed Description.
Intervention Type
Drug
Intervention Name(s)
Gemcitabine
Intervention Description
Please see Detailed Description.
Intervention Type
Drug
Intervention Name(s)
Oxaliplatin
Intervention Description
Please see Detailed Description.
Intervention Type
Drug
Intervention Name(s)
Irinotecan (CPT-11)
Intervention Description
Please see Detailed Description.
Intervention Type
Drug
Intervention Name(s)
Fluorouracil
Intervention Description
Please see Detailed Description.
Intervention Type
Drug
Intervention Name(s)
Anti-EGFR (Panitumumab or Cetuximab)
Intervention Description
Please see Detailed Description.
Primary Outcome Measure Information:
Title
Number of patients requiring stent replacements
Time Frame
1 year
Title
Percent frequency liver toxicity
Description
Alkaline phosphatase percent toxicity, Serum bilirubin percent toxicity
Time Frame
1 year
Secondary Outcome Measure Information:
Title
Overall survival
Description
Overall survival is defined as the time from treatment initiation till the day of death or last follow-up whichever occurs first.
Time Frame
1 year
Title
Progression free survival
Description
Progression free survival is defined as the time from treatment initiation till the day of progression or death whichever occurs first. Patients that are alive without progression at the end of the study will be censored.
Time Frame
1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: History of histologically confirmed colorectal adenocarcinoma metastatic to the liver with no clinically or radiographically confirmed extrahepatic disease (or) Histologically confirmed cholangiocarcinoma (Clinical or radiographic evidence of metastatic disease that has been resected is allowed, provided there is no recurrence in that area prior to protocol consent) Confirmation of diagnosis must be performed at VMMC Participant may have completely resected hepatic metastases without current evidence of other metastatic disease Lab values ≤14 days prior to registration: ANC ≥ 1.0(9)/L Platelet count ≥ 75 (9)/L Creatinine ≤1.8 mg/dL AST 0 to 2x reference value ALK PHOS 0 to < 1.2 x reference value Tot Bili 0 to < 1.2 x reference value Prior chemotherapy is acceptable if last dose of oxaliplatin or irinotecan is given ≥3 weeks prior to planned first dosing on this protocol. 5-FU or 5-FU leucovorin may be given ≥2 weeks prior to planned first dosing on this protocol. [Note: no chemotherapy to be given after resection of liver lesions prior to treatment on this study] Any investigation agent is acceptable if administered ≥3 months before planned first dose on this protocol ECOG <=1 Participants ≥18 years of age Exclusion Criteria: Prior radiation to the liver (prior radiation therapy to the pelvis is acceptable if competed at least 4 weeks prior to the planned first dose of treatment on protocol) Colorectal cancer that is BRAF mutant or defective in mismatch repair. Active infection, ascites, hepatic encephalopathy Female participants who are pregnant or lactating - or planning to become pregnant within 6 months after the end of the treatment (female participants of child-bearing potential must have negative pregnancy test ≤72 hours before treatment start) If in the opinion of the treating investigator a participant has any serious medical problems which may preclude receiving this type of treatment Participants with current evidence of hepatitis A, B, C (i.e., active hepatitis) Participants with history or known presence of primary CNS tumors, seizures not well- controlled with standard medical therapy, or history of stroke will also be excluded Serious or non-healing active wound, ulcer, or bone fracture History of other malignancy, except: Malignancy treated with curative intent and with no known active disease present for ≥3 years prior to registration and felt to be at low risk for recurrence by the treating physician Adequately treated non-melanomatous skin cancer or lentigo malignant without evidence of disease Adequately treated cervical carcinoma in situ without evidence of disease
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Hagen Kennecke, MD
Phone
206-223-6193
Email
Hagen.Kennecke@virginiamason.org
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Hagen Kennecke, MD
Organizational Affiliation
Virginia mason medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Virginia mason medical Center
City
Seattle
State/Province
Washington
ZIP/Postal Code
98101
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Hagen Kennecke, MD
Phone
206-223-6193
Email
Hagen.Kennecke@virginiamason.org
First Name & Middle Initial & Last Name & Degree
Hagen Kennecke, MD

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Study of the Use of the Medtronic Pump and Codman Catheter to Give Chemotherapy to Patients With Colorectal Carcinoma or Cholangiocarcinoma

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