search
Back to results

A Prospective, Single-arm, Multicenter Clinical Trial of Safety and Effectiveness of EUS-LA for Liver Cancer

Primary Purpose

Liver Cancer

Status
Not yet recruiting
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
EUS-LA by LaserPro Diode Laser System
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 liver cancer, laser, ablation, endoscopic ultrasound

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Liver malignant tumors with clear histopathology and cytology, or liver malignant tumors that meet clinical diagnosis and staging criteria. Liver tumors within the scope of EUS scanning. Single tumor≤ 3cm in diameter and the number of visible tumor were no more than 3. According to CT and MRI, there are no macrovascular and bile duct invasions visible by the naked eye. Liver function: Child-Pugh A or B. Age: 18-75 years old, regardless of gender. Patients signed informed consent to participate in the trial. Exclusion Criteria: Contraindication for EUS or the target tumor were beyond the scope of EUS scanning. Liver function: Child-pugh C, those could not improve after liver protective treatment. Uncorrectable coagulation dysfunction and severe haematological abnormalities, who tend to severe bleeding; platelet count less than 50×109/L, prothrombin time more than 30s or prothrombin activity less than 40%. Severe failure of major organs such as kidney, heart, lung and brain. Uncontrolled infection in any organ, especially inflammation of the biliary system. Esophageal (bottom of stomach) varices rupture and bleeding within 1 month before treatment.

Sites / Locations

  • The First Affiliated Hospital, Zhejiang University School of Medicine

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

EUS-LA by LaserPro Diode Laser System

Arm Description

This trial is a prospective, single-arm, multi-center clinical trial. Four hospitals with national medical trial institution qualifications are selected as clinical trial centers. Qualified participants will receive endoscopic ultrasound (EUS)-guided laser ablation (LA) by LaserPro Diode Laser System 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 procedure will be made according to groups.

Outcomes

Primary Outcome Measures

Complete ablation rate
Defined as the absence of any contrast uptake within or at the periphery of the ablative zone. One month after either one session or multiple LA sessions, CTA was confirmed by contrast-enhanced MRI.
Effectiveness analysis
The effective rate of EUS-LA by LaserPro Diode Laser System for liver cancer was evaluated by mRECIST criteria.

Secondary Outcome Measures

Technical success rate
Technical success rate of EUS-LA by LaserPro Diode Laser System for liver cancer.
Major complication rate
Major complication rate after EUS-LA by LaserPro Diode Laser System for liver cancer.
Partial response rate
Partial response rate after EUS-LA by LaserPro Diode Laser System for liver cancer.
Secondary ablation rate
Secondary ablation rate after EUS-LA by LaserPro Diode Laser System for liver cancer.
Progression-free survival (PFS)
Progression-free survival after EUS-LA by LaserPro Diode Laser System for liver cancer.
Overall survival rate (OS)
Overall survival rate after EUS-LA by LaserPro Diode Laser System for liver cancer.
Local tumor progression (LTP)
Local tumor progression after EUS-LA by LaserPro Diode Laser System for liver cancer.
Distant tumor recurrence (DTR)
Distant tumor recurrence after EUS-LA by LaserPro Diode Laser System for liver cancer.
Quality of life score
Quality of life score of participants after EUS-LA by LaserPro Diode Laser System for liver cancer.
Alpha-fetoprotein levels
The alpha-fetoprotein levels of participants after EUS-LA by LaserPro Diode Laser System for liver cancer.

Full Information

First Posted
January 25, 2023
Last Updated
February 13, 2023
Sponsor
First Affiliated Hospital of Zhejiang University
Collaborators
Yiwu Central Hospital, Zhejiang Provincial Tongde Hospital
search

1. Study Identification

Unique Protocol Identification Number
NCT05709886
Brief Title
A Prospective, Single-arm, Multicenter Clinical Trial of Safety and Effectiveness of EUS-LA for Liver Cancer
Official Title
A Prospective, Single-arm, Multicenter Clinical Trial of Safety and Effectiveness of Endoscopic Ultrasound-guided Laser Ablation for Liver Cancer by LaserPro Diode Laser System
Study Type
Interventional

2. Study Status

Record Verification Date
December 2022
Overall Recruitment Status
Not yet recruiting
Study Start Date
February 28, 2023 (Anticipated)
Primary Completion Date
December 31, 2024 (Anticipated)
Study Completion Date
March 31, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
First Affiliated Hospital of Zhejiang University
Collaborators
Yiwu Central Hospital, Zhejiang Provincial Tongde Hospital

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 trial is a prospective, single-arm, multi-center clinical trial. Four hospitals with national medical trial institution qualifications are selected as clinical trial centers. Qualified participants will receive endoscopic ultrasound-guided laser ablation by LaserPro Diode Laser System 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 procedure will be made according to groups.
Detailed Description
The prospective, single-arm, multi-center clinical trial is to evaluate whether the endoscopic ultrasound (EUS)-guided laser ablation (LA) by LaserPro Diode Laser System can achieve the safety and effectivenessof liver cancer ablation treatment. Four hospitals with national medical clinical trial institution qualifications are selected as clinical trial centers. This clinical trial requires 69 subjects. Qualified participants will receive EUS-guided LA by LaserPro Diode Laser System according to the routine procedures. The results will be recorded according to the requirements of the primary outcome (the complete ablation (CA) rate and the effective rate of EUS-guided LA by LaserPro Diode Laser System for liver cancer) and secondary outcomes (technical success rate, major complication rate, partial response rate, secondary ablation rate, progression-free survival (PFS), overall survival rate (OS), local tumor progression (LTP), distant tumor recurrence (DTR), quality of life score and alpha-fetoprotein levels). The one-month follow-up after the operation, three-phase MRI, liver function and tumor markers were reviewed monthly to observe the lesion necrosis and tumor marker changes. After that, tumor markers, three-phase MRI of liver were examined every 2 to 3 months. After then, statistical comparisons of safety and effectivenessof the producedure 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
liver cancer, laser, ablation, endoscopic ultrasound

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Model Description
To evaluate whether the LaserPro Diode Laser System under the guidance of EUS can achieve the safety and effectiveness of local ablation for liver cancer.
Masking
None (Open Label)
Allocation
N/A
Enrollment
69 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
EUS-LA by LaserPro Diode Laser System
Arm Type
Experimental
Arm Description
This trial is a prospective, single-arm, multi-center clinical trial. Four hospitals with national medical trial institution qualifications are selected as clinical trial centers. Qualified participants will receive endoscopic ultrasound (EUS)-guided laser ablation (LA) by LaserPro Diode Laser System 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 procedure will be made according to groups.
Intervention Type
Device
Intervention Name(s)
EUS-LA by LaserPro Diode Laser System
Intervention Description
This trial is a prospective, single-arm, multi-center clinical trial. Four hospitals with national medical trial institution qualifications are selected as clinical trial centers. Qualified participants will receive endoscopic ultrasound (EUS)-guided laser ablation (LA) by LaserPro Diode Laser System 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 procedure will be made according to groups.
Primary Outcome Measure Information:
Title
Complete ablation rate
Description
Defined as the absence of any contrast uptake within or at the periphery of the ablative zone. One month after either one session or multiple LA sessions, CTA was confirmed by contrast-enhanced MRI.
Time Frame
1 month
Title
Effectiveness analysis
Description
The effective rate of EUS-LA by LaserPro Diode Laser System for liver cancer was evaluated by mRECIST criteria.
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Technical success rate
Description
Technical success rate of EUS-LA by LaserPro Diode Laser System for liver cancer.
Time Frame
1 month
Title
Major complication rate
Description
Major complication rate after EUS-LA by LaserPro Diode Laser System for liver cancer.
Time Frame
6 months
Title
Partial response rate
Description
Partial response rate after EUS-LA by LaserPro Diode Laser System for liver cancer.
Time Frame
6 months
Title
Secondary ablation rate
Description
Secondary ablation rate after EUS-LA by LaserPro Diode Laser System for liver cancer.
Time Frame
6 months
Title
Progression-free survival (PFS)
Description
Progression-free survival after EUS-LA by LaserPro Diode Laser System for liver cancer.
Time Frame
6 months
Title
Overall survival rate (OS)
Description
Overall survival rate after EUS-LA by LaserPro Diode Laser System for liver cancer.
Time Frame
6 months
Title
Local tumor progression (LTP)
Description
Local tumor progression after EUS-LA by LaserPro Diode Laser System for liver cancer.
Time Frame
6 months
Title
Distant tumor recurrence (DTR)
Description
Distant tumor recurrence after EUS-LA by LaserPro Diode Laser System for liver cancer.
Time Frame
6 months
Title
Quality of life score
Description
Quality of life score of participants after EUS-LA by LaserPro Diode Laser System for liver cancer.
Time Frame
6 months
Title
Alpha-fetoprotein levels
Description
The alpha-fetoprotein levels of participants after EUS-LA by LaserPro Diode Laser System for liver cancer.
Time Frame
6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
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. Liver tumors within the scope of EUS scanning. Single tumor≤ 3cm in diameter and the number of visible tumor were no more than 3. According to CT and MRI, there are no macrovascular and bile duct invasions visible by the naked eye. Liver function: Child-Pugh A or B. Age: 18-75 years old, regardless of gender. Patients signed informed consent to participate in the trial. Exclusion Criteria: Contraindication for EUS or the target tumor were beyond the scope of EUS scanning. Liver function: Child-pugh C, those could not improve after liver protective treatment. Uncorrectable coagulation dysfunction and severe haematological abnormalities, who tend to severe bleeding; platelet count less than 50×109/L, prothrombin time more than 30s or prothrombin activity less than 40%. Severe failure of major organs such as kidney, heart, lung and brain. Uncontrolled infection in any organ, especially inflammation of the biliary system. Esophageal (bottom of stomach) varices rupture and bleeding within 1 month before treatment.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Tian'an Jiang, PhD
Phone
86-18857127666
Email
tiananjiang@zju.edu.cn
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Tian'an Jiang, PhD
Organizational Affiliation
Zhejiang University
Official's Role
Principal Investigator
Facility Information:
Facility Name
The First Affiliated Hospital, Zhejiang University School of Medicine
City
Hangzhou
State/Province
Zhejiang
ZIP/Postal Code
310003
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Tian'an Jiang, PhD
Phone
86-18857127666
Email
tiananjiang@126.com

12. IPD Sharing Statement

Citations:
PubMed Identifier
29031662
Citation
Nault JC, Sutter O, Nahon P, Ganne-Carrie N, Seror O. Percutaneous treatment of hepatocellular carcinoma: State of the art and innovations. J Hepatol. 2018 Apr;68(4):783-797. doi: 10.1016/j.jhep.2017.10.004. Epub 2017 Oct 13.
Results Reference
background
PubMed Identifier
16757969
Citation
Hong K, Georgiades CS, Geschwind JF. Technology insight: Image-guided therapies for hepatocellular carcinoma--intra-arterial and ablative techniques. Nat Clin Pract Oncol. 2006 Jun;3(6):315-24. doi: 10.1038/ncponc0512.
Results Reference
background
PubMed Identifier
30970190
Citation
Villanueva A. Hepatocellular Carcinoma. N Engl J Med. 2019 Apr 11;380(15):1450-1462. doi: 10.1056/NEJMra1713263. No abstract available.
Results Reference
background
PubMed Identifier
32681074
Citation
Petrowsky H, Fritsch R, Guckenberger M, De Oliveira ML, Dutkowski P, Clavien PA. Modern therapeutic approaches for the treatment of malignant liver tumours. Nat Rev Gastroenterol Hepatol. 2020 Dec;17(12):755-772. doi: 10.1038/s41575-020-0314-8. Epub 2020 Jul 17.
Results Reference
background
PubMed Identifier
19332729
Citation
Pacella CM, Francica G, Di Lascio FM, Arienti V, Antico E, Caspani B, Magnolfi F, Megna AS, Pretolani S, Regine R, Sponza M, Stasi R. Long-term outcome of cirrhotic patients with early hepatocellular carcinoma treated with ultrasound-guided percutaneous laser ablation: a retrospective analysis. J Clin Oncol. 2009 Jun 1;27(16):2615-21. doi: 10.1200/JCO.2008.19.0082. Epub 2009 Mar 30.
Results Reference
background
PubMed Identifier
18195382
Citation
Arienti V, Pretolani S, Pacella CM, Magnolfi F, Caspani B, Francica G, Megna AS, Regine R, Sponza M, Antico E, Di Lascio FM. Complications of laser ablation for hepatocellular carcinoma: a multicenter study. Radiology. 2008 Mar;246(3):947-55. doi: 10.1148/radiol.2463070390. Epub 2008 Jan 14.
Results Reference
background
PubMed Identifier
25251043
Citation
Di Costanzo GG, Tortora R, D'Adamo G, De Luca M, Lampasi F, Addario L, Galeota Lanza A, Picciotto FP, Tartaglione MT, Cordone G, Imparato M, Mattera S, Pacella CM. Radiofrequency ablation versus laser ablation for the treatment of small hepatocellular carcinoma in cirrhosis: a randomized trial. J Gastroenterol Hepatol. 2015 Mar;30(3):559-65. doi: 10.1111/jgh.12791.
Results Reference
background
PubMed Identifier
25349642
Citation
Di Costanzo GG, Francica G, Pacella CM. Laser ablation for small hepatocellular carcinoma: State of the art and future perspectives. World J Hepatol. 2014 Oct 27;6(10):704-15. doi: 10.4254/wjh.v6.i10.704.
Results Reference
background
PubMed Identifier
22191028
Citation
Pacella CM, Francica G, Di Costanzo GG. Laser ablation for small hepatocellular carcinoma. Radiol Res Pract. 2011;2011:595627. doi: 10.1155/2011/595627. Epub 2011 Dec 4.
Results Reference
background
PubMed Identifier
31383020
Citation
Chai W, Zhao Q, Song H, Cheng C, Tian G, Jiang T. Treatment response and preliminary efficacy of hepatic tumour laser ablation under the guidance of percutaneous and endoscopic ultrasonography. World J Surg Oncol. 2019 Aug 5;17(1):133. doi: 10.1186/s12957-019-1677-6.
Results Reference
background
PubMed Identifier
21030019
Citation
Di Matteo F, Grasso R, Pacella CM, Martino M, Pandolfi M, Rea R, Luppi G, Silvestri S, Zardi E, Costamagna G. EUS-guided Nd:YAG laser ablation of a hepatocellular carcinoma in the caudate lobe. Gastrointest Endosc. 2011 Mar;73(3):632-6. doi: 10.1016/j.gie.2010.08.019. Epub 2010 Oct 27. No abstract available.
Results Reference
background
PubMed Identifier
27958384
Citation
Jiang TA, Deng Z, Tian G, Zhao QY, Wang WL. Efficacy and safety of endoscopic ultrasonography-guided interventional treatment for refractory malignant left-sided liver tumors: a case series of 26 patients. Sci Rep. 2016 Dec 13;6:36098. doi: 10.1038/srep36098.
Results Reference
background
PubMed Identifier
29303406
Citation
Jiang T, Tian G, Bao H, Chen F, Deng Z, Li J, Chai W. EUS dating with laser ablation against the caudate lobe or left liver tumors: a win-win proposition? Cancer Biol Ther. 2018 Mar 4;19(3):145-152. doi: 10.1080/15384047.2017.1414760. Epub 2018 Jan 25.
Results Reference
background

Learn more about this trial

A Prospective, Single-arm, Multicenter Clinical Trial of Safety and Effectiveness of EUS-LA for Liver Cancer

We'll reach out to this number within 24 hrs