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A Study of the Use of Irreversible Electroporation in Pancreatic Ductal Cancer

Primary Purpose

Pancreatic Ductal Adenocarcinoma

Status
Completed
Phase
Not Applicable
Locations
Canada
Study Type
Interventional
Intervention
Irreversible Electroporation
NanoKnife System
Sponsored by
University Health Network, Toronto
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pancreatic Ductal Adenocarcinoma

Eligibility Criteria

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

Inclusion Criteria:

  • Histologically proven pancreatic ductal adenocarcinoma (PDAC)
  • Age ≥ 18 years
  • Locally advanced unresectable primary tumor
  • Tumors ≤5 cm in largest dimension at the time of enrollment that is technically amenable to treatment with irreversible electroporation (IRE)
  • At least 4 months of combination chemotherapy
  • Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 2
  • Acceptable organ and bone marrow function
  • Life expectancy estimated ≥6 months
  • Ability and willingness to sign informed consent form
  • Have a measurable primary tumor at the time of study enrollment
  • Suitable and fit to undergo general anesthetic and laparotomy
  • Women of child-producing potential must agree to use effective contraceptive methods prior to study entry, during study participation, and for at least 30 days after the last administration of study medication.

Exclusion Criteria:

  • Stage IV (i.e. metastatic) PDAC
  • Have a cystic subtype PDAC of the pancreas
  • Previous local treatments for locally advanced PDAC including IRE or radiotherapy
  • Recent or concurrent cancer, that is distinct from PDAC in primary site/histology, except cervical carcinoma in situ, localized prostate cancer, treated basal cell carcinoma, superficial bladder tumours (Ta, Tis & T1) and those that can be permitted with sufficient clinical justification confirming patient safety to undergo the procedure per Principle Investigator and is in the best interest of the patient. Cancer curatively treated ≥3 years prior to entry is permitted.
  • Prior chemotherapy within 3 years of diagnosis of PDAC. Chemotherapy for PDAC is permitted
  • Direct invasion of locally advanced PDAC into the stomach or duodenum
  • Metallic biliary stent that cannot be substituted with a plastic stent
  • Allergy to computed tomography (CT) or magnetic resonance imaging (MRI) contrast that cannot be safely managed with premedication which preclude assessment and/or surveillance of PDAC
  • History of cardiac disease (including, but not limited to: congestive heart failure, active coronary artery disease, uncontrolled hypertension)
  • Any active major medical illnesses of the respiratory or immune system, or other conditions that may affect patient's ability to tolerate general anesthesia and IRE therapy on this trial
  • History of solid organ transplantation or collagen vascular disease
  • Medical, psychological or social conditions that may interfere with the patient's participation in the study or evaluation of the study results
  • Pregnant or breast feeding women
  • Pre-menopausal women unwilling to take a pregnancy test
  • Any other condition that would, in the Investigator's judgment, contraindicate the patient's participation in the clinical study due to safety concerns or compliance with clinical study procedures (e.g.: infection/inflammation, intestinal obstruction, unable to swallow medication, social/ psychological issues, etc.)
  • History of human immunodeficiency virus (HIV) infection
  • Progression of the primary lesion as judged by the Investigator
  • Working knowledge of English is a must in order to complete the quality of life questionnaires being administered in this study. Patients who do not meet this requirement will be exempt from the quality of life assessments but remain eligible for all other components of the study.

Sites / Locations

  • Princess Margaret Cancer Centre

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Study Treatment

Arm Description

Single arm trial of irreversible electroporation using the NanoKnife system for locally advanced pancreatic ductal adenocarcinoma.

Outcomes

Primary Outcome Measures

Adverse event rate
Overall survival rate

Secondary Outcome Measures

Progression-free survival rate
Overall survival rate of disease
Progression-free survival rate of disease

Full Information

First Posted
August 9, 2017
Last Updated
August 10, 2022
Sponsor
University Health Network, Toronto
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1. Study Identification

Unique Protocol Identification Number
NCT03257150
Brief Title
A Study of the Use of Irreversible Electroporation in Pancreatic Ductal Cancer
Official Title
Irreversible Electroporation for Locally Advanced Pancreatic Ductal Adenocarcinoma (LEAP TRIAL): A Phase I/II Prospective Trial
Study Type
Interventional

2. Study Status

Record Verification Date
August 2022
Overall Recruitment Status
Completed
Study Start Date
September 22, 2017 (Actual)
Primary Completion Date
July 14, 2022 (Actual)
Study Completion Date
July 14, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University Health Network, Toronto

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 I/II study will evaluate to see how safe and useful irreversible electroporation (also called NanoKnife) is in patients with locally advanced pancreatic cancer.
Detailed Description
In this phase I/II trial, patients with locally advanced pancreatic ductal carcinoma will be assigned to receive interventional treatment of irreversible electroporation (IRE). IRE will be performed by laparotomy under general anesthesia in the operating room. All patients enrolled in the study will have a biopsy at the time of laparotomy. Blood will be collected for regular blood tests and correlative studies at baseline and during the study. Computed tomography (CT) scans will be done at baseline, 4 weeks post treatment, 12 weeks, 24 weeks, and 36 weeks follow up. Quality of Life (QOL) questionnaires will be completed at baseline and during the study. Patients will be given optional consent for storage of any leftover tissue and blood samples for future analysis. Patients will be followed up 4 weeks post treatment, then every 12 weeks until death.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pancreatic Ductal Adenocarcinoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
12 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Study Treatment
Arm Type
Experimental
Arm Description
Single arm trial of irreversible electroporation using the NanoKnife system for locally advanced pancreatic ductal adenocarcinoma.
Intervention Type
Procedure
Intervention Name(s)
Irreversible Electroporation
Intervention Description
Irreversible electroporation (IRE) is a process that uses the NanoKnife system to sent electrical currents to a cancer tumor which will disrupt the tumor cell and therefore causing the cell to die. Eligible patients will undergo in situ IRE performed via laparotomy surgery.
Intervention Type
Device
Intervention Name(s)
NanoKnife System
Intervention Description
A system consisting of electrode probes connected to a machine. The probes will be surgically placed around the tumor.
Primary Outcome Measure Information:
Title
Adverse event rate
Time Frame
30 days post IRE or index hospitalization
Title
Overall survival rate
Time Frame
Date of IRE treatment to the date of death, up to 2 years
Secondary Outcome Measure Information:
Title
Progression-free survival rate
Time Frame
IRE treatment to the date of documented disease progression or death, up to 2 years
Title
Overall survival rate of disease
Time Frame
Date of disease diagnosis to date of death, up to 2 years
Title
Progression-free survival rate of disease
Time Frame
Date of disease diagnosis to date of death, up to 2 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Histologically proven pancreatic ductal adenocarcinoma (PDAC) Age ≥ 18 years Locally advanced unresectable primary tumor Tumors ≤5 cm in largest dimension at the time of enrollment that is technically amenable to treatment with irreversible electroporation (IRE) At least 4 months of combination chemotherapy Eastern Cooperative Oncology Group (ECOG) performance status of ≤ 2 Acceptable organ and bone marrow function Life expectancy estimated ≥6 months Ability and willingness to sign informed consent form Have a measurable primary tumor at the time of study enrollment Suitable and fit to undergo general anesthetic and laparotomy Women of child-producing potential must agree to use effective contraceptive methods prior to study entry, during study participation, and for at least 30 days after the last administration of study medication. Exclusion Criteria: Stage IV (i.e. metastatic) PDAC Have a cystic subtype PDAC of the pancreas Previous local treatments for locally advanced PDAC including IRE or radiotherapy Recent or concurrent cancer, that is distinct from PDAC in primary site/histology, except cervical carcinoma in situ, localized prostate cancer, treated basal cell carcinoma, superficial bladder tumours (Ta, Tis & T1) and those that can be permitted with sufficient clinical justification confirming patient safety to undergo the procedure per Principle Investigator and is in the best interest of the patient. Cancer curatively treated ≥3 years prior to entry is permitted. Prior chemotherapy within 3 years of diagnosis of PDAC. Chemotherapy for PDAC is permitted Direct invasion of locally advanced PDAC into the stomach or duodenum Metallic biliary stent that cannot be substituted with a plastic stent Allergy to computed tomography (CT) or magnetic resonance imaging (MRI) contrast that cannot be safely managed with premedication which preclude assessment and/or surveillance of PDAC History of cardiac disease (including, but not limited to: congestive heart failure, active coronary artery disease, uncontrolled hypertension) Any active major medical illnesses of the respiratory or immune system, or other conditions that may affect patient's ability to tolerate general anesthesia and IRE therapy on this trial History of solid organ transplantation or collagen vascular disease Medical, psychological or social conditions that may interfere with the patient's participation in the study or evaluation of the study results Pregnant or breast feeding women Pre-menopausal women unwilling to take a pregnancy test Any other condition that would, in the Investigator's judgment, contraindicate the patient's participation in the clinical study due to safety concerns or compliance with clinical study procedures (e.g.: infection/inflammation, intestinal obstruction, unable to swallow medication, social/ psychological issues, etc.) History of human immunodeficiency virus (HIV) infection Progression of the primary lesion as judged by the Investigator Working knowledge of English is a must in order to complete the quality of life questionnaires being administered in this study. Patients who do not meet this requirement will be exempt from the quality of life assessments but remain eligible for all other components of the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Steven Gallinger, MD
Organizational Affiliation
Princess Margaret Cancer Centre
Official's Role
Principal Investigator
Facility Information:
Facility Name
Princess Margaret Cancer Centre
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G 2M9
Country
Canada

12. IPD Sharing Statement

Plan to Share IPD
No

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A Study of the Use of Irreversible Electroporation in Pancreatic Ductal Cancer

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