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
Active
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
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, 18-343
Eligibility Criteria
Inclusion Criteria:
- History of histologically confirmed colorectal adenocarcinoma metastatic to the liver with no clinicalyl 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 MSKCC
- Patient may have completely resected hepatic metastases without current evidence of other metastatic disease
Lab values ≤14 days prior to registration:
- WBC ≥2.5 K/uL
- Platelets ≥100,000/uL
- Creatinine <1.7mg/dL
- HGB ≥ 8.5 gm/dL
- Total Bilirubin ≤1.5 mg/dl
- Prior chemotherapy is acceptable if last dose given ≥3 weeks prior to registration to this study. [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
- KPS ≥60%
- Patients ≥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)
- Active infection, ascites, hepatic encephalopathy
- Female patients who are pregnant or lactating - or planning to become pregnant within 6 months after the end of the treatment (female patients of child-bearing potential must have negative pregnancy test ≤72 hours before treatment start)
- If in the opinion of the treating investigator a patient has any serious medical problems which may preclude receiving this type of treatment
- Patients with current evidence of hepatitis A, B, C (i.e., active hepatitis)
- Patients 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 maligna without evidence of disease
- Adequately treated cervical carcinoma in situ without evidence of disease
There is no exclusion of patients based on sex, ethnicity or race. For these reasons, the study results are expected to be generalizable to the Medicare beneficiary population.
Sites / Locations
- Memorial Sloan Kettering Basking Ridge
- Memorial Sloan Kettering Monmouth
- Memorial Sloan Kettering Bergen
- Memorial Sloan Kettering Commack
- Memorial Sloan Kettering Westchester
- Memorial Sloan Kettering Cancer Center
- Memorial Sloan Kettering Nassau
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
% frequency liver toxicity
alkaline phosphatase, serum bilirubin
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
NCT ID
NCT03693807
First Posted
October 1, 2018
Last Updated
October 3, 2023
Sponsor
Memorial Sloan Kettering Cancer Center
1. Study Identification
Unique Protocol Identification Number
NCT03693807
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 Using the Medtronic Pump and Codman Catheter for the Delivery of Hepatic Arterial Infusion (HAI) Chemotherapy in Patients With Colorectal Carcinoma or Cholangiocarcinoma
Study Type
Interventional
2. Study Status
Record Verification Date
October 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
October 18, 2018 (Actual)
Primary Completion Date
September 2024 (Anticipated)
Study Completion Date
September 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Memorial Sloan Kettering Cancer Center
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
Yes
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, so the first doses of systemic chemotherapy will be given on Cycle 1, Day 15, and then every 2 weeks thereafter. CT C/A/P every 2 months. A window of +/- 3 weeks for scans is allowed in order to accommodate patient schedules.
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, so the first doses of systemic chemotherapy will be given on Cycle 1, Day 15, and then every 2 weeks thereafter. Treatment will continue for 6 months in the absence of toxicity or patient withdrawal. CT C/A/P every 3 months. A window of +/- 3 weeks for scans is allowed in order to accommodate patient schedules.
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, so the first doses of systemic chemotherapy will be given on Cycle 1, Day 15, and then every 2 weeks thereafter. A CT C/A/P every 2 months during treatment. A window of +/- 3 weeks for scans is allowed in order to accommodate patient schedules.
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, 18-343
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
35 (Actual)
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
% frequency liver toxicity
Description
alkaline phosphatase, serum bilirubin
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 clinicalyl 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 MSKCC
Patient may have completely resected hepatic metastases without current evidence of other metastatic disease
Lab values ≤14 days prior to registration:
WBC ≥2.5 K/uL
Platelets ≥100,000/uL
Creatinine <1.7mg/dL
HGB ≥ 8.5 gm/dL
Total Bilirubin ≤1.5 mg/dl
Prior chemotherapy is acceptable if last dose given ≥3 weeks prior to registration to this study. [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
KPS ≥60%
Patients ≥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)
Active infection, ascites, hepatic encephalopathy
Female patients who are pregnant or lactating - or planning to become pregnant within 6 months after the end of the treatment (female patients of child-bearing potential must have negative pregnancy test ≤72 hours before treatment start)
If in the opinion of the treating investigator a patient has any serious medical problems which may preclude receiving this type of treatment
Patients with current evidence of hepatitis A, B, C (i.e., active hepatitis)
Patients 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 maligna without evidence of disease
Adequately treated cervical carcinoma in situ without evidence of disease
There is no exclusion of patients based on sex, ethnicity or race. For these reasons, the study results are expected to be generalizable to the Medicare beneficiary population.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Nancy Kemeny, MD
Organizational Affiliation
Memorial Sloan Kettering Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Memorial Sloan Kettering Basking Ridge
City
Basking Ridge
State/Province
New Jersey
ZIP/Postal Code
07920
Country
United States
Facility Name
Memorial Sloan Kettering Monmouth
City
Middletown
State/Province
New Jersey
ZIP/Postal Code
07748
Country
United States
Facility Name
Memorial Sloan Kettering Bergen
City
Montvale
State/Province
New Jersey
ZIP/Postal Code
07645
Country
United States
Facility Name
Memorial Sloan Kettering Commack
City
Commack
State/Province
New York
ZIP/Postal Code
11725
Country
United States
Facility Name
Memorial Sloan Kettering Westchester
City
Harrison
State/Province
New York
ZIP/Postal Code
10604
Country
United States
Facility Name
Memorial Sloan Kettering Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Facility Name
Memorial Sloan Kettering Nassau
City
Uniondale
State/Province
New York
ZIP/Postal Code
11553
Country
United States
12. IPD Sharing Statement
Links:
URL
http://www.mskcc.org/mskcc/html/44.cfm
Description
Memorial Sloan Kettering Cancer Center
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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