Clinical Utility for Ion Endoluminal System
Primary Purpose
Pulmonary Nodule, Lung Cancer, Lung Diseases
Status
Active
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Ion Endoluminal System™
Sponsored by
About this trial
This is an interventional other trial for Pulmonary Nodule
Eligibility Criteria
Inclusion Criteria:
- Patients aged 18 years and older
- Patient is suitable for elective bronchoscopy
- Patients with a moderate to high risk of lung cancer based on clinical, demographic and radiologic information or with suspected metastatic disease
- Solid or semi-solid pulmonary nodules of ≥ 1cm and ≤ 3cm in largest dimension
- Nodule is located in bronchial generation 4+ (i.e. beyond segmental bronchus*
- Patients are candidates for CT-guided needle biopsy and/or surgical resection
- Patient able to understand and adhere to study requirements
- Patient able to understand and adhere to study requirements and able to provide informed consent
- Patient not legally incapacitated or in legal/court ordered institution
- Patients with no dependency on the investigator or sponsor
Exclusion Criteria:
- Lack of fitness or exercise capacity to undergo bronchoscopy under general anesthesia as determined by physician prior to procedure
- Acute myocardial infarction or unstable angina ≤ 6 weeks prior to study procedure
- Clinically relevant partial trachea obstruction or obstruction of vena cava per physician assessment
- Acute respiratory failure, clinically significant hypoxemia, or high respiratory rate (i.e.> 30 breaths per minute) per physician assessment)
- Renal insufficiency that presents risk per physician's discretion or liver failure (i.e. CHILD-PUGH Class C)
- World Health Organization functional Class III or Class IV Pulmonary Hypertension or history of clinically significant mPAP
- Lung abscess
- Known or suspected pregnancy
- Recent head injury (<12 weeks pre-procedure) or subjects presenting with clinically significant neurologic deficits
- Unstable hemodynamic status (i.e. Dysrhythmia requiring intervention, altered mental status/consciousness)
- Subjects with pure ground glass opacity target nodule
- Inability to adequately oxygenate subject during procedure per physicians discretion (i.e. unable to achieve S02 > 92% or requiring >4L of oxygen prior to procedure)
- Subject with uncorrectable coagulopathy, bleeding or platelet disorders, history of major bleeding with bronchoscopy
- Subjects contraindicated for intubation or general anesthesia, or subjects with ASA ≥ 4
- Subjects taking antiplatelet (i.e. clopidogrel), anti-coagulant (i.e heparin or warfarin) or platelet aggression inhibitors (i.e. Abciximab or Eptifibatide) medications that cannot be stopped per standard practice, i.e. 5-7 days pre-procedure or heparin that cannot be held according to standard practice (6-12 hours). Aspirin not included.
- Any severe or life-threatening comorbidity that could increase the risk of bronchoscopic biopsy (i.e. >Stage 3 heart failure)
- Moderate-to-severe pulmonary fibrosis presenting procedural risk as assessed by physician
- Endobronchial lesion associated with lobar atelectasis
- Presence of bullae >1cm located within a cone based trajectory of biopsy instruments or in location presenting risk per physician assessment
- Known allergy, sensitivity or previous allergic reaction to ortho-phthalaldehyde (OPA)
- Subjects taking the following medications: Immunosuppressive treatment with systemic azathioprine, Cyclosporine, antibodies or cytostatics, other chemotherapeutic agents or medications acting on immunophilins
- Non-systemic treatment for lung cancer (i.e. SBRT, ablation) performed in the same lobe as the target nodule(s)
- Previous surgical intervention (i.e. wedge resection or lobectomy) within the same lobe as target nodule (s)
- Participation in any interventional clinical study or clinical study with experimental agents or agents of unknown risk in last 30 days prior to screening
Sites / Locations
- Massachusetts General Hospital
- Beth Israel Deaconness Medical Center
- Henry Ford Health System
- Mayo Clinic
- FirstHealth Moore Regional Hospital
- MD Anderson Cancer Center
Arms of the Study
Arm 1
Arm Type
Other
Arm Label
Robotic Bronchoscopy
Arm Description
The Ion™ Endoluminal System assists the user in navigating a catheter and endoscopic tools in the pulmonary tract using endoscopic visualization of the tracheobronchial tree for diagnostic and therapeutic procedures. The Ion™ Endoluminal System enables fiducial marker placement. It does not make a diagnosis and is not for pediatric use.
Outcomes
Primary Outcome Measures
Navigation Success
Biopsy Success
Sensitivity for Malignancy of System-Obtained Sample
Secondary Outcome Measures
Complications
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03893539
Brief Title
Clinical Utility for Ion Endoluminal System
Official Title
PRECIsE: A Prospective Evaluation of the Clinical Utility for the Ion Endoluminal System
Study Type
Interventional
2. Study Status
Record Verification Date
September 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
March 29, 2019 (Actual)
Primary Completion Date
December 26, 2022 (Anticipated)
Study Completion Date
January 2023 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Intuitive Surgical
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
The goal of this prospective, multi-center, single-arm, clinical study is to evaluate the clinical utility and performance of the FDA-cleared Ion™ Endoluminal System ("Ion") for bronchoscopically approaching and facilitating the tissue sampling of pulmonary nodules.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pulmonary Nodule, Lung Cancer, Lung Diseases
7. Study Design
Primary Purpose
Other
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
365 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Robotic Bronchoscopy
Arm Type
Other
Arm Description
The Ion™ Endoluminal System assists the user in navigating a catheter and endoscopic tools in the pulmonary tract using endoscopic visualization of the tracheobronchial tree for diagnostic and therapeutic procedures. The Ion™ Endoluminal System enables fiducial marker placement. It does not make a diagnosis and is not for pediatric use.
Intervention Type
Device
Intervention Name(s)
Ion Endoluminal System™
Intervention Description
The Ion™ Endoluminal System, Model IF1000, is a software-controlled, electro-mechanical system designed to assist qualified physicians to navigate a catheter and endoscopic tools in the pulmonary tract using endoscopic visualization of the tracheobronchial tree for diagnostic and therapeutic procedures.
Primary Outcome Measure Information:
Title
Navigation Success
Time Frame
Day 1 (Time of Procedure)
Title
Biopsy Success
Time Frame
Day 1 (Time of Procedure)
Title
Sensitivity for Malignancy of System-Obtained Sample
Time Frame
14 months Post-Procedure
Secondary Outcome Measure Information:
Title
Complications
Time Frame
Intra-procedure, Immediately Post-Procedure, Day 10 Post-Procedure, Day 30 Post-Procedure
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients aged 18 years and older
Patient is suitable for elective bronchoscopy
Patients with a moderate to high risk of lung cancer based on clinical, demographic and radiologic information or with suspected metastatic disease
Solid or semi-solid pulmonary nodules of ≥ 1cm and ≤ 3cm in largest dimension
Nodule is located in bronchial generation 4+ (i.e. beyond segmental bronchus*
Patients are candidates for CT-guided needle biopsy and/or surgical resection
Patient able to understand and adhere to study requirements
Patient able to understand and adhere to study requirements and able to provide informed consent
Patient not legally incapacitated or in legal/court ordered institution
Patients with no dependency on the investigator or sponsor
Exclusion Criteria:
Lack of fitness or exercise capacity to undergo bronchoscopy under general anesthesia as determined by physician prior to procedure
Acute myocardial infarction or unstable angina ≤ 6 weeks prior to study procedure
Clinically relevant partial trachea obstruction or obstruction of vena cava per physician assessment
Acute respiratory failure, clinically significant hypoxemia, or high respiratory rate (i.e.> 30 breaths per minute) per physician assessment)
Renal insufficiency that presents risk per physician's discretion or liver failure (i.e. CHILD-PUGH Class C)
World Health Organization functional Class III or Class IV Pulmonary Hypertension or history of clinically significant mPAP
Lung abscess
Known or suspected pregnancy
Recent head injury (<12 weeks pre-procedure) or subjects presenting with clinically significant neurologic deficits
Unstable hemodynamic status (i.e. Dysrhythmia requiring intervention, altered mental status/consciousness)
Subjects with pure ground glass opacity target nodule
Inability to adequately oxygenate subject during procedure per physicians discretion (i.e. unable to achieve S02 > 92% or requiring >4L of oxygen prior to procedure)
Subject with uncorrectable coagulopathy, bleeding or platelet disorders, history of major bleeding with bronchoscopy
Subjects contraindicated for intubation or general anesthesia, or subjects with ASA ≥ 4
Subjects taking antiplatelet (i.e. clopidogrel), anti-coagulant (i.e heparin or warfarin) or platelet aggression inhibitors (i.e. Abciximab or Eptifibatide) medications that cannot be stopped per standard practice, i.e. 5-7 days pre-procedure or heparin that cannot be held according to standard practice (6-12 hours). Aspirin not included.
Any severe or life-threatening comorbidity that could increase the risk of bronchoscopic biopsy (i.e. >Stage 3 heart failure)
Moderate-to-severe pulmonary fibrosis presenting procedural risk as assessed by physician
Endobronchial lesion associated with lobar atelectasis
Presence of bullae >1cm located within a cone based trajectory of biopsy instruments or in location presenting risk per physician assessment
Known allergy, sensitivity or previous allergic reaction to ortho-phthalaldehyde (OPA)
Subjects taking the following medications: Immunosuppressive treatment with systemic azathioprine, Cyclosporine, antibodies or cytostatics, other chemotherapeutic agents or medications acting on immunophilins
Non-systemic treatment for lung cancer (i.e. SBRT, ablation) performed in the same lobe as the target nodule(s)
Previous surgical intervention (i.e. wedge resection or lobectomy) within the same lobe as target nodule (s)
Participation in any interventional clinical study or clinical study with experimental agents or agents of unknown risk in last 30 days prior to screening
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Erik Folch, MD
Organizational Affiliation
Massachusetts General Hospital
Official's Role
Study Chair
Facility Information:
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
Beth Israel Deaconness Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02215
Country
United States
Facility Name
Henry Ford Health System
City
Detroit
State/Province
Michigan
ZIP/Postal Code
48202
Country
United States
Facility Name
Mayo Clinic
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States
Facility Name
FirstHealth Moore Regional Hospital
City
Pinehurst
State/Province
North Carolina
ZIP/Postal Code
28374
Country
United States
Facility Name
MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77054
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
Undecided
Citations:
PubMed Identifier
34656103
Citation
Simoff MJ, Pritchett MA, Reisenauer JS, Ost DE, Majid A, Keyes C, Casal RF, Parikh MS, Diaz-Mendoza J, Fernandez-Bussy S, Folch EE. Shape-sensing robotic-assisted bronchoscopy for pulmonary nodules: initial multicenter experience using the Ion Endoluminal System. BMC Pulm Med. 2021 Oct 16;21(1):322. doi: 10.1186/s12890-021-01693-2.
Results Reference
derived
PubMed Identifier
33590989
Citation
Agrawal A. Interventional Pulmonology: Diagnostic and Therapeutic Advances in Bronchoscopy. Am J Ther. 2021 Feb 9;28(2):e204-e216. doi: 10.1097/MJT.0000000000001344.
Results Reference
derived
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Clinical Utility for Ion Endoluminal System
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