Efficacy and Safety Study of PDT Using Photofrin in Unresectable Advanced Perihilar Cholangiocarcinoma (OPUS)
Hilar Cholangiocarcinoma
About this trial
This is an interventional treatment trial for Hilar Cholangiocarcinoma focused on measuring Cholangiocarcinoma, Unresectable perihilar cholangiocarcinoma, Klatskin tumor, Photodynamic therapy, Porfimer sodium, Photofrin, Gemcitabine, Cisplatin, Stents, CCA, PDT, Bile duct cancer, Bile duct tumor, Bile duct adenocarcinoma, Chemotherapy
Eligibility Criteria
Inclusion Criteria:
- Males or females aged 18 or older
- Diagnosed with radiologically and biopsy or cytology confirmed inoperable perihilar cholangiocarcinoma Bismuth Tumor Stage III/IV
- Non-menopausal or non-sterile female subjects of childbearing potential must have a negative serum beta-HCG and use a medically acceptable form of birth control
- Able to sign an informed consent
Exclusion Criteria:
- Diagnostic of cholangiocarcinoma made more than 45 days prior to randomization
- Cholangiocarcinoma with extra-hepatic metastasis or concurrent non-solid malignancy
- Presence or history of other neoplasms (treated during the last five years prior to study entry) other than carcinoma in situ of the cervix or basal carcinoma of the skin
- Previously received photodynamic therapy for cholangiocarcinoma
- Previously undergone surgical resection of the cholangiocarcinoma
- Previously undergone chemotherapy, brachytherapy, or radiotherapy prior to entering the study
- Previously undergone metal stent insertion
- Porphyria or hypersensitivity to porphyrins (constituents of porfimer sodium), gemcitabine, cisplatin or other platinum-containing compounds
- Presence of infection other than the infection of the bile duct (cholangitis)
- Acute or chronic medical or psychological illnesses that prevent endoscopy procedures
- Abnormal blood test results
- Severe impairment of your kidney or liver function
- Decompensated cirrhosis
- Pregnant or intend to become pregnant, breastfeeding or intend to breast-feed during this study
- Participated in another drug study within 90 days before this one
- Unable or unwilling to complete the follow-up evaluations required for the study
Sites / Locations
- Western Regional Medical Center, Inc.
- Mayo Clinic Cancer Center
- University of Southern California Keck School of Medicine
- UC Davis Medical Center
- University of Colorado Denver
- Oschner Medical Center
- Henry Ford Health System
- SUNY Downstate Medical Center
- Roswell Park Cancer Institute
- Weill Cornell Medical College
- Columbia University Medical Center
- Duke University Medical Center
- Southwestern Regional Medical Center, Inc.
- Thomas Jefferson University
- Allegheny Center for Digestive Health - AHN ASRI
- Methodist Dallas Medical Center
- Virginia Mason Medical Center
- Providence Sacred Heart Medical Center and Children's Hospital
- St. Michael's Hospital
- CHUM Hôpital St-Luc
- Klinikum Ludwigsburg
- Klinikum Mannheim GmbH
- Johann-Wolfgang-Goethe Universität Frankfurt
- Medizinische Hochschule Hannover
- Universitätsklinikum Essen (AöR)
- Konkuk University Medical Center
- Soonchunhyang University Bucheon Hospital
- Seoul National University Bundang Hospital
- Severance Hospital, Yonsei University Health System
- Seoul National University Hospital
- UniversitätsSpital Zürich
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Photodynamic therapy-Photofrin plus SMC
Standard Medical Care (SMC)
Photodynamic therapy (PDT) involves the i.v. injection of Photofrin followed by the illumination of the tumor using a fiber optic device. Two days after the injection, a laser light (180 J/cm(2)) will be applied to the tumor. A second light application will be given 96-120 hours after Photofrin injection if PDT could not initially be performed on all sides of the tumor. Post illumination, all patients will undergo stenting as part of standard medical care procedure. Up to 3 additional courses of PDT using a light dose of 120 J/cm(2) may be given at 3-month intervals. Standard Medical Care (SMC) is defined as stenting procedure plus chemotherapy regimen.
Standard Medical Care (SMC) is defined as stenting procedure plus chemotherapy regimen. The chemotherapy regimen will comprise gemcitabine (1 000 mg/m(2)) followed by cisplatin (25 mg/m(2)), each administered on days 1 and 8 every 3 weeks (21 day-cycle) for four cycles. An additional 12 weeks of the same chemotherapy regimen may be administered if there is no disease progression or intolerable toxicity.