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EUS-guided Intra-tumour Injection of OncoSil for Locally Advanced Pancreatic Carcinoma.

Primary Purpose

Pancreatic Cancer, Endoscopic Ultrasound

Status
Recruiting
Phase
Phase 2
Locations
Hong Kong
Study Type
Interventional
Intervention
EUS-guided oncosil injection
Sponsored by
Chinese University of Hong Kong
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pancreatic Cancer focused on measuring Pancreatic cancer, Endoscopic ultrasound

Eligibility Criteria

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

Inclusion Criteria:

  1. Study participants are ≥ 18 years of age at screening.
  2. Histologically or cytologically proven adenocarcinoma of the pancreas.
  3. Unresectable locally advanced pancreatic carcinoma. Patients with technically resectable tumours (T1-T3) will also be eligible, if they are deemed unresectable due to medical comorbidities or refusal of surgery.
  4. Pancreatic target tumour diameter ≥ 2.0 cm (shortest axis) to ≤ 6.0 cm (longest axis)
  5. An ECOG Performance Status of 0 to 1 and Karnofsky Performance Status of 80 - 100.
  6. Willing and able to complete study procedures within the study timelines.
  7. Adequate renal function: serum creatinine less than 1.5 x upper limit of normal (ULN).
  8. Adequate liver function: Serum SGOT/AST and serum SGPT/SLT < 3 times ULN and serum bilirubin <1.5 times the ULN unless the patient is known to have prior Gilbert's Syndrome.
  9. Adequate bone marrow function: white blood cells (WBCs) ≥ 3,000/mm3, absolute neutrophil count (ANC) ≥ 1,500/mm3, haemoglobin ≥ 9 g/dL, and platelets ≥ 100,000/mm3.
  10. Life expectancy of at least 3 months at the time of screening as judged by the investigator.
  11. Not pregnant, and if of childbearing potential, agrees to use adequate birth control (hormonal or barrier method of birth control or abstinence) prior to study entry and during the study and agrees not to donate sperm or ova, for the duration of the study and 12 months post implantation of the investigational device.
  12. Provide signed Informed Consent.
  13. Technically feasible - tumour must be within reach of the EUS probe for fine needle Injection.

Exclusion Criteria:

  1. More than one primary lesion.
  2. Any prior radiotherapy or chemotherapy for pancreatic cancer.
  3. Use of other investigational agent at the time of screening, or within 30 days or five half-lives of Screening Visit 1, whichever is longer.
  4. History of malignancy, treated or untreated, within the past five years whether or not there is evidence of local recurrence or metastases, with the exception of basal cell carcinoma of the skin and cervical carcinoma in situ.
  5. Evidence of tumour invasion into stomach, duodenum or peritoneum
  6. In the opinion of the investigator, EUS directed implantation posing undue study participant risk. This includes:

    1. Where previous EUS-FNA was considered technically too difficult to perform;
    2. Imaging demonstrates multiple collateral vessels surrounding or adjacent to the target tumour within the pancreas;
    3. Presence (or significant risk) of varices near to the target tumour.
  7. A known allergy or history of hypersensitivity to silicon, Phosphorus or any of the OncoSil™ components.
  8. Patients who do not consent to chemotherapy
  9. Actively on medication that increase bleeding risk (i.e. aspirin, clopidogrel, warfarin, NOAC).
  10. Any other health condition that would preclude participation in the study in the judgment of the investigator.

Sites / Locations

  • Department of Surgery, Prince of Wales HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

EUS-guided oncosil injection

Arm Description

All patients will receive OncoSilTM during the 4th week of the first chemotherapy cycle.

Outcomes

Primary Outcome Measures

Adverse events
Any untoward medical occurrence, unintended disease or injury, oruntoward clinical signs (including abnormal laboratory findings) in subjects, users or other persons, whether or not related to the investigational medical device

Secondary Outcome Measures

Overall survival
Overall survival of the patient
Local Disease Control Rate
proportion of study participants whose local tumour response is stable disease (SD), partial response (PR), or complete response (CR)
Local Progression Free Survival
the time from enrolment to the date of the radiological scan used to determine local tumour progression or date of death, whichever comes first.
Progression Free Survival
the time from enrolment to the date of tumour progression or of recurrence (in case of complete response (CR))

Full Information

First Posted
November 12, 2021
Last Updated
February 6, 2023
Sponsor
Chinese University of Hong Kong
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1. Study Identification

Unique Protocol Identification Number
NCT05131776
Brief Title
EUS-guided Intra-tumour Injection of OncoSil for Locally Advanced Pancreatic Carcinoma.
Official Title
Concurrent EUS-guided Intra-tumour Injection of OncoSil (32P) With Chemotherapy in Locally Advanced Pancreatic Carcinoma.
Study Type
Interventional

2. Study Status

Record Verification Date
February 2023
Overall Recruitment Status
Recruiting
Study Start Date
November 1, 2021 (Actual)
Primary Completion Date
October 31, 2024 (Anticipated)
Study Completion Date
October 31, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Chinese University of Hong Kong

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The outcomes of concurrent EUS-guided intra-tumour injection of P-32 microparticles (OncoSil; OncoSil Medical, Australia) with chemotherapy in locally advanced pancreatic carcinoma in the local population is uncertain. The aim of the current study is to assess efficacy and safety of the intervention in the local population. We hypothesis that the intervention is safe and useful for tumour downstaging.
Detailed Description
This would be a cohort study including patients with locally advanced pancreatic cancer medically fit to receive chemotherapy. Eligible patients would receive gemcitabine (GNP; 28- day cycles). P-32 microparticles (OncoSil; OncoSil Medical) implantation will be planned at weeks 4-5. P-32 activity will be calculated from patients' tumor volume (TV) to deliver 100 Gy absorbed dose, with implantation assessment by EUS and Bremsstrahlung SPECT/CT imaging. The primary endpoint was safety and tolerability, graded using CTCAE v4.0. Response will be assessed using RECIST 1.1 with 8-weekly CT scans and FDG-PET scans at baseline and week 12. The outcome parameters include adverse events, response of the tumour, local progression free survival and overall survival (OS).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pancreatic Cancer, Endoscopic Ultrasound
Keywords
Pancreatic cancer, Endoscopic ultrasound

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Single Group Assignment
Model Description
OncoSil™ is comprised of OncoSil Phosphorous-32 Microparticles (hereafter Microparticles) and OncoSil Diluent (hereafter Diluent). OncoSil™ is an active implantable (radiological) medical device intended for use in brachytherapy, where cancer is treated by the insertion of radioactive implants directly into the cancerous tissue. OncoSil™ has been designed to be injected directly into, and to deliver an average absorbed dose of 100 Gy to the target treatment tumour. In therapeutic use 98% of the radiation is delivered within 81 days.
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
EUS-guided oncosil injection
Arm Type
Experimental
Arm Description
All patients will receive OncoSilTM during the 4th week of the first chemotherapy cycle.
Intervention Type
Device
Intervention Name(s)
EUS-guided oncosil injection
Intervention Description
All patients will receive OncoSilTM during the 4th week of the first chemotherapy cycle.
Primary Outcome Measure Information:
Title
Adverse events
Description
Any untoward medical occurrence, unintended disease or injury, oruntoward clinical signs (including abnormal laboratory findings) in subjects, users or other persons, whether or not related to the investigational medical device
Time Frame
30 day
Secondary Outcome Measure Information:
Title
Overall survival
Description
Overall survival of the patient
Time Frame
5 years
Title
Local Disease Control Rate
Description
proportion of study participants whose local tumour response is stable disease (SD), partial response (PR), or complete response (CR)
Time Frame
16 week
Title
Local Progression Free Survival
Description
the time from enrolment to the date of the radiological scan used to determine local tumour progression or date of death, whichever comes first.
Time Frame
6 months
Title
Progression Free Survival
Description
the time from enrolment to the date of tumour progression or of recurrence (in case of complete response (CR))
Time Frame
5 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Study participants are ≥ 18 years of age at screening. Histologically or cytologically proven adenocarcinoma of the pancreas. Unresectable locally advanced pancreatic carcinoma. Patients with technically resectable tumours (T1-T3) will also be eligible, if they are deemed unresectable due to medical comorbidities or refusal of surgery. Pancreatic target tumour diameter ≥ 2.0 cm (shortest axis) to ≤ 6.0 cm (longest axis) An ECOG Performance Status of 0 to 1 and Karnofsky Performance Status of 80 - 100. Willing and able to complete study procedures within the study timelines. Adequate renal function: serum creatinine less than 1.5 x upper limit of normal (ULN). Adequate liver function: Serum SGOT/AST and serum SGPT/SLT < 3 times ULN and serum bilirubin <1.5 times the ULN unless the patient is known to have prior Gilbert's Syndrome. Adequate bone marrow function: white blood cells (WBCs) ≥ 3,000/mm3, absolute neutrophil count (ANC) ≥ 1,500/mm3, haemoglobin ≥ 9 g/dL, and platelets ≥ 100,000/mm3. Life expectancy of at least 3 months at the time of screening as judged by the investigator. Not pregnant, and if of childbearing potential, agrees to use adequate birth control (hormonal or barrier method of birth control or abstinence) prior to study entry and during the study and agrees not to donate sperm or ova, for the duration of the study and 12 months post implantation of the investigational device. Provide signed Informed Consent. Technically feasible - tumour must be within reach of the EUS probe for fine needle Injection. Exclusion Criteria: More than one primary lesion. Any prior radiotherapy or chemotherapy for pancreatic cancer. Use of other investigational agent at the time of screening, or within 30 days or five half-lives of Screening Visit 1, whichever is longer. History of malignancy, treated or untreated, within the past five years whether or not there is evidence of local recurrence or metastases, with the exception of basal cell carcinoma of the skin and cervical carcinoma in situ. Evidence of tumour invasion into stomach, duodenum or peritoneum In the opinion of the investigator, EUS directed implantation posing undue study participant risk. This includes: Where previous EUS-FNA was considered technically too difficult to perform; Imaging demonstrates multiple collateral vessels surrounding or adjacent to the target tumour within the pancreas; Presence (or significant risk) of varices near to the target tumour. A known allergy or history of hypersensitivity to silicon, Phosphorus or any of the OncoSil™ components. Patients who do not consent to chemotherapy Actively on medication that increase bleeding risk (i.e. aspirin, clopidogrel, warfarin, NOAC). Any other health condition that would preclude participation in the study in the judgment of the investigator.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Anthony YB Teoh, FRCSEd
Phone
35052956
Email
anthonyteoh@surgery.cuhk.edu.hk
First Name & Middle Initial & Last Name or Official Title & Degree
Zero Chung
Phone
35052956
Email
zerochung@surgery.cuhk.edu.hk
Facility Information:
Facility Name
Department of Surgery, Prince of Wales Hospital
City
Hong Kong
Country
Hong Kong
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Anthony YB Teoh, FRCSEd(Gen)
Phone
35052956
Email
anthonyteoh@surgery.cuhk.edu.hk
First Name & Middle Initial & Last Name & Degree
Anthony YB Teoh

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
No plan
Citations:
PubMed Identifier
18266048
Citation
Rosemurgy A, Luzardo G, Cooper J, Bowers C, Zervos E, Bloomston M, Al-Saadi S, Carroll R, Chheda H, Carey L, Goldin S, Grundy S, Kudryk B, Zwiebel B, Black T, Briggs J, Chervenick P. 32P as an adjunct to standard therapy for locally advanced unresectable pancreatic cancer: a randomized trial. J Gastrointest Surg. 2008 Apr;12(4):682-8. doi: 10.1007/s11605-007-0430-6. Epub 2008 Feb 12.
Results Reference
result

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EUS-guided Intra-tumour Injection of OncoSil for Locally Advanced Pancreatic Carcinoma.

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