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POWER Study (Prospective Transbronchial Microwave + Robotic-Assisted Bronchoscopy)

Primary Purpose

Lung Neoplasms

Status
Recruiting
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Transbronchial Microwave Ablation
Sponsored by
Ethicon, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Lung Neoplasms

Eligibility Criteria

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

INCLUSION CRITERIA:

  • Signed informed consent.
  • Subjects greater or equal to 22 years old.
  • Performance status 0-2 (Eastern Cooperative Oncology Group classification (ECOG).
  • Willing to fulfill all follow-up visit requirements.
  • Subjects with at least one oligometastatic lung tumor where the primary tumor is controlled (in the opinion of the investigator or treating oncologist).
  • Oligometastatic lung tumor(s) planned to be ablated in the outer two-thirds of the lung and not closer than 1cm to the pleura.

EXCLUSION CRITERIA:

  • Pregnant or breastfeeding.
  • Subjects with thoracic implantable devices, including pacemakers or other electronic implants.
  • Chronic, continuous ventilator support, which uses bi-level positive airway pressure (PAP) to improve lung function for severe conditions. (However, intermittent PAP, for non-pulmonary conditions, such as sleep apnea, is permitted).
  • Prior pneumonectomy.
  • Severe bronchiectasis (with FEV1 <30%) or disease deemed to be too severe in the opinion of the investigator.
  • Platelet count ≤ 50,000/mm3.
  • Subjects with uncorrectable coagulopathy at time of screening.
  • Subjects medically unable to stop anti-platelet agents (e.g., aspirin, clopidogrel, prasugrel, ticagrelor) at least 5 days prior to the procedure through 48-72 hours after the procedure.
  • Subjects medically unable to stop warfarin at least 3-5 days prior to the ablation procedure, or until INR < 1.5, through 48-72 hours after the procedure. On the day of the procedure, subjects with an INR > 1.5 cannot have the procedure completed that day but may be rescheduled or postponed.
  • Subjects medically unable to stop anticoagulants (e.g., rivaroxaban, apixaban, dabigatran, endoxaban) at least 3 days prior to the ablation procedure through 48-72 hours after the procedure.
  • Expected survival less than 6 months in the opinion of the investigator and/or treating oncologist.
  • Subjects with known or suspected brain metastases.
  • Subject has had any radiation (i.e., SBRT or EBRT) to the intended ablation zone.
  • Endobronchial tumors proximal to and including the segmental airways.
  • Lung ablation, surgical resection therapy, radiotherapy, or any other treating procedure within 30 days prior to the planned study ablation procedure or those who plan to receive a lung ablation, surgical resection, or radiation therapy on the ablated lung side before completing the primary endpoint assessment (30 days post-ablation).
  • Systemic therapy (e.g., chemotherapy, targeted drug therapy, or immunotherapy) within 14 days prior to the planned study ablation procedure or those who plan to receive systemic therapy before completing the primary endpoint assessment (30 days post-ablation).

Sites / Locations

  • Stanford University School of MedicineRecruiting
  • UCONN HealthRecruiting
  • Minnesota Lung CenterRecruiting
  • FirstHealth Moore Regional HospitalRecruiting
  • Cleveland ClinicRecruiting
  • University of PennsylvaniaRecruiting
  • MD AndersonRecruiting
  • University of Toronto
  • Centre Hospitalier de l'Universite de MontrealRecruiting
  • Prince of Wales HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Transbronchial Microwave Ablation

Arm Description

Transbronchial microwave ablation will be performed using the NEUWAVE FLEX Microwave Ablation System and Accessories on oligometastatic tumors in the peripheral lung, guided by the Auris MONARCH Platform for visualization and access while using cone beam CT (computed tomography) to confirm probe tip placement and final ablation zone.

Outcomes

Primary Outcome Measures

Technique Efficacy
Ablation of the target tumor(s) with the ablation zone completely overlapping or encompassing the entire target tumor(s) using CT imaging.

Secondary Outcome Measures

Technical Success
A complete tumor ablation with a surrounding minimal margin as assessed by cone beam CT imaging.
Navigational Success
Successful navigation to the targeted peripheral lung tumor(s) as confirmed using cone beam CT.
Local Tumor Progression
Recurrence of the originally ablated target tumor(s) within or abutting the ablation zone using the 30-day post-ablation imaging as the baseline.
Local Tumor Progression Free Survival
Time from the ablation until local tumor(s) progression or death, whichever occurs first.
Progression Free Survival
Time from the original ablation until tumor(s) progression or death, whichever occurs first (includes local, regional, or distant progression).
Disease (cancer) Specific Survival
Time from the original ablation until death from the treated primary malignancy.
Overall Survival
Time from the original ablation until subject death (includes death from any cause).
Repeat Ablation Efficacy Rate
Rate of original tumors that have been re-ablated successfully (i.e., Technical Success of tumors that have been re-ablated out of all original tumors that have been re-ablated).
Change in Pulmonary Function Tests (Spirometry I)
Change in all available (i.e., what is site standard-of-care) spirometry tests from pre-ablation baseline values to values at 3-months, 6-months, and 12-months post-ablation. Spirometry tests are non-invasive and measure how much air one can breathe in and out of one's lungs, as well as how easily and fast one can the blow the air out of one's lungs. These tests include FVC (forced vital capacity, % of predicted), FEV1 (forced expiratory volume, % of predicted), FEV1/FVC (% ratio), and FEV 25-75 (average flow at which 25% has been exhaled through the point which 75% has been exhaled), all of which are expressed as a percentage.
Change in Pulmonary Function Tests (Spirometry II)
Change in peak expiratory flow and maximum ventilation volume spirometry tests from pre-ablation baseline values to values at 3-months, 6-months, and 12-months post-ablation. Peak Expiratory Flow is the maximal rate that one can exhale during a short maximal expiratory effort after a full inspiration and Maximum Ventilation Volume is the maximum minute volume of ventilation that one can maintain for 12-15 seconds. Both tests are expressed as L/min.
Change in Pulmonary Function Tests (Diffusion Capacity)
Change in diffusion capacity from the pre-ablation baseline value to values at 3-months, 6-months, and 12-months post-ablation. The diffusion capacity test measures the volume of carbon monoxide transferred from the lung to blood and is measured in ml/min/mmHg and put into a percentage (% of predicted).
Change in Pulmonary Function Tests (Lung Volume)
Change in lung volume from the pre-ablation baseline values to values at 3-months, 6-months, and 12-months post-ablation. The lung volume tests include plethysmographic TLC (total lung capacity), plethysmographic FRC (functional residual capacity), plethysmographic RV (residual volume), gas dilution TLC, gas dilution FRC, and gas dilution RV. A plethysmograph measures changes in volume within an organ and a gas dilution test may determine lung volumes that cannot be determined from simple spirometry. All assessments are collected in liters (L) and put into a percentage (% of predicted).
Change in EORTC QLQ-C30
Change in quality of life scores per the validated EORTC (European Organization for Research and Treatment of Cancer) QLQ-C30 questionnaire from pre-ablation baseline scores to scores at 3-months, 6-months, and 12-months post-ablation. The questionnaire asks cancer patients to choose a response that most closely describes them for 30 questions on a scale from 1-4 (1 being 'not at all', 2 being 'a little', 3 being 'quite a bit' and 4 being 'very much). The 30 questions are separated into sections for 'general quality of life', 'during the past week', and 'overall health and quality of life'.
Change in EORTC QLQ-LC13
Change in quality of life scores per the validated EORTC (European Organization for Research and Treatment of Cancer) QLQ-LC13 questionnaire from pre-ablation baseline scores to scores at 3-months, 6-months, and 12-months post-ablation. The questionnaire asks lung-cancer patients to choose a response that most closely describes them for 13 questions on a scale from 1-4 (1 being 'not at all', 2 being 'a little', 3 being 'quite a bit' and 4 being 'very much). The 13 questions are all about symptoms and problems experienced during the past week.

Full Information

First Posted
March 3, 2022
Last Updated
October 9, 2023
Sponsor
Ethicon, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT05299606
Brief Title
POWER Study (Prospective Transbronchial Microwave + Robotic-Assisted Bronchoscopy)
Official Title
A Prospective Multicenter Study of Transbronchial Microwave Ablation Using Robotic-Assisted Bronchoscopy in Subjects With Oligometastatic Tumors in the Lung
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
October 24, 2022 (Actual)
Primary Completion Date
January 31, 2025 (Anticipated)
Study Completion Date
December 31, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ethicon, Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Device Product Not Approved or Cleared by U.S. FDA
Yes
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a prospective, multicenter, single-arm study on transbronchial microwave ablation using the NEUWAVE FLEX Microwave Ablation System and Accessories on oligometastatic tumors in the peripheral lung, guided by the Auris MONARCH Platform for visualization and access while using cone beam CT (computed tomography) to confirm probe tip placement and final ablation zone. The primary endpoint is Technique Efficacy, assessed 30-days post-ablation via CT imaging.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Lung Neoplasms

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Transbronchial Microwave Ablation
Arm Type
Experimental
Arm Description
Transbronchial microwave ablation will be performed using the NEUWAVE FLEX Microwave Ablation System and Accessories on oligometastatic tumors in the peripheral lung, guided by the Auris MONARCH Platform for visualization and access while using cone beam CT (computed tomography) to confirm probe tip placement and final ablation zone.
Intervention Type
Device
Intervention Name(s)
Transbronchial Microwave Ablation
Intervention Description
Transbronchial microwave ablation will be performed using the NEUWAVE FLEX Microwave Ablation System and Accessories on oligometastatic tumors in the peripheral lung, guided by the Auris MONARCH Platform for visualization and access while using cone beam CT (computed tomography) to confirm probe tip placement and final ablation zone.
Primary Outcome Measure Information:
Title
Technique Efficacy
Description
Ablation of the target tumor(s) with the ablation zone completely overlapping or encompassing the entire target tumor(s) using CT imaging.
Time Frame
30 days (-7 to +14 days) post-ablation
Secondary Outcome Measure Information:
Title
Technical Success
Description
A complete tumor ablation with a surrounding minimal margin as assessed by cone beam CT imaging.
Time Frame
Immediately post-ablation (day 0)
Title
Navigational Success
Description
Successful navigation to the targeted peripheral lung tumor(s) as confirmed using cone beam CT.
Time Frame
During navigation (day 0)
Title
Local Tumor Progression
Description
Recurrence of the originally ablated target tumor(s) within or abutting the ablation zone using the 30-day post-ablation imaging as the baseline.
Time Frame
12-month visit
Title
Local Tumor Progression Free Survival
Description
Time from the ablation until local tumor(s) progression or death, whichever occurs first.
Time Frame
12-month visit
Title
Progression Free Survival
Description
Time from the original ablation until tumor(s) progression or death, whichever occurs first (includes local, regional, or distant progression).
Time Frame
12-month visit
Title
Disease (cancer) Specific Survival
Description
Time from the original ablation until death from the treated primary malignancy.
Time Frame
12-month visit
Title
Overall Survival
Description
Time from the original ablation until subject death (includes death from any cause).
Time Frame
12-month visit
Title
Repeat Ablation Efficacy Rate
Description
Rate of original tumors that have been re-ablated successfully (i.e., Technical Success of tumors that have been re-ablated out of all original tumors that have been re-ablated).
Time Frame
12-month visit
Title
Change in Pulmonary Function Tests (Spirometry I)
Description
Change in all available (i.e., what is site standard-of-care) spirometry tests from pre-ablation baseline values to values at 3-months, 6-months, and 12-months post-ablation. Spirometry tests are non-invasive and measure how much air one can breathe in and out of one's lungs, as well as how easily and fast one can the blow the air out of one's lungs. These tests include FVC (forced vital capacity, % of predicted), FEV1 (forced expiratory volume, % of predicted), FEV1/FVC (% ratio), and FEV 25-75 (average flow at which 25% has been exhaled through the point which 75% has been exhaled), all of which are expressed as a percentage.
Time Frame
12-month visit
Title
Change in Pulmonary Function Tests (Spirometry II)
Description
Change in peak expiratory flow and maximum ventilation volume spirometry tests from pre-ablation baseline values to values at 3-months, 6-months, and 12-months post-ablation. Peak Expiratory Flow is the maximal rate that one can exhale during a short maximal expiratory effort after a full inspiration and Maximum Ventilation Volume is the maximum minute volume of ventilation that one can maintain for 12-15 seconds. Both tests are expressed as L/min.
Time Frame
12-month visit
Title
Change in Pulmonary Function Tests (Diffusion Capacity)
Description
Change in diffusion capacity from the pre-ablation baseline value to values at 3-months, 6-months, and 12-months post-ablation. The diffusion capacity test measures the volume of carbon monoxide transferred from the lung to blood and is measured in ml/min/mmHg and put into a percentage (% of predicted).
Time Frame
12-month visit
Title
Change in Pulmonary Function Tests (Lung Volume)
Description
Change in lung volume from the pre-ablation baseline values to values at 3-months, 6-months, and 12-months post-ablation. The lung volume tests include plethysmographic TLC (total lung capacity), plethysmographic FRC (functional residual capacity), plethysmographic RV (residual volume), gas dilution TLC, gas dilution FRC, and gas dilution RV. A plethysmograph measures changes in volume within an organ and a gas dilution test may determine lung volumes that cannot be determined from simple spirometry. All assessments are collected in liters (L) and put into a percentage (% of predicted).
Time Frame
12-month visit
Title
Change in EORTC QLQ-C30
Description
Change in quality of life scores per the validated EORTC (European Organization for Research and Treatment of Cancer) QLQ-C30 questionnaire from pre-ablation baseline scores to scores at 3-months, 6-months, and 12-months post-ablation. The questionnaire asks cancer patients to choose a response that most closely describes them for 30 questions on a scale from 1-4 (1 being 'not at all', 2 being 'a little', 3 being 'quite a bit' and 4 being 'very much). The 30 questions are separated into sections for 'general quality of life', 'during the past week', and 'overall health and quality of life'.
Time Frame
12-month visit
Title
Change in EORTC QLQ-LC13
Description
Change in quality of life scores per the validated EORTC (European Organization for Research and Treatment of Cancer) QLQ-LC13 questionnaire from pre-ablation baseline scores to scores at 3-months, 6-months, and 12-months post-ablation. The questionnaire asks lung-cancer patients to choose a response that most closely describes them for 13 questions on a scale from 1-4 (1 being 'not at all', 2 being 'a little', 3 being 'quite a bit' and 4 being 'very much). The 13 questions are all about symptoms and problems experienced during the past week.
Time Frame
12-month visit

10. Eligibility

Sex
All
Minimum Age & Unit of Time
22 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
INCLUSION CRITERIA: Signed informed consent. Subjects greater or equal to 22 years old. Performance status 0-2 (Eastern Cooperative Oncology Group classification (ECOG). Willing to fulfill all follow-up visit requirements. Subjects with at least one oligometastatic lung tumor where the primary tumor is controlled (in the opinion of the investigator or treating oncologist). Oligometastatic lung tumor(s) planned to be ablated in the outer two-thirds of the lung and not closer than 1cm to the pleura. EXCLUSION CRITERIA: Pregnant or breastfeeding. Subjects with thoracic implantable devices, including pacemakers or other electronic implants. Chronic, continuous ventilator support, which uses bi-level positive airway pressure (PAP) to improve lung function for severe conditions. (However, intermittent PAP, for non-pulmonary conditions, such as sleep apnea, is permitted). Prior pneumonectomy. Severe bronchiectasis (with FEV1 <30%) or disease deemed to be too severe in the opinion of the investigator. Platelet count ≤ 50,000/mm3. Subjects with uncorrectable coagulopathy at time of screening. Subjects medically unable to stop anti-platelet agents (e.g., aspirin, clopidogrel, prasugrel, ticagrelor) at least 5 days prior to the procedure through 48-72 hours after the procedure. Subjects medically unable to stop warfarin at least 3-5 days prior to the ablation procedure, or until INR < 1.5, through 48-72 hours after the procedure. On the day of the procedure, subjects with an INR > 1.5 cannot have the procedure completed that day but may be rescheduled or postponed. Subjects medically unable to stop anticoagulants (e.g., rivaroxaban, apixaban, dabigatran, endoxaban) at least 3 days prior to the ablation procedure through 48-72 hours after the procedure. Expected survival less than 6 months in the opinion of the investigator and/or treating oncologist. Subjects with known or suspected brain metastases. Subject has had any radiation (i.e., SBRT or EBRT) to the intended ablation zone. Endobronchial tumors proximal to and including the segmental airways. Lung ablation, surgical resection therapy, radiotherapy, or any other treating procedure within 30 days prior to the planned study ablation procedure or those who plan to receive a lung ablation, surgical resection, or radiation therapy on the ablated lung side before completing the primary endpoint assessment (30 days post-ablation). Systemic therapy (e.g., chemotherapy, targeted drug therapy, or immunotherapy) within 14 days prior to the planned study ablation procedure or those who plan to receive systemic therapy before completing the primary endpoint assessment (30 days post-ablation).
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Erin Meyers, MBA
Phone
937-681-0322
Email
eprifog1@its.jnj.com
Facility Information:
Facility Name
Stanford University School of Medicine
City
Stanford
State/Province
California
ZIP/Postal Code
94305
Country
United States
Individual Site Status
Recruiting
Facility Name
UCONN Health
City
Farmington
State/Province
Connecticut
ZIP/Postal Code
06030
Country
United States
Individual Site Status
Recruiting
Facility Name
Minnesota Lung Center
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55407
Country
United States
Individual Site Status
Recruiting
Facility Name
FirstHealth Moore Regional Hospital
City
Pinehurst
State/Province
North Carolina
ZIP/Postal Code
28374
Country
United States
Individual Site Status
Recruiting
Facility Name
Cleveland Clinic
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Individual Site Status
Recruiting
Facility Name
University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Individual Site Status
Recruiting
Facility Name
MD Anderson
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Individual Site Status
Recruiting
Facility Name
University of Toronto
City
Toronto
State/Province
Ontario
Country
Canada
Individual Site Status
Not yet recruiting
Facility Name
Centre Hospitalier de l'Universite de Montreal
City
Montreal
State/Province
Quebec
Country
Canada
Individual Site Status
Recruiting
Facility Name
Prince of Wales Hospital
City
Sha Tin
Country
Hong Kong
Individual Site Status
Recruiting

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Johnson & Johnson Medical Device Companies have an agreement with the Yale Open Data Access (YODA) Project to serve as the independent review panel for evaluation of requests for clinical study reports and participant level data from investigators and physicians for scientific research that will advance medical knowledge and public health. Requests for access to the study data can be submitted through the YODA Project site at http://yoda.yale.edu.
IPD Sharing URL
http://yoda.yale.edu

Learn more about this trial

POWER Study (Prospective Transbronchial Microwave + Robotic-Assisted Bronchoscopy)

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