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Clinical Trial Details — Status: Not yet recruiting

Administrative data

NCT number NCT02732483
Other study ID # 4-2016-0031
Secondary ID
Status Not yet recruiting
Phase Phase 2
First received March 27, 2016
Last updated April 4, 2016
Start date April 2016
Est. completion date April 2018

Study information

Verified date April 2016
Source Yonsei University
Contact Jun Chul Park, MD
Phone + 82-2-2228-2272
Email JUNCHUL75@yuhs.ac
Is FDA regulated No
Health authority Korea: Institutional Review Board
Study type Interventional

Clinical Trial Summary

Gastrointestinal(GI) hemorrhage related with gastric cancer is prevalent in advanced cases mostly. As endoscopic hemostatic methods such as argon plasma ablation (APC) had developed, controlling GI hemorrhage in gastric cancer is much easier these days. but re-bleeding rate is still high, even after successful hemostasis with APC or electrical coagulation. Furthermore patients who were experienced re-bleeding are expected poorer survival outcomes than those who are not. So excellent bleeding control in gastric cancer is most important in GI hemorrhage of gastric cancer.

Recently developed hemostatic powder [Endo-Clot(TM)] is easy to use and have proven its usefulness in GI hemorrhage in peptic ulcer diseases. So in this study, investigator will try to find out feasibility & safety of Endo-Clot(TM) in GI hemorrhage in gastric cancer.


Recruitment information / eligibility

Status Not yet recruiting
Enrollment 32
Est. completion date April 2018
Est. primary completion date April 2018
Accepts healthy volunteers No
Gender Both
Age group 19 Years to 80 Years
Eligibility Inclusion Criteria:

- Age over 19 and less 80 yeas old

- Gastric cancer was diagnosed with biopsy and/or computed tomography

- Endoscopic hemostasis is needed upto GI hemorrhage

- Endoscopic examination is available in 24hours

- ECOG performance status(PS) <2

Exclusion Criteria:

- Double primary caner

- Hypersensitivity of hemostatic power[Endo-Clot(TM)]

- Variceal bleeding or benign gastric ulcer bleeding

- Hemodynamically unstable with low systolic BP<90mmHg and/or tachycardia PR>120bpm

- endoscopic hemostasis within 7 days before screening

- Contraindication for endoscopic examination

- Pregnant

- Breast feeding

- bleeding tendency with low platelet count <50,000 /mm^3 and/or INR>2

- Bacterial infection with needs for antibiotics therapy

- Unavailable to discontinue anti-coagulation agent for 3days

- Vascular shunt

- Cardiovascular and/or pulmonary diseases

- Active hepatitis or severe liver diseases

- Renal dysfunction

- Bone marrow dysfunction

- Neurologic deficit and/or psychotic feature

- Unavailable informed consent

Study Design

Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment


Related Conditions & MeSH terms


Intervention

Drug:
Endo-Clot(TM)
The patients agreed in this study, bleeding control will going to be done with Endo-Clot(TM)

Locations

Country Name City State
Korea, Republic of Department of Internal Medicine, Seoul

Sponsors (1)

Lead Sponsor Collaborator
Yonsei University

Country where clinical trial is conducted

Korea, Republic of, 

References & Publications (16)

Asakura H, Hashimoto T, Harada H, Mizumoto M, Furutani K, Hasuike N, Matsuoka M, Ono H, Boku N, Nishimura T. Palliative radiotherapy for bleeding from advanced gastric cancer: is a schedule of 30 Gy in 10 fractions adequate? J Cancer Res Clin Oncol. 2011 — View Citation

Bustamante-Balén M, Plumé G. Role of hemostatic powders in the endoscopic management of gastrointestinal bleeding. World J Gastrointest Pathophysiol. 2014 Aug 15;5(3):284-92. doi: 10.4291/wjgp.v5.i3.284. Review. — View Citation

Chaw CL, Niblock PG, Chaw CS, Adamson DJ. The role of palliative radiotherapy for haemostasis in unresectable gastric cancer: a single-institution experience. Ecancermedicalscience. 2014 Jan 10;8:384. doi: 10.3332/ecancer.2014.384. eCollection 2014. — View Citation

Hashimoto K, Mayahara H, Takashima A, Nakajima TE, Kato K, Hamaguchi T, Ito Y, Yamada Y, Kagami Y, Itami J, Shimada Y. Palliative radiation therapy for hemorrhage of unresectable gastric cancer: a single institute experience. J Cancer Res Clin Oncol. 2009 — View Citation

Huang R, Pan Y, Hui N, Guo X, Zhang L, Wang X, Zhang R, Luo H, Zhou X, Tao Q, Liu Z, Wu K. Polysaccharide hemostatic system for hemostasis management in colorectal endoscopic mucosal resection. Dig Endosc. 2014 Jan;26(1):63-8. doi: 10.1111/den.12054. Epub — View Citation

Isobe Y, Nashimoto A, Akazawa K, Oda I, Hayashi K, Miyashiro I, Katai H, Tsujitani S, Kodera Y, Seto Y, Kaminishi M. Gastric cancer treatment in Japan: 2008 annual report of the JGCA nationwide registry. Gastric Cancer. 2011 Oct;14(4):301-16. doi: 10.1007 — View Citation

Kim MM, Rana V, Janjan NA, Das P, Phan AT, Delclos ME, Mansfield PF, Ajani JA, Crane CH, Krishnan S. Clinical benefit of palliative radiation therapy in advanced gastric cancer. Acta Oncol. 2008;47(3):421-7. — View Citation

Kim SB, Lee SH, Kim KO, Jang BI, Kim TN, Jeon SW, Kwon JG, Kim EY, Jung JT, Park KS, Cho KB, Kim ES, Kim HJ, Park CK, Park JB, Yang CH. Risk Factors Associated with Rebleeding in Patients with High Risk Peptic Ulcer Bleeding: Focusing on the Role of Secon — View Citation

Kim YI, Choi IJ, Cho SJ, Lee JY, Kim CG, Kim MJ, Ryu KW, Kim YW, Park YI. Outcome of endoscopic therapy for cancer bleeding in patients with unresectable gastric cancer. J Gastroenterol Hepatol. 2013 Sep;28(9):1489-95. doi: 10.1111/jgh.12262. — View Citation

Lasithiotakis K, Antoniou SA, Antoniou GA, Kaklamanos I, Zoras O. Gastrectomy for stage IV gastric cancer. a systematic review and meta-analysis. Anticancer Res. 2014 May;34(5):2079-85. Review. — View Citation

Lee HJ, Yang HK, Ahn YO. Gastric cancer in Korea. Gastric Cancer. 2002;5(3):177-82. Review. — View Citation

Ono S, Ono M, Nakagawa M, Shimizu Y, Kato M, Sakamoto N. Delayed bleeding and hemorrhage of mucosal defects after gastric endoscopic submucosal dissection on second-look endoscopy. Gastric Cancer. 2015 Jun 19. [Epub ahead of print] — View Citation

Romera Barba E, Castañer Ramón-Llín J, Sánchez Pérez A, García Marcilla JA, Vázquez Rojas JL. Transcatheter arterial embolization in the management of acute bleeding from advanced gastric cancer. Cir Esp. 2014 Aug-Sep;92(7):492-4. doi: 10.1016/j.ciresp.20 — View Citation

Sheibani S, Kim JJ, Chen B, Park S, Saberi B, Keyashian K, Buxbaum J, Laine L. Natural history of acute upper GI bleeding due to tumours: short-term success and long-term recurrence with or without endoscopic therapy. Aliment Pharmacol Ther. 2013 Jul;38(2 — View Citation

Tey J, Choo BA, Leong CN, Loy EY, Wong LC, Lim K, Lu JJ, Koh WY. Clinical outcome of palliative radiotherapy for locally advanced symptomatic gastric cancer in the modern era. Medicine (Baltimore). 2014 Nov;93(22):e118. doi: 10.1097/MD.0000000000000118. — View Citation

Thrumurthy SG, Chaudry MA, Hochhauser D, Mughal M. The diagnosis and management of gastric cancer. BMJ. 2013 Nov 4;347:f6367. doi: 10.1136/bmj.f6367. Review. — View Citation

* Note: There are 16 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary Rebleeding rate Proportion of patients who are experience rebleeding events after hemostasis within 30 days expected to be lower than 10 %.
Definition rebleeding events 1. Overt symptoms of GI bleeding(such as hematemesis, melena) and/or Hemoglobin down more than 2g/dl compared to Hemoglobin level which were checked just after procedure.
within 30 days No
Secondary Success of bleeding control rate Proportion of patients who are experience successful hemostasis is expected to be higher than 80 %applying Endo-Clotâ„¢, Rebleeding rate in 3days, rate of additional intervention other than initial endoscopic hemostasis, Mortalities within 2 weeks and 4 weeks No
Secondary Rebleeding rate Proportion of patients experience rebleeding events after hemostasis within 3 days expected to be lower than 5 %. Definition of Rebleeding rate in 3days 1. Overt symptoms of GI bleeding(such as hematemesis, melena) and/or Hemoglobin down more than 2g/dl compared to Hemoglobin level which were checked just after procedure. in 3 days No
Secondary Rate of additional intervention other than initial endoscopic hemostasis Definition of Successful hemostasis; controlled bleeding vessel in 5 minute after applying Endo-Clotâ„¢ within 2 weeks to 4 weeks No
Secondary Mortalities within 2 weeks to 4 weeks No