A Treatment of Unresectable Hepatocellular Carcinoma With TheraSphere®

Hepatocellular Carcinoma Clinical Trial

Official title:

A Treatment of Unresectable Hepatocellular Carcinoma With TheraSphere®

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00877136
• Other study ID #: 08-029 TheraSphere®
• Status: Completed
• Start date: February 2009
• Est. completion date: March 2021

Study information

• Verified date: April 2021
• Source: St. Joseph Hospital of Orange
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

This is an interdisciplinary study that falls into the Humanitarian Use Device category. There are no hypotheses to be tested in this treatment protocol. The study has the following objectives:

1. Provide supervised access to treatment with TheraSphere® to eligible patients with primary cancer to the liver who are not surgical resection candidates.

2. Evaluate patient experience and toxicities associated with TheraSphere® treatment.

3. Measure tumor response rates

Description:

The purpose of this protocol is to provide supervised access at this institution to TheraSphere® treatment for a heterogeneous population of patients with unresectable primary liver tumors, with the liver being the only dominant site of disease. Based on experience gained in previous studies and well-established interventional radiology techniques, this protocol allows multiple treatments with TheraSphere® that may be delivered on an inpatient or out patient basis. Patients may receive a single dose to the whole liver, or lobar treatment delivered as a sequence of treatments approximately 30 - 90 days apart. The investigator, working with co-investigators in radiation oncology, interventional radiology and nuclear medicine, will develop a specific treatment plan for each patient, based upon the presenting condition of the patient, the vascular anatomy, and the desired goal of treatment.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 18
• Est. completion date: March 2021
• Est. primary completion date: February 2015
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Confirmed diagnosis of hepatocellular carcinoma. The histopathology confirmation criterion may be waived in patients with a radiographically identifiable liver mass with known laboratory or clinical risk factors for cancer or elevated tumor markers such as AFP (clinical diagnosis)

• Surgical evaluation must conclude the patient is not a candidate for resection or ablation.

• ECOG Performance Status Score 0 - 2.

• Age 18 years or older.

• Able to comprehend and provide written informed consent in accordance with institutional and federal guidelines.

Exclusion Criteria:

Any pre-treatment laboratory findings within 15 days of treatment demonstrating:

• Absolute granulocyte count less than or equal to 1,500/ul

• Uncorrected Platelet count less than or equal to 75,000/ul

• Serum creatinine greater than or equal to 3.0 mg/dl

• Serum bilirubin greater than or equal to 2.0 mg/dl

• Any of the following contraindications to angiography and selective visceral catheterization, 1.)History of severe allergy or intolerance to any contrast media, narcotics, sedatives, or atropine, 2.) Bleeding diathesis, not correctable by usual forms of therapy, and/or 3.) Severe peripheral vascular disease that would preclude catheterization.

• Portal hypertension with portal venous shunt away from the liver.

• Evidence of potential delivery of greater than 16.5 mCi (30 Gy absorbed dose) of radiation to the lungs on either: 1) first TheraSphere® administration; or 2) cumulative delivery of radiation to the lungs > 30 Gy over multiple treatments.

• Evidence of any detectable Tc-99m MAA flow to the stomach or duodenum, after application of established angiographic techniques to stop such flow.

• Significant extrahepatic disease representing an imminent life-threatening outcome.

• Severe liver dysfunction (Childs' Classification C) or pulmonary insufficiency (requiring continuous oxygen therapy).

• Active uncontrolled infection

• Significant underlying medical or psychiatric illness.

• Pregnant women may not participate.

• Children may not participate due to lack of clinical experience.

Related Conditions & MeSH terms

• Carcinoma
• Carcinoma, Hepatocellular
• Hepatocellular Carcinoma
• Hepatoma
• Liver Neoplasms
• Liver Tumors
• Neoplasms

Intervention

Device:
• TheraSphere®
TheraSphere® consists of insoluble glass microspheres where yttrium-90 is an integral constituent of the glass. TheraSphere® is delivered into the liver tumor through a catheter placed into the hepatic artery. This artery provides the main blood supply to the tumor in the liver. TheraSphere® being unable to traverse the tumor vasculature is embolized within the tumor and exerts a local beta radiation radiotherapeutic effect with relatively limited concurrent injury to surrounding normal tissue.

Locations

Country	Name	City	State
United States	The Center for Cancer Prevention & Treatment at St. Joseph Hospital of Orange	Orange	California

Sponsors (1)

Lead Sponsor	Collaborator
St. Joseph Hospital of Orange

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Number of patients given access to treatment with TheraSphere.	The number of eligible patients provided with supervised access to treatment with TheraSphere with primary cancer to the liver who are not surgical resection candidates.	24 months
Primary	Evaluate patient experience with Therasphere.	Evaluation of patient experience and toxicities associated with Therasphere via patient follow-ups with clinician notes.	24 months
Secondary	Tumor response to treatment with TheraSphere®	Diagnostic imaging studies for assessment of tumor response will be performed according to usual standard of care as established by the referring oncologist.	24 Months