Hilar Cholangiocarcinoma Clinical Trial
Official title:
Multicenter, Open-label, Randomized, Controlled Phase III Clinical Study of the Efficacy and Safety of Photodynamic Therapy Using Porfimer Sodium for Injection as Treatment for Unresectable Advanced Perihilar Cholangiocarcinoma
Photodynamic therapy (PDT) is a combination of a drug, porfimer sodium (Photofrin), which is
activated by a light from a laser that emits no heat. This technique works to allow the
medical doctor to specifically target and destroy abnormal or cancer cells while limiting
damage to surrounding healthy tissue. The activation of the drug is done by lighting the
abnormal areas using a fiber optic device (very fine fiber like a fishing line that permits
light transmission) inserted into a flexible tube with a light called cholangioscope for the
bile duct. The light will activate the porfimer sodium concentrated in the abnormal tissue,
leading to its destruction.
This research study will evaluate the efficacy and safety of PDT with porfimer sodium
administered with Standard Medical Care (SMC) compared to SMC alone on the overall survival
time of patients with non-operable advanced cholangiocarcinoma, a rare cancer of the bile
ducts. It will involve 200 patients across North America and Europe. Other countries may
participate if needed. Participation will last at least 18 months.
Photodynamic therapy (PDT) is a combination of a drug, porfimer sodium (Photofrin), which is
activated by a light from a laser that emits no heat. This technique works to allow the
medical doctor to specifically target and destroy abnormal or cancer cells while limiting
damage to surrounding healthy tissue. The activation of the drug is done by lighting the
abnormal areas using a fiber optic device (very fine fiber like a fishing line that permits
light transmission) inserted into a flexible tube with a light called cholangioscope for the
bile duct. The light will activate the porfimer sodium concentrated in the abnormal tissue,
leading to its destruction.
Cholangiocarcinoma (CCA) is defined as primary malignant tumors of the bile ducts. The exact
etiology remains unknown. These cancerous tumors block the bile flow and can be intrahepatic
(IH) or extrahepatic (EH). The distinction between IH- and EH-CCA has become increasingly
important, as the epidemiological features (i.e., incidence and risk factors), the biologic
and pathologic characteristics and the clinical course are largely different. Unfortunately,
most subjects are found to have metastases or unresectable disease at the time of diagnosis.
Median survival for subjects with unresectable perihilar-CCA varies between five and eight
months. The one-year survival is 50%, with 20% surviving at two years and 10% at three years.
Unresected CCA is a rapidly fatal process with cholangitis being a significant cause of
morbidity and mortality in these subjects.
This study was designed to confirm the efficacy of PHOPDT + standard medical care (SMC)
defined as stents plus gemcitabine/cisplatin chemotherapy regimen on the overall survival of
subjects with unresectable cholestasis perihilar Bismuth type III or IV - tumor TNM stage III
or IVa CCA.
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