Intrathoracic Chemotherapy for TETs With Pleural Spread or Recurrence

Thymic Epithelial Tumor Clinical Trial

— CHOICE  

Official title:

Cytoreductive Surgery and Hyperthermic Intrathoracic Chemotherapy for the Treatment of Thymic Epithelial Malignancies With Pleural Spread or Recurrence (CHOICE): a Prospective, Open, Single-arm Study Choice

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05446935
• Other study ID #: B2021-703R
• Status: Recruiting
• Phase: N/A
• Start date: October 1, 2022
• Est. completion date: November 30, 2025

Study information

• Verified date: September 2022
• Source: Shanghai Zhongshan Hospital
• Contact: Jianyong Ding, MD
• Phone: 18616881268
• Email: ding.jianyong[@]zs-hospital.sh.cn
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Hyperthermic intrathoracic chemotherapy (HITOC) offers an additional treatment option for malignant pleural tumors after surgical cytoreduction. Especially it is used to further improve local tumor control in thymic malignancies with pleural spread, who underwent multimodality therapy including surgical resection. A phase II clinical study was conducted to explore the efficacy and safety of surgery followed by HITOC (POD1: DOX, POD2: cisplatin) for thymic epithelial tumors with pleural spread or recurrence.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 37
• Est. completion date: November 30, 2025
• Est. primary completion date: November 30, 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 16 Years to 80 Years

Eligibility

Inclusion Criteria:

1. Puncture biopsy, thoracoscopic/mediastinal biopsy, or surgery to confirm pathologically thymic epithelial tumor (TETs)

2. Imaging examination shows TETs with pleural spread or recurrence, and the mediastinal MDT team considers HITOC suitable.

3. Patients with =16 and =80 years old.

4. ASA I-II.

5. The patients should have no functional disorders in the main organs.

6. There was no history of other malignant carcinomas.

7. The duration from the last chemotherapy was >4 weeks, the duration from the last radiotherapy was >6 weeks, and the duration from the last immunotherapy was >6 weeks.

8. Not allergic to cisplatin or doxorubicin.

9. The patients should be able to understand our research and sign the informed consent.

Exclusion Criteria:

1. Imaging or pathological examination shows TETs without pleural spread or recurrence, or with pericardial dissemination or extrathoracic metastasis.

2. Patients with lymphoid system, neurogenic or reproductive system carcinoma.

3. Patients who have been receiving chemotherapy, radiotherapy, immunotherapy, or targeted therapy.

4. Patients with myasthenia gravis in unstable or acute exacerbation stage.

5. The patients have been proven history of congestive heart failure, angina without good control with medicine; ECG-proved penetrating myocardial infarction; hypertension with bad control; valvulopathy with clinical significance; arrhythmia with high risk and out of control.

6. The patients have the severe systematic intercurrent disease, such as active infection or poorly controlled diabetes; coagulation disorders; hemorrhagic tendency or under-treatment of thrombolysis or anticoagulant therapy.

7. Female who is positive for a serum pregnancy test or during lactation period.

8. The patients have a history of organ transplantation (including autologous bone marrow transplantation and peripheral stem cell transplantation.

9. The patients have a history of peripheral nerve system disorders, obvious mental disorders, or central nerve system disorders.

10. The patients attend other clinical trials.

Related Conditions & MeSH terms

• Recurrence
• Thymic Epithelial Tumor

Intervention

Procedure:
• HITOC
Doxorubicin(dose: 25mg/m2) + Cisplatin(dose: 50mg/m2).

Locations

Country	Name	City	State
China	Shanghai Zhongshan Hospital	Shanghai

Sponsors (1)

Lead Sponsor	Collaborator
Shanghai Zhongshan Hospital

Country where clinical trial is conducted

China, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Postoperative hospital stay	Postoperative hospital stay is the duration for every enrolled patient until the date of meeting the criteria of hospital discharge since the date of surgery.; The criteria of hospital discharge were defined as with the volume of postoperative drainage < 200 ml/day, a normal chest X-ray, and good physical condition.	Up to the date of meeting the criteria of hospital discharge since the data of surgery, up to 1 month
Primary	treatment-related adverse events and complications	Number and severity of adverse events that are related to the treatment of each patient. Postoperative treatment-related complications were assessed by the Clavien-Dindo Classification. Treatment-related adverse events as assessed by CTCAE v5.0.	Up to the date of meeting the criteria of hospital discharge since the data of surgery, up to 1 month
Primary	EORTC QLQ-C30 score for overall quality of life	Overall quality of life is respectively evaluated at randomization and 1 month, 3 month, 6 month after surgery among patients by using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C-30 Scale (EORTC QLQ-C30) (V3.0).; The minimum value of EORTC QLQ-C30 score was 0, and the maximum was 100. Zero indicates the worst quality of life, while 100 represents the best quality of life.	Up to the end of follow-up since the date of randomization, up to 6 months.
Secondary	Visual Analog Scales scores for postoperative pain	the cumulative daily pain score at rest using VAS from postoperative 0 to 72 hours. The minimum value of the VAS score was 0,and the maximum was 10. Zero indicates the least painful, while 1 represents the worst. The smaller (larger) cumulative daily pain score represents the less (more) pain.	from 0 to 72 hours after surgery
Secondary	Volume of postoperative drainage	The volume of postoperative drainage of the patient was the sum of his daily drainage volume after the surgery. The types of drainage equipment include the thorax close drainage equipment and the unidirectional negative-pressure drainage ball.	Up to the date of removal of drainage equipment since the data of completion of surgery, up to 7 days
Secondary	Progression-free survival (PFS)	the duration from the date of S-HITOC to the date of the first progression. Disease progression is defined as locoregional (anterior mediastinal area, lung, pericardiac metastasis or pleural progression) or metastatic (supraclavicular lymph nodes or distant organs).	Through study completion, an average of 5 year
Secondary	Overall survival (OS)	the duration from the date of S-HITOC to the date of the death.	Through study completion, an average of 5 year