Lung Cancer
Conditions
Keywords
Lung Cancer, Bio-Seal Track Plug, Lung Biopsy, Lung Plug, Air Leaks
Brief summary
The purpose of this study is to demonstrate safety and effectiveness of the Bio-Seal Biopsy Track Plug in a clinical setting for use in lung biopsy procedures to reduce the rate of air leaks, commonly associated with the procedure. The Bio-Seal System is cleared in the U.S. with an indication for use as a lung biopsy site marker.
Detailed description
Air leaks are the most common problem after a lung biopsy. Air leaks can be mild to severe. Mild air leaks are monitored by chest x-ray and may go away by themselves. Air leaks can cause pain and require repeated x-rays, and in some cases the need for a tube to be inserted into the chest for drainage of the air. If you agree to take part in this study, you will be randomly assigned (as in the toss of a coin) to 1of 2 groups. Participants in one group will receive the experimental lung plug after the lung biopsy. Participants in the other group will just have the standard lung biopsy without placement of the plug. There is an equal chance of being assigned to either group. All participants will have the routine lung biopsy performed by their doctor with the aid of a computerized tomography (CT) scan. During a lung biopsy, a needle is inserted into the mass in the lung using the CT for guidance. A smaller needle is then inserted through the first needle to collect a sample of the tissue. If you are assigned to receive the lung plug, it will be inserted into the track left when the biopsy needle is removed. The smaller sampling needle is removed, and the lung plug is inserted through the larger needle using a delivery tool that has a plunger to push the plug in place. The lung plug remains in the track left when the larger needle is removed. Regardless of which group you are assigned to, you will be receive the same follow-up treatment. The rates of air leaks after the lung biopsy will be compared between 2 groups of participants. This will provide researchers with the data to learn if the lung plug should be used for all patients receiving a lung biopsy to decrease the number of air leaks. Your doctor will watch you carefully for air leaks. You will have a chest x-ray about 1 hour after the procedure to again check for air leaks. If a leak is detected, you will receive the normal treatment for air leaks, which includes chest x-rays on a regular basis. If the air leak grows, you may need a chest tube placed for drainage. It is possible that this may require you to stay in the hospital overnight. In the most extreme cases, additional surgery may be needed to stop the air leak. Over time, your body will absorb the plug. A final x-ray will be taken 1 month after the biopsy to be sure that an air leak has not developed. You will be asked to be in the study for 30 days. This will include the time you spend in the hospital for the biopsy and, if you have an air leak, the entire time you spend in the hospital, if it needs to be treated. In addition, you will return to your doctor the day following the biopsy and 30 days later to have a chest x-ray to look for any late air leaks.
Interventions
DEVICEBio-Seal Track Plug
The lung plug will be inserted into the left track when the biopsy needle is removed. The smaller sampling needle is removed, and the lung plug is inserted through the larger needle using a delivery tool that has a plunger to push the plug in place. The lung plug remains in the track left when the larger needle is removed.
OTHERNo lung plug
Standard lung biopsy without placement of the plug.
Sponsors
M.D. Anderson Cancer Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. The patient, or legal representative, must understand and provide written consent for the procedure 2. The patient has a non-calcified, radiologically suspicious opacity or lung nodule, including a metastatic lung module, or mass of at least 1.0 cm in size; as determined by CT scan equipped with measurement software. Suspicious nodules observed by CT scan are defined as non-calcified masses with convex borders, not known to be stable. Suspicious nodules can also be defined as masses demonstrating opacity on x-ray that are suspicious by radiographic or clinical means and require biopsy. 3. The patient must meet all medical conditions for lung biopsy; 4. The patient must be at least 18 years of age;
Exclusion criteria
1. Patients with radiological findings of bullous emphysema, and the bullae are located near the intended area for biopsy. (Patients may enter the study who have radiological findings of bullous emphysema, as long as the cysts, blebs, or bullae are not in the area of the anticipated biopsy, and biopsy needle track). 2. Female patients who are pregnant. Note: patients of childbearing potential should have a pregnancy test no more than one week prior to the biopsy procedure, and be instructed to have no unprotected sexual intercourse after the test until the biopsy procedure is completed 3. Patients who are uncooperative or cannot follow instructions 4. Patients who are currently enrolled in another Investigational New Drug (IND) or Device Exemption (IDE) clinical investigation that has not completed the required follow-up period 5. Patients who cannot tolerate mild sedation, possibly secondary to poor respiratory status; 6. Patients with fungal infections (Patients with known or imaging evidence highly suggestive of pulmonary fungal infection)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants With Absence of Pneumothoraces | X-Rays at 0-60 minutes, 24 hours and 30 days | Treatment Success defined as absence of pneumothoraces to measure the effects of the hydrogel plug in three follow-up radiographic assessment (x-rays post procedure by 0-60 minutes, 24 hours and 30 days). |
Countries
United States
Participant flow
Recruitment details
Recruitment Period: September 12, 2005 to February 21, 2008. All recruitment done at UT MD Anderson Cancer Center.
Pre-assignment details
Participants who met the eligibility criteria (77 participants) were consented into study while another set of criteria had to be met for randomization. Only 47 participants met the randomization criteria.
Participants by arm
| Arm | Count |
|---|---|
| Pleural Plug Experimental lung plug after the lung biopsy. | 22 |
| No Pleural Plug The standard lung biopsy without placement of the plug. | 25 |
| Total | 47 |
Baseline characteristics
| Characteristic | Pleural Plug | No Pleural Plug | Total |
|---|---|---|---|
| Age Continuous | 45 years | 35 years | 45 years |
| Region of Enrollment United States | 22 participants | 25 participants | 47 participants |
| Sex: Female, Male Female | 10 Participants | 9 Participants | 19 Participants |
| Sex: Female, Male Male | 12 Participants | 16 Participants | 28 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 0 / 22 | 0 / 25 |
| serious Total, serious adverse events | 0 / 22 | 0 / 25 |
Outcome results
Primary
Number of Participants With Absence of Pneumothoraces
Treatment Success defined as absence of pneumothoraces to measure the effects of the hydrogel plug in three follow-up radiographic assessment (x-rays post procedure by 0-60 minutes, 24 hours and 30 days).
Time frame: X-Rays at 0-60 minutes, 24 hours and 30 days
Population: Intent-to-treat (ITT) population of all subjects who were randomized.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Pleural Plug | Number of Participants With Absence of Pneumothoraces | 18 Participants |
| No Pleural Plug | Number of Participants With Absence of Pneumothoraces | 18 Participants |