Metastatic Pancreatic Cancer, Pancreatic Adenocarcinoma, Pancreatic Cancer, Unresectable Pancreatic Cancer
Conditions
Keywords
pancreatic cancer, Unresectable Pancreatic Cancer, Metastatic Pancreatic Cancer, Pancreatic Adenocarcinoma, Pancreas Neoplasm, Alpha radiation, Pancreas Cancer, Pancreas Metastases
Brief summary
A unique approach for cancer treatment employing intratumoral diffusing alpha radiation emitter device for advanced pancreatic cancer.
Detailed description
This is a prospective, single-center, open label, single arm study. The study is designed to evaluate the feasibility, safety and preliminary efficacy of intratumoral alpha radiation mediated treatment with Alpha DaRT seeds for the treatment of advanced pancreatic cancer. The study will be comprised of a screening period, DaRT insertion visit, acute follow-up phase of 4-6 weeks and a long-term follow up phase of 24 months. The total duration of the study will be 24 months from the DaRT insertion procedure. 30 patients with advanced pancreatic cancer will be recruited by the investigational site. Eligible patients who meet inclusion/exclusion criteria (as assessed during the screening period) will be invited to the site for the procedure of DaRT seeds insertion. The patients will be monitored for a period of 24 months post insertion.
Interventions
An intratumoral insertion of radioactive sources \[Ra-224 containing stainless-steel 316LVM tubes- (Alpha DaRT seeds)\]. The seeds release by recoil into the tumor short-lived alpha-emitting atoms.
Sponsors
Alpha Tau Medical LTD.
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Histologically and/or cytologically proven locally advanced (Stage II or III) or metastatic (Stage IV) pancreatic, adenocarcinoma * Inoperable pancreatic cancer due to at least one of the following: a) unresectability, b) metastatic disease, c) medically unfit for surgery * ECOG performance status ≤ 2 * Measurable lesion per RECIST (version 1.1) criteria * Maximum lesion of 4cm in the longest diameter (including primary tumor and regional lymph nodes) * ≥ 18 years of age * Estimated life expectancy of at least 12 weeks * Women of childbearing potential (WOCBP) will have evidence of negative pregnancy test * Subjects are willing to sign an informed consent
Exclusion criteria
* Prior chemotherapy does not exclude the patient * Prior abdominal radiation therapy * Concomitant chemotherapy or immunotherapy * Borderline resectable pancreatic cancer and medically fit for surgery * Connective tissue disease (scleroderma, lupus) * Patients with significant comorbidities that the treating physician deems may conflict with the endpoints of the study (e.g., poorly controlled autoimmune diseases, vasculitis, etc.) * Patients undergoing systemic immunosuppressive therapy excepting intermittent, brief use of systemic corticosteroids * Volunteers participating in another interventional study in the past 30 days which might conflict with the endpoints of this study or the evaluation of response or toxicity of DaRT * High probability of protocol non-compliance (in opinion of investigator) * Patients not willing to sign an informed consent form * Women who are pregnant or lactating
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Feasibility - DaRT seed placement | Day 0 (Day of insertion) | Assessment of the DaRT seed placement within the tumor or less than 5 mm from the tumor using CT imaging on the day of DaRT insertion. |
| Safety - Adverse events | 3 months | Assessment of the frequency, severity and causality of acute AEs and SAEs related to DaRT seeds insertion. AEs and SAEs will be assessed and graded according to Common Terminology and Criteria for Adverse Events (CTCAE) version 5.0 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Efficiency - Long-term effect | 2 years following DaRT seeds insertion | Assessment of the overall survival (OS) following DaRT seeds insertion |
| Stent durability | Day of DaRT insertion up to 24 months. | Stent durability will be assessed by the time elapsed from DaRT insertion to the need for follow-up referral for ERCP for stent change due to tumor ingrowth |
| Efficiency - Short-term effect | 4-6 weeks after DaRT seeds insertion | Assessment of the objective response rate (ORR) following DaRT seeds insertion using CT scan |
| Change in quality of life: QLQ-PAN26 | Day -14 to 60 days after insertion | Assessment of patient reported health-related Quality of Life (QoL) outcomes after DaRT treatment, using QoL questionnaires QLQ-PAN26. The module comprises 26 questions assessing pain, dietary changes, jaundice, altered bowel habit, emotional problems related to pancreatic cancer, and other symptoms (cachexia, indigestion, flatulence, dry mouth, taste changes). |
| Change in quality of life: EORTC-QLQ-C30 | Day -14 to 60 days after insertion | Assessment of patient reported health-related Quality of Life (QoL) outcomes after DaRT treatment, using QoL questionnaires EORTC-QLQ-C30 (version 3.0). Scale range in score from 0 (best) to 100(worst). |
| Tissue damage evaluation | Day -14 to 60 days after insertion | Measuring CA19-9 as a marker to tissue damage. Elevation during treatment, and reduction as a result of tumor ablation. Serum levels of CA 19-9 can be measured using chemiluminescent assay on an Unicel DxI 800 analyzer (BeckmanCoulter, Brea, CA, USA). |
Countries
Canada
Outcome results
None listed