NCT02828709

Brief Summary

Irreversible Electroporation (IRE) is an emerging technique delivering electrical pulses to ablate tissue, with the theoretical advantage to overcome the main shortcomings of conventional thermal ablation. Recent short-term research showed that IRE for the ablation of renal masses is a safe and feasible treatment option. In an ablate and resect design, histopathological analysis 4 weeks after radical nephrectomy demonstrated that IRE targeted renal tumors were completely covered by ablation zone. In order to develop a validated long-term IRE follow-up study, it is essential to obtain clinical confirmation of the efficacy of this novel technology. Additionally, follow-up after IRE ablation obliges verification of a suitable imaging modality. The objectives of this study are the clinical efficacy and safety of IRE ablation of renal masses and to evaluate the use of cross-sectional imaging modalities in the follow-up after IRE in renal tumours. This is a prospective, human, in-vivo study among 20 patients presenting with solid enhancing SRM on cross sectional imaging suspect for renal cell carcinoma (RCC). Preoperatively, imaging is required through Magnetic Resonance Imaging (MRI), Contrast-enhanced ultrasound (CEUS) and contrast-enhanced Computed Tomography (CT). Furthermore, serum creatinine levels and VAS scores are obtained. A biopsy of the SRM will be performed in preoperative setting. IRE ablation will be performed using CT-guidance and ablation success will be measured directly after the ablation through contrast-enhanced CT. Device related adverse events (AE) will be registered using the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0 guideline. One week post ablation only CEUS and MRI will be performed to limit exposure to ionizing radiation. At 3 months, 6 months and 12 months post ablation CEUS, MRI and CT will be performed. Additionally, at these time points serum creatinine levels and VAS scores will be obtained, and quality of life will be assessed through SF-36 questionnaires. Residual and recurrent disease will be assessed through tissue enhancement on cross sectional imaging.

Trial Health

43
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Enrollment
20

participants targeted

Target at below P25 for phase_2

Timeline
Completed

Started Jul 2016

Typical duration for phase_2

Geographic Reach
1 country

1 active site

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

July 1, 2016

Completed
3 days until next milestone

First Submitted

Initial submission to the registry

July 4, 2016

Completed
8 days until next milestone

First Posted

Study publicly available on registry

July 12, 2016

Completed
2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

July 1, 2018

Completed
1 year until next milestone

Study Completion

Last participant's last visit for all outcomes

July 1, 2019

Completed
Last Updated

September 27, 2016

Status Verified

September 1, 2016

Enrollment Period

2 years

First QC Date

July 4, 2016

Last Update Submit

September 26, 2016

Conditions

Kidney Cancer

Outcome Measures

Primary Outcomes (1)

  • safety IRE ablation procedure (evaluating device and procedural adverse events using CTCAE v4.0)

    To determine the safety and feasibility of IRE ablation of small renal masses (≤ 4cm), by evaluating device and procedural adverse events using CTCAE v4.0

    2 years

Secondary Outcomes (6)

  • Clinical efficacy ((non-)presence of tumour enhancement on cross-sectional imaging post IRE)

    2 years

  • Cross sectional imaging post ablation

    2 years

  • Renal function

    2 years

  • Average length of hospital stay

    2 years

  • Quality of Life

    2 years

  • +1 more secondary outcomes

Study Arms (1)

Irreversible electroporation (IRE)

EXPERIMENTAL

IRE is based on high current electric pulses, transferred between two or more placed needle electrodes. Charging the cell membrane causes holes in the cell membrane called "nanopores", resulting in increased permeability of the cell and subsequent cell death.

Device: Irreversible Electroporation

Interventions

Irreversible ElectroporationDEVICE

Guided by CT and accompanied by an external spacer for fixation, needle electrodes will be placed. The amount of probes and probe placement will be attuned for specific tumour size and location, granting 15mm between the electrodes with an active tip length of 15mm. IRE pulses with pulse intensity of 1500 V/cm will be delivered in 90 consecutive pulses of 90µs.

Also known as: Nanoknife
Irreversible electroporation (IRE)

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Age ≥ 18 years
  • Solid, enhancing mass on cross sectional imaging
  • Signed informed consent
  • Candidate for focal ablative therapy

You may not qualify if:

  • Irreversible bleeding disorders
  • Inability/unwillingness to interrupt anticoagulation therapy
  • Previous cryoablation, RFA or partial nephrectomy in affected kidney
  • Anaesthesia Surgical Assignment (ASA), category ≤ IV
  • ICD / pacemaker

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Academic Medical Center (AMC)

Amsterdam, North Holland, 1105AZ, Netherlands

RECRUITING

Related Publications (8)

  • Thomson KR, Cheung W, Ellis SJ, Federman D, Kavnoudias H, Loader-Oliver D, Roberts S, Evans P, Ball C, Haydon A. Investigation of the safety of irreversible electroporation in humans. J Vasc Interv Radiol. 2011 May;22(5):611-21. doi: 10.1016/j.jvir.2010.12.014. Epub 2011 Mar 25.

    PMID: 21439847BACKGROUND

  • Wendler JJ, Ricke J, Pech M, Fischbach F, Jurgens J, Siedentopf S, Roessner A, Porsch M, Baumunk D, Schostak M, Kollermann J, Liehr UB. First Delayed Resection Findings After Irreversible Electroporation (IRE) of Human Localised Renal Cell Carcinoma (RCC) in the IRENE Pilot Phase 2a Trial. Cardiovasc Intervent Radiol. 2016 Feb;39(2):239-50. doi: 10.1007/s00270-015-1200-6. Epub 2015 Sep 4.

    PMID: 26341653BACKGROUND

  • Trimmer CK, Khosla A, Morgan M, Stephenson SL, Ozayar A, Cadeddu JA. Minimally Invasive Percutaneous Treatment of Small Renal Tumors with Irreversible Electroporation: A Single-Center Experience. J Vasc Interv Radiol. 2015 Oct;26(10):1465-71. doi: 10.1016/j.jvir.2015.06.028. Epub 2015 Aug 4.

    PMID: 26250855BACKGROUND

  • Pech M, Janitzky A, Wendler JJ, Strang C, Blaschke S, Dudeck O, Ricke J, Liehr UB. Irreversible electroporation of renal cell carcinoma: a first-in-man phase I clinical study. Cardiovasc Intervent Radiol. 2011 Feb;34(1):132-8. doi: 10.1007/s00270-010-9964-1. Epub 2010 Aug 15.

    PMID: 20711837BACKGROUND

  • van den Bos W, de Bruin DM, van Randen A, Engelbrecht MR, Postema AW, Muller BG, Varkarakis IM, Skolarikos A, Savci-Heijink CD, Jurhill RR, Zondervan PJ, Laguna Pes MP, Wijkstra H, de Reijke TM, de la Rosette JJ. MRI and contrast-enhanced ultrasound imaging for evaluation of focal irreversible electroporation treatment: results from a phase I-II study in patients undergoing IRE followed by radical prostatectomy. Eur Radiol. 2016 Jul;26(7):2252-60. doi: 10.1007/s00330-015-4042-3. Epub 2015 Oct 8.

    PMID: 26449559BACKGROUND

  • van den Bos W, Scheffer HJ, Vogel JA, Wagstaff PG, de Bruin DM, de Jong MC, van Gemert MJ, de la Rosette JJ, Meijerink MR, Klaessens JH, Verdaasdonk RM. Thermal Energy during Irreversible Electroporation and the Influence of Different Ablation Parameters. J Vasc Interv Radiol. 2016 Mar;27(3):433-43. doi: 10.1016/j.jvir.2015.10.020. Epub 2015 Dec 17.

    PMID: 26703782BACKGROUND

  • Wagstaff PG, de Bruin DM, van den Bos W, Ingels A, van Gemert MJ, Zondervan PJ, Verdaasdonk RM, van Lienden KP, van Leeuwen TG, de la Rosette JJ, Laguna Pes MP. Irreversible electroporation of the porcine kidney: Temperature development and distribution. Urol Oncol. 2015 Apr;33(4):168.e1-7. doi: 10.1016/j.urolonc.2014.11.019. Epub 2014 Dec 31.

    PMID: 25557146BACKGROUND

  • Buijs M, van Lienden KP, Wagstaff PG, Scheltema MJ, de Bruin DM, Zondervan PJ, van Delden OM, van Leeuwen TG, de la Rosette JJ, Laguna MP. Irreversible Electroporation for the Ablation of Renal Cell Carcinoma: A Prospective, Human, In Vivo Study Protocol (IDEAL Phase 2b). JMIR Res Protoc. 2017 Feb 16;6(2):e21. doi: 10.2196/resprot.6725.

    PMID: 28209559DERIVED

MeSH Terms

Conditions

Kidney Neoplasms

Interventions

Electroporation

Condition Hierarchy (Ancestors)

Urologic NeoplasmsUrogenital NeoplasmsNeoplasms by SiteNeoplasmsFemale Urogenital DiseasesFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesKidney DiseasesUrologic DiseasesMale Urogenital Diseases

Intervention Hierarchy (Ancestors)

Cytological TechniquesClinical Laboratory TechniquesInvestigative TechniquesElectrochemical Techniques

Study Officials

  • Maria Pilar Laguna Pes, MD, PhD

    Academic Medical Center (AMC) Amsterdam

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Mara Buijs, MD

CONTACT

+31(0)205665793m.buijs@amc.uva.nl

Maria Pilar Laguna Pes, MD, PhD

CONTACT

+31(0)205666928m.p.lagunapes@amc.uva.nl

Study Design

Study Type
interventional
Phase
phase 2
Allocation
NA
Masking
NONE
Purpose
TREATMENT
Intervention Model
SINGLE GROUP
Sponsor Type
OTHER
Responsible Party
SPONSOR INVESTIGATOR
PI Title
Prof. Dr.

Study Record Dates

First Submitted

July 4, 2016

First Posted

July 12, 2016

Study Start

July 1, 2016

Primary Completion

July 1, 2018

Study Completion

July 1, 2019

Last Updated

September 27, 2016

Record last verified: 2016-09

Data Sharing

IPD Sharing
Will not share

Locations

NL(1)