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Trial registered on ANZCTR
Registration number
ACTRN12611000937910
Ethics application status
Approved
Date submitted
8/12/2008
Date registered
31/08/2011
Date last updated
31/08/2011
Type of registration
Retrospectively registered
Titles & IDs
Public title
Irreversible Electroporation (IRE) for the treatment of focal liver, kidney and lung cancer ablation: a pilot study
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Scientific title
Irreversible Electroporation (IRE) for the treatment focal liver, kidney and lung cancer ablation: a pilot study
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Secondary ID [1]
262951
0
NA
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Universal Trial Number (UTN)
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Trial acronym
IRE study
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Focal tumours of the liver
4093
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Focal tumours of the lung
270681
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Focal tumours of the kidney
270682
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Condition category
Condition code
Cancer
4288
4288
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0
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Kidney
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Cancer
270850
270850
0
0
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Liver
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Cancer
270851
270851
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0
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Lung - Small cell
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The intervention is ablation using Irreversible electroporation (direct current) which disrupts the cell membrane killing the tumour cells.
The whole procedure takes between 2 to 3 hours. Once the needle electrodes are in place the ablation takes approximately one minute. Depending on the size of the tumour the needle electrodes may be repositioned and further ablations (2 to approximately 10) may be performed. If complete ablation is not achieved a second procedure can be performed.
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Intervention code [1]
3802
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Treatment: Surgery
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Comparator / control treatment
none
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Safety - Determined by the composite number of adverse events
The risks of ablation procedures include:
* Pain and nausea: nearly all patients experience some pain and nausea.
* Delayed ablation syndrome where you may have a fever/ malaise - 25%. Roughly one in four patients may develop a "post-ablation syndrome" with flu-like symptoms that appear three to five days after the procedure and usually last about five days. An occasional patient may remain ill for two to three weeks. Paracetamol taken by mouth is commonly used to control fever.
* For patients with lung tumours there is a 50% chance of pheumothorax . Pneumothorax is when air collects between the lung and inner chest and this causes the lung to collapse. This can be treated by placing a chest tube between the ribs into the space around the lungs to drain the air out of the space and to allow the lung to re-expand. If pneumothorax results you will be required to stay in hospital as an inpatient until the pneumothorax is resolved and the chest tube can be removed.
* Infection (very rare). Any procedure where the skin is penetrated carries a risk of infection. The chance of infection requiring antibiotic treatment appears to be less than one in 1,000.
* Post operative haemorrhage requiring transfusion (very rare). Some cases of bleeding have been reported but it usually stops on its own. If bleeding is severe, an additional procedure or surgery may be needed to control it.
* Injury to surrounding tissue (none noted to date in animal studies and human prostate studies of the Angiodynamics System). RFA however, because it relies on heat to damage cells, depending on the site of treatment, it may cause brief or, rarely, long-lasting shoulder pain; inflammation of the gallbladder that subsides after a few weeks; damage to the bile ducts resulting in biliary obstruction - a blockage in the tubes that carry a liquid called bile from the liver to the gallbladder and small intestine; this liquid helps digest fat. An operation may be needed to rectify the problem; or thermal damage to the bowel (3-5%).
* Death (extremely rare).
Having a drug injected or blood taken may cause some discomfort or bruising. Sometimes, the blood vessel may swell, or blood may clot in the blood vessel, or the spot from which tissue is taken could become inflamed. Rarely, there could be a minor infection or bleeding. If this happens, it can be easily treated.
Medical treatments often cause side effects. You may have none, some or all of the effects listed above, and they may be mild, moderate or severe. If you have any of these side effects, or are worried about them, talk with your doctor. Your doctor will also be looking out for side effects.
Many side effects go away shortly after treatment ends. However, sometimes side effects can be serious, long lasting or permanent. If a severe side effect or reaction occurs. Tell your doctor if you have any problems. Your doctor will discuss the best way of managing any side effects with you
Computer Tomography (CT) imaging uses X-rays and therefore exposes you to ionising radiation. Ionising radiation represents a significant risk to unborn children. Therefore, all women of childbearing age will be screened for pregnancy. This screening is standard procedure for all women of childbearing age prior to undergoing a X-ray or CT. This screening may include a blood or urine pregnancy test. If you think that you may be pregnant or plan to become pregnant you should not participate in this study. If you become pregnant during this study, immediately contact your research doctor.
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Assessment method [1]
5173
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Timepoint [1]
5173
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Procedure, 1 month, 6 months
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Primary outcome [2]
279530
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Efficacy of ablation - Determined by contrast enhanced computer tomography
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Assessment method [2]
279530
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Timepoint [2]
279530
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At one then every 3 months post procedure
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Secondary outcome [1]
8707
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n/a
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Assessment method [1]
8707
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Timepoint [1]
8707
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n/a
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Eligibility
Key inclusion criteria
Ages 35-85 years, Signed informed consent, Failed conventional treatment, Ability to visualize cancer foci adequately on imaging.
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Minimum age
35
Years
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Maximum age
85
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Patients not deemed suitable for ablation procedure.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
10/11/2008
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
40
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
4259
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Other
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Name [1]
4259
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Angiodynamics Inc.
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Address [1]
4259
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603 Queensbury Avenue
Queensbury, New York 13805
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Country [1]
4259
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United States of America
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Primary sponsor type
Hospital
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Name
The Alfred Hospital
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Address
The Alfred Hospital Melbourne, Vic 3004
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Country
Australia
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Secondary sponsor category [1]
3832
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None
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Name [1]
3832
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Address [1]
3832
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Country [1]
3832
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
6310
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The Alfred HREC
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Ethics committee address [1]
6310
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Commercial Road Melbourne, Vic 3004
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Ethics committee country [1]
6310
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Australia
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Date submitted for ethics approval [1]
6310
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Approval date [1]
6310
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18/09/2008
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Ethics approval number [1]
6310
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1/08/0204
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Summary
Brief summary
In cases where patients have inoperable tumours, direct destruction of focal tumours using various energy sources such as heat (radiofrequency ablation, microwaves), cold (cryotherapy) or ethanol injection have been used for the last twenty years. A needle is placed into the tumour under image guidance in a similar way to taking a biopsy. The energy used, heat or cold, destroys the tumour. Currently not all inoperable tumours can be treated in this way because tumours may lie close to vital structures that may be affected and therefore pose a large risk to patients. The new technology, irreversible electroporation, does not use heat or cold and therefore spares vital structures. Direct electrical current is used to destroy the outer membrane of the tumour cells. We are testing the safety and effectiveness of this form of ablation.
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Trial website
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Trial related presentations / publications
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
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Public notes
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Contacts
Principal investigator
Name
35015
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Address
35015
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Country
35015
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Phone
35015
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Fax
35015
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Email
35015
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Contact person for public queries
Name
12362
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Helen Kavnoudias
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Address
12362
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Radiology Department
The Alfred
Commercial Road
Melbourne, VIC 3004
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Country
12362
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Australia
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Phone
12362
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+61 3 9076 3606
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Fax
12362
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+61 3 9076 2153
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Email
12362
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[email protected]
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Contact person for scientific queries
Name
3290
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Helen Kavnoudias
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Address
3290
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The Alfred
Commercial Road
Melbourne, Vic 3004
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Country
3290
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Australia
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Phone
3290
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+61 3 9076 3606
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Fax
3290
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+61 3 9076 2153
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Email
3290
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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