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Phase II Trial of Radical Pleurectomy With or Without Intraoperative PDT for Malignant Pleural Mesothelioma

Phase 2
Active, not recruiting
Conditions
Epitheliod Malignant Pleural Mesothelioma
Interventions
Radiation: Photodynamic Therapy
Radiation: Chemotherapy
Procedure: Radical Pleurectomy
Registration Number
NCT02153229
Lead Sponsor
Abramson Cancer Center at Penn Medicine
Brief Summary

A randomized Phase II trial to test whether the addition of intraoperative Photofrin-mediated photodynamic therapy to radical pleurectomy and post-operative chemo.improves OS in the treatment of patients with epithelioid MPM. Subjects assigned to the PDT arm will be given the photosensitizer prior to surgery . All subjects will receive maximal surgical debulking. Subjects in the PDT arm will receive intraoperative treatment using real-time, isotropic light dosimetry.

Detailed Description

Not available

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
52
Inclusion Criteria
  • Patients with a histologic diagnosis of MPM, epithelioid subtype, who in the opinion of the attending thoracic surgeon can receive a macroscopically complete resection of tumor.
  • Patients must have disease limited to the hemithorax.
  • Patients who have received prior surgery, gene therapy, or combination chemotherapy will be permitted if it has been at least 30 days since the last treatment.
  • Subjects treated with pemetrexed previously will be eligible only if 30 days have elapsed between the last dose of pemetrexed and the date of surgery.
  • ECOG performance status of 0-1.
  • Medical suitability for resection, including documented medical and cardiac clearance.
  • 18 years of age or older.
  • Patients must sign a document that indicates that they are aware of the investigative nature of the treatment of this protocol, and the potential benefits and risks. Patients unwilling or unable due to cognitive impairment to sign informed consent are excluded from the study.

EXCLUSION CRITERIA

  • Patients with active invasive cancers, other than MPM, that require additional treatment, except non-melanomatous skin cancer, superficial bladder or cervical cancer, and early-stage prostate cancer
  • Pregnant or lactating patients.
  • Patients who have a history of HIV disease.
  • Patients who have a white count less than 2,500 per cubic mm or platelets less than 100,000/cubic mm.
  • Serum creatinine equal or greater than 2.5 mg/deciliter.
  • Patients who have severe liver disease including cirrhosis, Grade III-IV elevations in liver function studies, or bilirubin in excess of 1.5 mg/deciliter.
  • Patients with porphyria or hypersensitivity to porphyrin or porphyrin-like compounds.
  • Patients who have been treated with pemetrexed if the last dose of pemetrexed is < 30 days to the date of surgery.
  • Patients that have been treated with prior Mantle field radiation.
  • Patients with distant metastatic disease or otherwise not confined to the ipsilateral hemithorax.
  • Subjects who have received more than 2 doses of neo-adjuvant chemotherapy
Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
patients who undergo RP plus photofrin-based PDTPhotofrin 2.0 mg/kg-
patients who undergo RP aloneChemotherapy-
patients who undergo RP plus photofrin-based PDTRadical Pleurectomy-
patients who undergo RP aloneRadical Pleurectomy-
patients who undergo RP plus photofrin-based PDTPhotodynamic Therapy-
patients who undergo RP plus photofrin-based PDTChemotherapy-
Primary Outcome Measures
NameTimeMethod
Survival months4 years
Secondary Outcome Measures
NameTimeMethod
Local Control4 years

progression with death as a competing risk

Receipt of Pembrolizumab4 years
Progression-free survival months4 years

Trial Locations

Locations (2)

Roswell Park Cancer Institute

🇺🇸

Buffalo, New York, United States

University of Pennsylvania

🇺🇸

Philadelphia, Pennsylvania, United States

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