Interscope Endorotor® Mucosal Resection System With Continued Ablative Therapy In Subjects With Refractory Dysplastic Barrett's Esophagus
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 120
- 试验地点
- 8
- 主要终点
- Incidence of complete removal of refractory Barrett's esophagus
研究概览
简要总结
The aim of the clinical trial is to evaluate the EndoRotor®'s ability to completely remove areas of Barrett's esophagus considered refractory after 3 failed ablation treatments (Radiofrequency Ablation (RFA) and/or Cryotherapy) or in patients with at least 1 failed ablative procedure (RFA and/or Cryotherapy) and are intolerant to the procedure due to pain, where intolerant is defined as post-dysphagia or odynophagia persisting for 24 hours or greater or requiring narcotic analgesia for a duration of more than 24 hours.
详细描述
Prospective, multi-center, randomized controlled trial, pivotal, investigational device exemption (IDE) to compare the safety and performance of the EndoRotor® Mucosal Resection System with continued ablative therapy in subjects with refractory Barrett's Esophagus.
The EndoRotor® Endoscopic Mucosal Resection System is an automated mechanical endoscopic mucosal resection system for use in the gastrointestinal tract for benign neoplastic or pre-malignant tissue removal by interventional gastroenterologists and GI surgeons. The EndoRotor® System performs both tissue dissection and resection with a single device through an endoscope's instrument biopsy channel.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 30 Years 至 89 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Subjects who are greater than 30 and less than 90 years of age; inclusive of males and females.
- •Subjects with confirmed Barrett's esophagus with dysplasia (low-grade or high-grade) and meeting at least one of the following criteria:
- •Failed 3 ablative procedures (RFA and/or Cryotherapy).
- •Failed at least 1 ablative procedure (RFA and/or Cryotherapy) and are intolerant to the procedure due to pain, where intolerant is defined as post-procedure dysphagia or odynophagia persisting for 24 hours or greater or requiring narcotic analgesia for a duration of more than 24 hours.
- •Residual Barrett's length is ≥1 cm and ≤6 cm.
- •No confirmed evidence of esophageal adenocarcinoma (EAC) at the time of therapy.
- •Subject capable of giving informed consent.
- •Subject has a reasonable expectation for prolonged survival (greater than 2 years).
- •Subject can tolerate repeated endoscopic procedures.
- •Absence of strictures refractory to dilation that preclude the passage of the endoscope
- •Patients who were on acid suppression therapy (i.e. PPIs) during the course of failed primary ablative therapy, and who can continue acid suppression therapy for the entire time they are on the clinical study.
- •Subjects with the ability to understand the requirements of the study, who have provided written informed consent, and who are willing and able to return for the required follow-up assessments through 12 months, as indicated.
排除标准
- •Subject unable to give informed consent.
- •Subject is unwilling to return for repeated endoscopies.
- •Confirmed endoscopic and or histologic evidence of EAC at time of therapy.
- •Residual Barrett's longer than 6 cm.
- •Subjects with nodular Barrett's esophagus.
- •Subjects who are on anticoagulant therapy that cannot be discontinued for 5 days before and after the procedure.
- •Subjects with known coagulopathy defined as abnormal prothrombin or partial thromboplastin time.
- •History of esophageal varices
- •LA Grade B, C, or D esophagitis.
- •Esophageal stricture refractory to dilation preventing passage of endoscope or catheter.
- •Any previous esophageal surgery, except fundoplication without complications.
- •Medically uncorrectable hypotension or hypertension.
- •Any condition that in the opinion of the investigator would create an unsafe clinical situation that would not allow the patient to safely undergo an endoscopic procedure (lack of medical clearance).
- •Pregnant or lactating women or women of childbearing potential who do not employ a reliable method of contraception as judged by the Investigator, and/or are not willing to use reliable contraception for the duration of study participation.
- •Subject has known severe psychiatric disorder, substance abuse, or other reason for being unable to follow trial follow-up instructions.
- •Patient has a known significant concomitant illness with a life expectancy of less than 2 years.
- •Subject is known to be currently enrolled in another investigational trial that could interfere with the endpoint analyses of this trial.
结局指标
主要结局
Incidence of complete removal of refractory Barrett's esophagus
时间窗: 12 months
The primary effectiveness endpoint for this study is the complete removal of refractory Barrett's esophagus in no more than three treatments as assessed by a biopsy negative for Barrett's esophagus at the 12 month follow-up visit.
Rate of device- and procedure-related serious adverse events (SAEs)
时间窗: 12 months
The primary safety endpoint for this study is the rate of device- and procedure-related serious adverse events (SAEs) for bleeding, perforation, and stricture in the EndoRotor arm will be no greater than that of the continued ablative therapy arm.
次要结局
- Percent Reduction of Barrett's Esophagus(12 months)
- Activated Fibroblasts(12 months)
- Post Procedure Pain(9 months)