Kinectics of Distribution of Doxorubicin-Lipiodol Emulsion in c-TACE
- Conditions
- Hepato Cellular Carcinoma
- Interventions
- Drug: Super selective transarterial chemoembolization of CHC, with doxorubicin reconstituted in 5cc normal salineDrug: Super selective transarterial chemoembolization of CHC, with doxorubicin reconstituted in 5cc iso-osmolar ionic iodinated contrast media
- Registration Number
- NCT03706157
- Lead Sponsor
- University Hospital, Strasbourg, France
- Brief Summary
Conventional transarterial chemoembolization with Doxorubicin (c-TACE) is the gold standard treatment for Hepato Cellular Carcinoma (HCC) stage B (BCLC) / stages A and B (Child-Pugh). Clinical recommendations for cTACE indicate that the doxorubicin solution may be reconstituted in either aqueous solution or iso-osmolar ionic iodinated contrast media. There is no consensus on which solvent should be used. Hence, the clinical evaluation of Lipiodol cTACE would benefit from a standardization in the reconstitution of the drug. In this study, the comparison of the kinetics of distribution of the drug within the tumor micro-environment is expected to allow for comparison of drug solvents.
This pilot study aims at evaluating the kinetics of distribution of the drug within the tumor micro-environment, for the two main solvents used in reconstituting the drug, namely normal saline and contrast media. The kinetics of distribution in the tumor will be evaluated primarily through regular biopsy sampling, and secondary with confocal laser endomicroscopy.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 10
- Adult (>18)
- Informed consent
- CHC Child-Pugh stage A or B, BCLC stage B
- Referred for chemoembolization of a non-surgery-candidate CHC
- Blood test results compatible with cTACE (INR ≤ 1,5, ASAT/ALAT<5N, albumine>2,5g/dl)
- Contraindication to cTACE, angiography, confocal laser endomicroscopy or liver biopsy Hyperthyroidism
- Contraindication to the use of fluorescein, Ariblastine,Lipiodol, Visipaque, Gelita spon, Avitene
- extra hepatic metastasis
- Subcapsular or exophytic tumor impeding direct percutaneous access through healthy liver tissue
- Waiting list for liver transplant
- Complete portal venous thrombosis or flow inversion
- Pregnancy or breast feeding
- Protected major (Guardianship)
- Patient in situation of exclusion (determined by a previous or ongoing study)
- Subject incapacity to understand informed consent
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Normal saline Super selective transarterial chemoembolization of CHC, with doxorubicin reconstituted in 5cc normal saline Doxorubicin solution reconstituted in 5 mL normal saline Iodinate contrast Super selective transarterial chemoembolization of CHC, with doxorubicin reconstituted in 5cc iso-osmolar ionic iodinated contrast media Doxorubicin solution reconstituted in 5 mL iso-osmolar ionic iodinated contrast media
- Primary Outcome Measures
Name Time Method Histological analysis of biopsy samples for the evaluation of the kinetics of distribution of doxorubicine in tumor compartments depending on the solvent used for drug reconstitution T3: 1 min after cTACE drug injection is completed Biopsy samples of liver tumor tissue. Histological analysis will provide a quantification of the doxorubicin drug in tumor compartment.
- Secondary Outcome Measures
Name Time Method In vivo evaluation of the kinetics of distribution of doxorubicine in tumoral tissue with confocal laser endomicroscopy, depending on the solvent used for drug reconstitution 1 min after cTACE drug injection is completed, Continuous image recording (videos) through the course of the cTACE drug injection, from 1 minute before drug injection starts to the time when cTACE drug injection is completed
Trial Locations
- Locations (1)
University Hospital, Strasbourg, france
🇫🇷Strasbourg, France