Multicenter Study of Cryoablation for Palliation of Painful Bone Metastases

Not Applicable

Completed

Brief Summary: This study will evaluate the efficacy of cryoablation for palliation of painful metastases in participants with metastatic lesions involving bone who have failed, are not candidates for, or are not experiencing adequate pain relief from current pain therapies (for example, radiation, analgesics).

Detailed Description: Participants with painful metastatic lesions involving bone who meet the eligibility criteria and who have been determined to be an appropriate candidate for cryoablation therapy were offered enrollment into the study. Participants agreeing to participate will read and sign an informed consent form and thus become participants in the study. Treatment will be performed using a Galil Medical cryoablation system and Galil Medical cryoablation needles. Participants will have one cryoablation procedure and will be followed for up to 6 months for palliation of pain, quality of life, and analgesic usage. Baseline and follow-up data will be collected for each participant via a web-based electronic data collection tool.

Recruitment & Eligibility

Inclusion Criteria

18 years of age or older
Metastatic disease involving bone with metastatic disease previously confirmed by prior biopsy; or Metastatic disease involving bone previously confirmed on imaging (for example, computed tomography [CT] or magnetic resonance imaging [MRI]) with known (biopsied) primary disease (primary bone cancer is excluded)
Current analgesic therapies have failed, the participant is not a candidate for, or the participant is not experiencing adequate pain relief from current pain therapies (for example, radiation, analgesics)
The 'worst pain' in the last 24 hours must be reported to be 4 or above on a scale of 0 (no pain) to 10 (pain as bad as participant can imagine)
Pain must be from one painful metastatic lesion involving the bone that is amenable to cryoablation with CT (additional less painful metastatic sites may be present)
Cryoablation should be performed within 14 days of screening visit
If taking hormonal therapy, use should be stable (no changes within 4 weeks prior to the cryoablation procedure)
Karnofsky Performance Scale (KPS) score ≥60
Life expectancy ≥3 months
No debilitating medical or psychiatric illness that would preclude giving informed consent or receiving optimal treatment and follow-up
Known coagulopathy or bleeding disorders are controlled

Exclusion Criteria

Primary cancer is leukemia, lymphoma, or myeloma
Tumor involves a weight-bearing long bone of the lower extremity with the tumor causing >50% loss of cortical bone
Has undergone prior surgery at the tumor site or the index tumor has undergone previous surgery or ablation treatment
Prior radiation therapy of the index tumor <3 weeks prior to the screening visit
Index tumor causing clinical or radiographic evidence of spinal cord or cauda equina compression/effacement
Anticipated treatment of the index tumor that would require iceball formation within 0.5 centimeters (cm) of the spinal cord, brain, other critical nerve structure, or large abdominal vessel (possibly achieved with additional maneuvers such as hydrodissection)
Index tumor involves the skull
Currently pregnant, nursing, or wishing to become pregnant during the study
Serious medical illness, including any of the following: uncontrolled congestive heart failure, uncontrolled angina, myocardial infarction, or cerebrovascular event within 6 months prior to the screening visit
Concurrent participation in other studies that could affect the primary endpoint

Arm && Interventions

Group	Intervention	Description
Cryoablation	Cryoablation	All participants will have one cryoablation procedure on one painful metastatic lesion involving bone using a Galil Medical cryoablation system and needles within 14 days of screening. In the case of participants with multiple metastatic lesions involving bone, the most painful lesion is to be selected for cryoablation. If treatment could not be completed within 14 days of screening, the participant will be re-screened using the inclusion and exclusion criteria. Participant preparation, anesthesia, intra-operative monitoring, and postoperative management for the study cryoablation procedure will be identical to those for standard cryoablation treatment routinely performed at the clinical centers that participated in this study and will be at the discretion of the Investigators.

Primary Outcome Measures

Name	Time	Method
Change From Baseline in Worst Pain Scores as Assessed by the Brief Pain Inventory-Short Form (BPI-SF) at Week 8	Baseline, Week 8	The BPI-SF is a validated instrument used widely in clinical research to assess cancer pain. Assessments were of self-reported worst pain scores in the last 24 hours in the target lesion treated with study cryoablation on a scale from 0 (no pain) to 10 (worst pain imaginable) using the BPI-SF. Improvement in self-reported pain scores is defined by ≥2-point reduction in worst pain. A mean difference of a 2-point reduction is considered clinically significant, that is improvement. Baseline data and change from Baseline data at Week 8 is presented.

Secondary Outcome Measures

Name	Time	Method

Locations (11): Crittenton Hospital
🇺🇸
Rochester, Michigan, United States
Mayo Clinic Rochester
🇺🇸
Rochester, Minnesota, United States
Massachusetts General Hospital
🇺🇸
Boston, Massachusetts, United States
UCLA Ronald Reagan Medical Center
🇺🇸
Los Angeles, California, United States
Institut Bergonié
🇫🇷
Bordeaux, France
University Hospital of Strasbourg
🇫🇷
Strasbourg, France
Emory University Hospital
🇺🇸
Atlanta, Georgia, United States
Centre Léon Bérard
🇫🇷
Lyon, France
Institut Gustave Roussy
🇫🇷
Villejuif, France
Washington University in St. Louis
🇺🇸
Saint Louis, Missouri, United States
Rhode Island Hospital
🇺🇸
Providence, Rhode Island, United States