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Photo-induction as a Means to Improve Cisplatin Delivery to Pleural Malignancies

Phase 1
Terminated
Conditions
Pleural Effusion, Malignant
Interventions
Drug: Cisplatin, liposomal
Device: Device for Intrapleural Visudyne-mediated Low-Dose Photodynamic Therapy with integrated in situ light dosimetry
Registration Number
NCT02702700
Lead Sponsor
Centre Hospitalier Universitaire Vaudois
Brief Summary

This clinical study aims to explore intrapleural low-dose Visudyne®-mediated photodynamic therapy (photo-induction) as a pathway to promote the uptake of systemically administered Lipoplatin™ in pleural malignancies of patients undergoing video-assisted talcage for their malignant pleural effusions. Photo-induction is expected to overcome the chemo-resistance of pleural malignancies for cisplatin-based chemotherapeutics and thereby improve local tumor control.

Detailed Description

The primary objective of the study is to assess the safety and tolerability of intrapleural Visudyne®-mediated photo-induction as a means to selectively increase tumor uptake of systemically administered Lipoplatin™ in patients with primary or secondary pleural malignancies.

The secondary objectives are:

Assessment of treatment efficacy as measured by dyspnea reduction, pleural effusion free survival as well as local relapse rate, progression free and median overall survival.

Analysis of the pleural intratumor penetration of Lipoplatin™ by repeated biopsies for Lipoplatin concentration measurements before and after Visudyne® treatment as well as vessel modulation related parameters (pericyte coverage, vessels morphology).

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
1
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Lipoplatin/Visudyne-mediated photodynamic therapyDevice for Intrapleural Visudyne-mediated Low-Dose Photodynamic Therapy with integrated in situ light dosimetry200 mg/m2 Lipoplatin™ will be delivered as iv perfusion. Then, intrapleural photo-induction will be realized through a classical video-assisted thoracoscopic (VATS) approach using 3 mg/m2 Visudyne® activated at 689 nm. At the end of the procedure, the patients will receive chemical pleurodesis by VATS as per standard-of-care treatment for malignant pleural effusion.
Lipoplatin/Visudyne-mediated photodynamic therapyCisplatin, liposomal200 mg/m2 Lipoplatin™ will be delivered as iv perfusion. Then, intrapleural photo-induction will be realized through a classical video-assisted thoracoscopic (VATS) approach using 3 mg/m2 Visudyne® activated at 689 nm. At the end of the procedure, the patients will receive chemical pleurodesis by VATS as per standard-of-care treatment for malignant pleural effusion.
Lipoplatin/Visudyne-mediated photodynamic therapyVerteporfin200 mg/m2 Lipoplatin™ will be delivered as iv perfusion. Then, intrapleural photo-induction will be realized through a classical video-assisted thoracoscopic (VATS) approach using 3 mg/m2 Visudyne® activated at 689 nm. At the end of the procedure, the patients will receive chemical pleurodesis by VATS as per standard-of-care treatment for malignant pleural effusion.
Primary Outcome Measures
NameTimeMethod
Dyspnea according to CTCAE v4.030-day postoperative
Tolerability of the treatment as assessed by 30-day postoperative mortality30 days

survival status at 30 days

Safety of the treatment as assessed by 30-day postoperative mortality30 days

survival status at 30 days

Feasibility30 days

survival status at 30 days

Acute respiratory failure rate30-day postoperative
Chest pain rate according to CTCAE v4.030-day postoperative
Dyspnea according to Medical Research Council (MRC) chronic dyspnea scale (5-point)30-day postoperative
Secondary Outcome Measures
NameTimeMethod
Dyspnea reduction according to CTCAE v4.030 days after treatment

CTCAE v4.0

Progression-free survival (PFS)according to local standard

Evaluation Criteria in Solid Tumors (RECIST) version 1.1

Duration of Response (DOR)according to local standard

Evaluation Criteria in Solid Tumors (RECIST) version 1.1

Malignant effusion recurrence-free - percentage of patients without recurrent pleural effusion at 30 days30 days after treatment
Overall survival (OS)every 3 months up to 3 years
Tumor responseaccording to local standard

Evaluation Criteria in Solid Tumors (RECIST) version 1.1.

Overall response rate (ORR) based on investigator assessment according to Responseaccording to local standard

Evaluation Criteria in Solid Tumors (RECIST) version 1.1

Trial Locations

Locations (1)

Oncology Department, Centre Hospitalier Universitaire Vaudois (CHUV)

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Lausanne, Vaud (VD), Switzerland

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