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Transbronchial Biopsy Assisted by Robot Guidance in the Evaluation of Tumors of the Lung

Completed
Conditions
Pulmonary Nodule
Lung Cancer
Interventions
Device: Robotic assisted bronchoscopy
Registration Number
NCT04182815
Lead Sponsor
Auris Health, Inc.
Brief Summary

This study is designed to evaluate clinical safety and diagnostic accuracy of the robotic-assisted bronchoscopy with biopsy performed with the Monarch™ Endoscopy Platform in a broad range of patients with pulmonary lesions.

Detailed Description

Despite technological advancements in guided bronchoscopy such as electromagnetic navigation bronchoscopy and radial probe endobronchial ultrasound, successful biopsy of peripheral pulmonary lesions remains a challenge due to a number of factors, one of which may be the ability to gain access to peripheral lesions due to the size and maneuverability of conventional bronchoscopes. The diagnostic yield of conventional bronchoscopic approaches for peripheral lesions remains suboptimal.

A novel robotic assisted bronchoscopy procedure now exists for patients with lung nodules. This procedure is performed using the Monarch™ platform (Auris Health, Inc., Redwood City, CA). This study is expected to enroll up to 1200 patients at up to 30 investigative sites.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
691
Inclusion Criteria
  1. Over 21 years of age;
  2. Capable and willing to give informed consent;
  3. Acceptable candidate for an elective, non-emergent bronchoscopic procedure;
  4. Lung lesions, 8 mm to 50 mm in size, requiring bronchoscopic diagnosis which were identified on thin slice CT scan within 28 days of the intended bronchoscopy
Exclusion Criteria
  1. Medical contraindication to bronchoscopy as assessed by the investigator
  2. Presence of uncorrectable bleeding disorders
  3. Medical devices interfering with electro-magnetic navigation, including but not limited to pacemaker
  4. Patients with the target lesion having endobronchial involvement seen on chest CT
  5. Lack fitness to undergo flexible bronchoscopy as determined by the bronchoscopist prior to procedure,
  6. Participation in any other clinical trial within 30 days of enrollment that would interfere with this study;
  7. Uncontrolled or irreversible coagulopathy;
  8. Female subjects who are pregnant or nursing at the time of the procedure or those of child-bearing potential refusing a pregnancy test prior to the procedure;
  9. CT scan done greater than 28 days before the bronchoscopy procedure.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Robotic assisted bronchoscopyRobotic assisted bronchoscopyRobotic assisted bronchoscopy procedures will be performed using the Monarch platform.
Primary Outcome Measures
NameTimeMethod
Incidence of device or procedure related complicationsup to 7 days post procedure

The primary endpoint is a composite that includes pneumothorax requiring intervention rated as \> Grade 1 according to the Common Terminology Criteria for Adverse Events (CTCAE) scale, bleeding requiring medical intervention, rated as \> Grade 1 according to the CTCAE scale, and respiratory failure, rated as \> Grade 3 according to the CTCAE scale.

Secondary Outcome Measures
NameTimeMethod
Total procedure timeDuring the procedure
Rate of conversion to conventional bronchoscopic procedureDuring the procedure
Rate of device or procedure related complicationsup to 7 days post procedure

Individual components of the primary endpoint

Sensitivity for malignancyup to 24 months post procedure
Rate of post-bronchoscopy infectionsup to 7 days post-procedure
Rate of adverse events unrelated to device or procedureup to 7 days post procedure
Rate of all pneumothoraxesup to 7 days post procedure
Stage at diagnosisup to 24 months post procedure

Stage at diagnosis (if applicable) will be evaluated for all robotic-assisted bronchoscopy procedures performed for suspicion of lung cancer

Diagnostic yieldup to 24 months post procedure

Diagnostic yield for all robotic-assisted procedure performed for suspicion of lung cancer will be evaluated based on histopathological assessment of acquired tissue samples

Trial Locations

Locations (19)

University Health Network

🇨🇦

Toronto, Ontario, Canada

The University of Connecticut Health Center

🇺🇸

Farmington, Connecticut, United States

Mayo Clinic Arizona

🇺🇸

Scottsdale, Arizona, United States

Franciscan Health Indianapolis

🇺🇸

Indianapolis, Indiana, United States

Minnesota Lung Center, Ltd

🇺🇸

Minneapolis, Minnesota, United States

TriStar Centennial Medical Center

🇺🇸

Nashville, Tennessee, United States

Eisenhower Medical Center

🇺🇸

Rancho Mirage, California, United States

Costal Pulmonary Associates

🇺🇸

Encinitas, California, United States

Sarasota Memorial Hospital

🇺🇸

Sarasota, Florida, United States

University of Chicago Medicine

🇺🇸

Chicago, Illinois, United States

Northwestern Medicine Central DuPage Hospital

🇺🇸

Winfield, Illinois, United States

Spectrum Health System

🇺🇸

Grand Rapids, Michigan, United States

Roswell Park Cancer Institute

🇺🇸

Buffalo, New York, United States

Cleveland Clinic

🇺🇸

Cleveland, Ohio, United States

Clinical Research Associates of Central PA

🇺🇸

Altoona, Pennsylvania, United States

University of Pittsburgh Medical Center, Hamot

🇺🇸

Erie, Pennsylvania, United States

Prince of Wales Hospital

🇨🇳

Hong Kong, Hong Kong, China

Cancer Treatment Centers of America

🇺🇸

Tulsa, Oklahoma, United States

Medical University of South Carolina

🇺🇸

Charleston, South Carolina, United States

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