E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Peritoneal carcinomatosis from colorectal origin |
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E.1.1.1 | Medical condition in easily understood language |
Metastases on the peritoneum from bowel cancer |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 18.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10052358 |
E.1.2 | Term | Colorectal cancer metastatic |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
- Evaluate tumour detection sensitivity and specificity with the following image enhancement modalities:
- 1 ‘narrow-band imaging’, 2 ‘autofluorescent imaging’, 3 ‘near-infrared indocyanin green imaging’, 4 ‘5-aminolevulinic acid fluorescent imaging’, 5 ‘three-dimensional imaging’ and 6 ‘spray-dye chromoendoscopy’ compared to conventional white light laparoscopy in patients with peritoneal carcinomatosis in order to achieve best tumour detection.
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E.2.2 | Secondary objectives of the trial |
- To evaluate if the use of narrow-band imaging is feasible for this procedure.
- To evaluate if the use of autofluorescent imaging is feasible for this procedure.
- To evaluate if the use of intravenous indocyanin green injection visualized by near-infrared imaging is safe and feasible for this procedure.
- To evaluate if the use of fluorescent imaging with 5-aminolevulinic acid is safe and feasible for this procedure.
- To evaluate if the use of three-dimensional imaging is feasible for this procedure.
- To evaluate if the use of spray-dye chromoendoscopy with indigo carmine blue is safe and feasible for this procedure.
- To evaluate extra operating time by the use of these image enhancement modalities
- To evaluate possible adverse effects
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
• Oral and written informed consent
• Age 18 years and older
• Elective cytoreductive surgery followed by HIPEC
• Regular preoperative work-up
• Laparoscopic approach
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E.4 | Principal exclusion criteria |
• Patients who are legally or mentally incapable or unable to give informed consent
• Patients younger than 18 years
• ASA (American Society of Anaesthesiologists) score higher than 3
• Exclusion criteria for cytoreductive surgery followed by HIPEC
• Exclusion criteria for resection of colorectal cancer
• Patients who have had major open abdominal surgery
• Hypersensitivity reaction to prior usage of indigo carmine or other dyes
• Severe high blood pressure, cardiac ischemia and heart insufficiency
• Iodine allergy
• Patients with hyperthyroidism or autonomous hyperthyroid adenoma
• Interaction with any of the following medication: any anticonvulsive medicine, bisulphites, haloperidol, heroin, meperidine, metamizol, methadone, morfine, nitrofurantoine, opiate alkaloids, fenobarbital, fenylbutazon, cyclopropane, probenicid, rifamycin, tetracyclines, sulphonamides, fluoroquinolones and hypericin extracts
• Hypersensitivity reaction to prior usage of indocyanin green injection
• Hypersensitivity to 5-ALA or porphyrins
• Acute or chronic types of porphyria
• Urgent indication for surgery
• Pregnancy
• Chronic kidney failure (eGFR<55)
• Chronic liver failure
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E.5 End points |
E.5.1 | Primary end point(s) |
-Evaluate tumour detection sensitivity and specificity with the following image enhancement modalities:
1 ‘narrow-band imaging’, 2 ‘autofluorescent imaging’, 3 ‘near-infrared indocyanin green imaging’, 4 ‘5-aminolevulinic acid fluorescent imaging’, 5 ‘three-dimensional imaging’ and 6 ‘spray-dye chromoendoscopy’ compared to conventional white light laparoscopy in patients with peritoneal carcinomatosis in order to achieve best tumour detection.
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
After the surgical procedure when pathological examination of the specimen and biopsies is completed |
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E.5.2 | Secondary end point(s) |
- To evaluate if the use of narrow-band imaging is feasible for this procedure.
- To evaluate if the use of autofluorescent imaging is feasible for this procedure.
- To evaluate if the use of intravenous indocyanin green injection visualized by near-infrared imaging is safe and feasible for this procedure.
- To evaluate if the use of fluorescent imaging with 5-aminolevulinic acid is safe and feasible for this procedure.
- To evaluate if the use of three-dimensional imaging is feasible for this procedure.
- To evaluate if the use of spray-dye chromoendoscopy with indigo carmine blue is safe and feasible for this procedure.
- To evaluate extra operating time by the use of these image enhancement modalities
- To evaluate possible adverse effects
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
After the surgical procedure when pathological examination of the specimen and biopsies is completed |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | Yes |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | Yes |
E.8.1.7.1 | Other trial design description |
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E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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The trial is completed when 10 patients are included |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |