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Pre-operative Biliary SEMS RCT During Neoadjuvant Therapy


2015-03-24


2018-02-21


2018-04-10


119

Study Overview

Pre-operative Biliary SEMS RCT During Neoadjuvant Therapy

The purpose of this study is to demonstrate non-inferiority of Fully Covered biliary SEMS to Uncovered biliary SEMS in biliary drainage for the pre-operative management of biliary obstructive symptoms caused by pancreatic cancer in patients undergoing neoadjuvant therapy.

N/A

  • Pancreatic Cancer
  • DEVICE: WallFlex™ Biliary RX Fully Covered/Uncovered Stent System
  • 90905950
  • E7034 (OTHER Identifier) (OTHER: Boston Scientific)

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates Results Reporting Dates Study Record Updates

2014-05-02  

2019-07-25  

2020-02-14  

2014-09-10  

2020-02-14  

2020-02-17  

2014-09-12  

2020-02-17  

2020-02  

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

Design Details

Primary Purpose:
Treatment


Allocation:
Randomized


Interventional Model:
Parallel


Masking:
None


Arms and Interventions

Participant Group/ArmIntervention/Treatment
ACTIVE_COMPARATOR: WallFlex Biliary RX Fully Covered Stent System

Patients in this group will receive a fully covered study SEMS (self-expanding metal stent) Reintervention can occur with either a WallFlex™ Biliary RX Fully Covered or Uncovered Stent System

DEVICE: WallFlex™ Biliary RX Fully Covered/Uncovered Stent System

  • Reintervention can occur in Arm 1 or Arm 2 with either a WallFlex™ Biliary RX Fully Covered or Uncovered Stent System
ACTIVE_COMPARATOR: WallFlex Biliary RX Uncovered Stent System

Patients in this group will receive an uncovered study SEMS (self-expanding metal stent). Reintervention can occur with either a WallFlex™ Biliary RX Fully Covered or Uncovered Stent System

DEVICE: WallFlex™ Biliary RX Fully Covered/Uncovered Stent System

  • Reintervention can occur in Arm 1 or Arm 2 with either a WallFlex™ Biliary RX Fully Covered or Uncovered Stent System
Primary Outcome MeasuresMeasure DescriptionTime Frame
Sustained Biliary Drainage, Defined as Absence of Reinterventions for the Management of Biliary Obstructive SymptomsSustained biliary drainage, defined as absence of reinterventions for the management of biliary obstructive symptoms, assessed from self-expanding metal stent (SEMS) placement until curative intent surgery (CIS) when applicable, or to one year after SEMS placement otherwise.From SEMS placement until CIS (for patients undergoing CIS; median 110 days to CIS) or from SEMS placement to one year after SEMS placement (for patients not undergoing CIS)
Secondary Outcome MeasuresMeasure DescriptionTime Frame
Procedure-related or Stent-related Serious Adverse EventsSerious adverse events related to the stent placement procedure or to the stentFrom stent placement procedure up to one year after stent placement procedure
Technical SuccessTechnical success defined as the ability to deploy the stent in a satisfactory position across the stricture; proximal end of the stent is no more than 1-2cm beyond the proximal end of the stricture.During the Stent Placement Procedure
Ability to Complete Neoadjuvant Therapy as Intended Without Stent-related Interruptions of Neoadjuvant Therapy and Without Biliary ReinterventionThe ability to complete neoadjuvant therapy as intended without stent-related interruptions of neoadjuvant therapy and without biliary reinterventionFrom initial stent placement procedure to curative intent surgery (CIS) (median 110 days to CIS), or from initial stent placement procedure to one year after initial stent placement for participants not undergoing CIS
Number of Participants With Stent MigrationThe number of participants with stent migrationAt the time of curative intent surgery (CIS) (median 110 days to CIS) or transition to palliation for participants not underoing CIS
Subjective Impression of the Surgeon That the Presence of a Self-expanding Metal Stent May Have Impacted the Surgical ProcedureThe subjective impression of the surgeon that the presence of a self-expanding metal stent (SEMS) may have impacted the surgical procedure.At the time of curative intent surgery (CIS) (median 110 days to CIS)
For Participants Not Undergoing Curative Intent Surgery, Sustained Biliary Drainage to One Year After Stent PlacementFor participants not undergoing curative intent surgery, sustained biliary drainage from stent placement to one year after stent placement.From stent placement to one year after stent placement for participants not undergoing curative intent surgery

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person’s general health condition or prior treatments.

Ages Eligible for Study:
ALL

Sexes Eligible for Study:
18 Years

Accepts Healthy Volunteers:

    Inclusion Criteria:

  • Age 18 or older
  • Patient indicated for biliary metal stent placement for the treatment of jaundice and/or cholestasis
  • Willing and able to comply with the study procedures and provide written informed consent to participate in the study
  • Suspicion of pancreatic adenocarcinoma
  • Likely indicated for neoadjuvant treatment
  • Distal biliary obstruction consistent with pancreatic cancer
  • Location of distal biliary obstruction such that it would allow the proximal end of a stent to be positioned at least 2 cm from the hilum
  • Endoscopic and surgical treatment to be provided at the same institution

  • Exclusion Criteria:

  • Benign biliary strictures
  • Malignancy secondary to Intraductal Papillary Mucinous Neoplasm
  • Surgically altered anatomy where ERCP is not possible
  • Previous biliary drainage using a SEMS or multiple plastic stents
  • Contraindications for endoscopic techniques
  • Patients who are currently enrolled in another investigational trial that would directly interfere with the current study
  • Pregnancy

Collaborators and Investigators

This is where you will find people and organizations involved with this study.


    • PRINCIPAL_INVESTIGATOR: Yousuke Nakai, MD, PhD, Tokyo University

    Publications

    The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

    General Publications

    • Seo DW, Sherman S, Dua KS, Slivka A, Roy A, Costamagna G, Deviere J, Peetermans J, Rousseau M, Nakai Y, Isayama H, Kozarek R; Biliary SEMS During Neoadjuvant Therapy Study Group. Covered and uncovered biliary metal stents provide similar relief of biliary obstruction during neoadjuvant therapy in pancreatic cancer: a randomized trial. Gastrointest Endosc. 2019 Oct;90(4):602-612.e4. doi: 10.1016/j.gie.2019.06.032. Epub 2019 Jul 2.