PCI Treatment/Gemcitabine & Chemotherapy vs Chemotherapy Alone in Patients With Inoperable Extrahepatic Bile Duct Cancer

Overview

About this study

The purpose of this study is to assess the safety and effectiveness of fimaporfin-induced photochemical internalisation (PCI) of gemcitabine complemented by systemic gemcitabine/cisplatin chemotherapy compared to gemcitabine/cisplatin alone, in patients with inoperable cholangiocarcinoma (CCA).

Participation eligibility

Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Guidelines differ from study to study, and identify who can or cannot participate. There is no guarantee that every individual who qualifies and wants to participate in a trial will be enrolled. Contact the study team to discuss study eligibility and potential participation.

Inclusion Criteria:

  • Capable of understanding the written informed consent, provides signed and witnessed written informed consent, and agrees to comply with protocol requirements.
  • Male or female patient ≥ 8 years of age.
  • Cholangiocarcinoma verified as adenocarcinoma by histopathology or cytology with a perihilar or distal stenosis that has been stented or will require stenting, and that is accessible for PCI light treatment.
  • Cholangiocarcinoma must be considered inoperable with respect to radical resection (including partial liver resection or liver transplantation).
  • At least 1 radiologically evaluable lesion (measurable and/or non-measurable) that can be assessed at baseline and is suitable for repeated radiological evaluation.
  • If metastatic disease, metastasis must be limited to tissues other than bone or the central nervous system
  • Adequate biliary drainage (at least 50% of the liver volume or at least 2 sectors), with no evidence of active uncontrolled infection (patients on antibiotics are eligible).
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
  • Estimated life expectancy of at least 12 weeks.

Exclusion Criteria:

  • Previously received any anti-tumour (either local or systemic) treatment for CCA, except for previous treatment of up to 2 cycles of gemcitabine/cisplatin.
  • Severe visceral disease other than CCA.
  • A history of frequently recurring septic biliary events.
  • Porphyria or hypersensitivity to porphyrins.
  • A second primary cancer with a disease-free interval of < 5 years. A second primary cancer that has been treated with intent to cure may be allowed after consultation with the study Medical Monitor. Adequately treated basal cell carcinoma, squamous cell carcinoma or other non-melanomatous skin cancer, in-situ carcinoma of the uterine cervix, or prostate cancer that is controlled by hormone therapy (patients may continue hormone therapy while on study) are allowed.
  • Unable to undergo contrast-enhanced CT or MRI.
  • Currently participating in any other interventional clinical study.
  • Planned surgery, endoscopic examination, or dental treatment in the first 30 days after PCI treatment.
  • Co-existing ophthalmic disease likely to require slit-lamp examination within the first 90 days after PCI treatment.
  • Clinically significant and uncontrolled cardiac disease including unstable angina, acute myocardial infarction within 6 months prior to baseline, congestive heart failure, and arrhythmia requiring therapy, except for extra systoles or minor conduction abnormalities and controlled and well treated chronic atrial fibrillation.
  • Known allergy or sensitivity to photosensitisers, (the active substance and/or any of the excipients); or chronic use of other photosensitising therapies; treatment with amiodarone during the last 12 months.
  • Known hypersensitivity to or contraindication to the use of gemcitabine (the active substance and/or any of the excipients).
  • Known hypersensitivity, or contraindication to the use of cisplatin (the active substance and/or any of the excipients).
  • Ataxia telangiectasia.
  • Upon the Investigator’s discretion, evidence of any other medical conditions (such as psychiatric illness, physical examination or laboratory findings) that may interfere with the planned PCI treatment, affect patient compliance or place the patient at high risk from treatment-related complications.
  • Plans to have, or has recently had, vaccination with a live vaccine, including for yellow fever.
  • Concurrently receiving treatment with phenytoin.
  • Male patients unwilling to use highly effective contraception, or women of childbearing potential (WOCBP) unwilling to use a highly effective form of contraception such as the following:
    • Combined (oestrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation (oral, intravaginal and transdermal);
    • Progestogen-only hormonal contraception associated with inhibition of ovulation (oral, injectable, or implantable);
    • Intrauterine devices;
    • Intrauterine hormone-releasing system;
    • Bilateral tubal ligation;
    • Vasectomised partner;*
    • Sexual abstinence.**  Patients must continue the use of contraception during PCI treatment and subsequent chemotherapy, and for at least 9 months after last dose of Amphinex or 6 months after last dose of chemotherapy, whichever is the latest.

*  Vasectomised partner is a highly effective birth control method only if the partner is the sole sexual partner of the WOCBP study participant and if the vasectomised partner has received medical assessment of the surgical success.

** Sexual abstinence is considered a highly effective method only if defined as refraining from heterosexual intercourse during the entire period of risk associated with the study treatments. The reliability of sexual abstinence needs to be evaluated in relation to the duration of the clinical study and the preferred and usual lifestyle of the patient.

  • Breastfeeding women or women with a positive pregnancy test at baseline.
  • Inadequate bone marrow function as evidenced by one of the following:
    • Absolute neutrophil count (ANC) 5 × the ULN for the institution;
    • AST or ALT > 3.0 × ULN (> 5 × ULN if liver metastases are present);
    • ALP levels > 5.0 × ULN.
    • Inadequate renal function, as determined by local practice for patients on fractionated platinum-based chemotherapy. Patients with creatinine clearance < 60 mL/min must not be included.

Participating Mayo Clinic locations

Study statuses change often. Please contact the study team for the most up-to-date information regarding possible participation.

Mayo Clinic Location Status Contact

Rochester, Minn.

Mayo Clinic principal investigator

Kenneth Wang, M.D.

Contact us for the latest status

Contact information:

Bryan Linn

(507) 255-4631

Linn.Bryan@mayo.edu

More information

Publications

Publications are currently not available

Study Results Summary

Not yet available

Supplemental Study Information

Not yet available

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CLS-20488675

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