UMIN-ICDS Clinical Trial

Unique ID issued by UMIN UMIN000031029
Receipt number R000035435
Scientific Title Feasibility of a fast-track randomised controlled trial of cell-free and concentrated ascites reinfusion therapy for patients with malignant ascites
Date of disclosure of the study information 2018/02/19
Last modified on 2022/01/31 10:06:14

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Basic information

Public title

Feasibility of a fast-track randomised controlled trial of cell-free and concentrated ascites reinfusion therapy for patients with malignant ascites

Acronym

Feasibility of a fast-track RCT of cell-free and concentrated ascites reinfusion therapy for patients with malignant ascites

Scientific Title

Feasibility of a fast-track randomised controlled trial of cell-free and concentrated ascites reinfusion therapy for patients with malignant ascites

Scientific Title:Acronym

Feasibility of a fast-track RCT of cell-free and concentrated ascites reinfusion therapy for patients with malignant ascites

Region

Japan


Condition

Condition

malignant ascites

Classification by specialty

Medicine in general

Classification by malignancy

Malignancy

Genomic information

NO


Objectives

Narrative objectives1

To determine the feasibility of conducting a fast-track trial of concentrated ascites reinfusion therapy(CART) for patients with malignant ascites.

Basic objectives2

Others

Basic objectives -Others

To estimate the efficacy and safety of CART for malignant ascites.

Trial characteristics_1

Exploratory

Trial characteristics_2

Pragmatic

Developmental phase

Not applicable


Assessment

Primary outcomes

The rate of patients whose time to next paracentesis are evaluable.

Key secondary outcomes

The period until ascites reaccumulation(e.g., Time to next paracentesis, paracentesis-free survival, abdominal distention relapse-free period, abdminal circumference rebound-free period, and paracentesis request-free period), intensity of ascites-related symptoms, and adverse events.


Base

Study type

Interventional


Study design

Basic design

Parallel

Randomization

Randomized

Randomization unit

Individual

Blinding

Open -no one is blinded

Control

Active

Stratification

YES

Dynamic allocation

YES

Institution consideration

Institution is not considered as adjustment factor.

Blocking

NO

Concealment

Central registration


Intervention

No. of arms

2

Purpose of intervention

Treatment

Type of intervention

Maneuver

Interventions/Control_1

In this fast-track RCT, patients are randomised either to an intervention group, where they receive concentrated ascites reinfusion therapy(CART), or the control group, whrer they receive paracentesis only. After the first intervention, patients receive the opposite treatment when their ascites are reaccumulated.

Paracentesis:
Paracentesis is performed under sterile conditions and local anethesia. A 20 gauge aspiration needle is inserted into the peritoneal cavity in the left or right lower quadrant and ascitic fluid is removed by gravity in one to two hours. The removal volume of ascitic fluid is around 2000mL.

Interventions/Control_2

CART:
1) paracentesis
2) Removed ascitic fluid is filtrated with AHF-MOW (Asahi Kasei Medical, Tokyo, Japan), and is concentrated in about one-tenth with AHF-UP (Asahi Kasei Medical, Tokyo).
3) The filtered and concentrated ascetic fluid is reinfused into the patient via a
peripheral vein by 50-100mL/hour. To prevent fever up, acetaminophen 400mg is infused before ascites reinfusion.

Interventions/Control_3


Interventions/Control_4


Interventions/Control_5


Interventions/Control_6


Interventions/Control_7


Interventions/Control_8


Interventions/Control_9


Interventions/Control_10



Eligibility

Age-lower limit

20 years-old <=

Age-upper limit


Not applicable

Gender

Male and Female

Key inclusion criteria

1. Metastatic or locally advanced cancer patients diagnosed either pathologically or clinically.
2. Life expectancy >= 14 days
3. Hospitalized in Seirei Hospice
4. At least one symptomatic paracentesis within 3 weeks as well as an objectively verified, clinical need for a second paracentesis.
5. Refractory or resistant to chemotherapy, or standard chemotherapy is no longer feasible.
6. Patients who are fluent in Japanese.
7. Concent to this trial.

Key exclusion criteria

1. Patient who received chemotherapy, immunotherapy, hormonal therapy, or abdominal radiotherapy in the previous 28 days.
2. Patient who have systemic infections or abdominal infections.
3. Patient who generate fever >= 38 degree celsius.
4. Patient whose systolic blood pressure < 80mmHg.
5. Hemoglobine <6.0 mg/dL
Creatinine >= 2.0ug/dL
Total bilirubine >= 5.0mg/dL
6. Patient who have history of hepatic encephalopathy.
7. Patient who have cognitive inpairement.
8. Patient without any intravenous line.
9. Other reasons by which physicians judge they are ineligible.

Target sample size

20


Research contact person

Name of lead principal investigator

1st name Naosuke
Middle name
Last name Yokomichi

Organization

Seirei Mikatahara General Hospital

Division name

Seirei Hospice

Zip code

433-8558

Address

3453, Mikatahara-cho, Kita-ku, Hamamatsu, Shizuoka

TEL

053-436-1251

Email

n-yokomichi@sis.seirei.or.jp


Public contact

Name of contact person

1st name Naosuke
Middle name
Last name Yokomichi

Organization

Seirei Mikatahara General Hospital

Division name

Seirei Hospice

Zip code

433-8558

Address

3453, Mikatahara-cho, Kita-ku, Hamamatsu, Shizuoka

TEL

053-436-1251

Homepage URL


Email

n-yokomichi@sis.seirei.or.jp


Sponsor or person

Institute

Seirei Hospice, Seirei Mikatahara General Hospital

Institute

Department

Personal name



Funding Source

Organization

Sasagawa Memorial Health Foundation

Organization

Division

Category of Funding Organization

Non profit foundation

Nationality of Funding Organization



Other related organizations

Co-sponsor


Name of secondary funder(s)



IRB Contact (For public release)

Organization

Seirei Mikatahara General Hospital

Address

3453, Mikatahara-cho, Kita-ku, Hamamatsu, Shizuoka

Tel

053-436-1251

Email

mk-rinri@sis.seirei.or.jp


Secondary IDs

Secondary IDs

NO

Study ID_1


Org. issuing International ID_1


Study ID_2


Org. issuing International ID_2


IND to MHLW



Institutions

Institutions

聖隷三方原病院


Other administrative information

Date of disclosure of the study information

2018 Year 02 Month 19 Day


Related information

URL releasing protocol

N/A

Publication of results

Unpublished


Result

URL related to results and publications

N/A

Number of participants that the trial has enrolled

20

Results

This study was an open-label, fast-track, randomized controlled, feasibility trial. Patients were randomly assigned 1:1 to a CART arm or control (simple paracentesis) arm. The feasibility endpoint was the percentage of patients who completed the study intervention.

Of 20 patients allocated, 18 patients (90%, 95% CI: 68.3-98.8) completed the study intervention.

A fast-track randomized controlled trial of CART for patients with malignant ascites is feasible.

Results date posted

2021 Year 08 Month 01 Day

Results Delayed

Delay expected

Results Delay Reason

Under review

Date of the first journal publication of results


Baseline Characteristics

The median age was 71.5, and 80% were female. All patients had an ECOG performance status of 3 or 4. The most frequent primary tumor site was the pancreas (25%), followed by the gastrointestine (20%), and liver and bile duct (15%). Massive liver metastasis existed in 30% of patients.

Participant flow

We screened 953 patients for eligibility. Of 61 patients with refractory malignant ascites, 21 patients were determined as eligible. Finally, 20 patients consented and were allocated

Adverse events

One patient in the CART arm developed Grade 1 fever.

Outcome measures

18 patients (90%, 95% CI: 68.3-98.8) completed the study intervention. Median paracentesis-free survivals were 5 days (95% CI: 2-6) in the CART arm, and 6 days (3-9) in the control arm. Median PRO-paracentesis-free survivals were 4 days (2-5) and 5 days (1-9), respectively.

Plan to share IPD


IPD sharing Plan description



Progress

Recruitment status

Completed

Date of protocol fixation

2018 Year 02 Month 19 Day

Date of IRB

2018 Year 02 Month 19 Day

Anticipated trial start date

2018 Year 02 Month 20 Day

Last follow-up date

2020 Year 02 Month 19 Day

Date of closure to data entry

2020 Year 03 Month 19 Day

Date trial data considered complete

2020 Year 03 Month 31 Day

Date analysis concluded

2021 Year 03 Month 31 Day


Other

Other related information



Management information

Registered date

2018 Year 01 Month 28 Day

Last modified on

2022 Year 01 Month 31 Day



Link to view the page

Value
https://center6.umin.ac.jp/cgi-open-bin/icdr_e/ctr_view.cgi?recptno=R000035435


Research Plan
Registered date File name

Research case data specifications
Registered date File name

Research case data
Registered date File name