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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT02807181
Registration number
NCT02807181
Ethics application status
Date submitted
13/05/2016
Date registered
21/06/2016
Date last updated
9/05/2025
Titles & IDs
Public title
SIRT Followed by CIS-GEM Chemotherapy Versus CIS-GEM Chemotherapy Alone as 1st Line Treatment of Patients With Unresectable Intrahepatic Cholangiocarcinoma
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Scientific title
Prospective, Multicenter, Randomized, Controlled Study Evaluating SIR-Spheres Y-90 Resin Microspheres Preceding Cisplatin-gemcitabine (CIS-GEM) Chemotherapy Versus CIS-GEM Chemotherapy Alone as First-line Treatment of Patients With Unresectable Intrahepatic Cholangiocarcinoma
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Secondary ID [1]
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STX0115
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Universal Trial Number (UTN)
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Trial acronym
SIRCCA
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Intrahepatic Cholangiocarcinoma
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Condition category
Condition code
Cancer
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Biliary tree (gall bladder and bile duct)
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Oral and Gastrointestinal
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Cisplatin-gemcitabine
Treatment: Devices - Radiation: SIRT + chemotherapy (cisplatin-gemcitabine)
Active comparator: Chemotherapy (Cisplatin-Gemcitabine) - Cisplatin 25mg/m2 in 1000ml 0.9% saline given over 1 hour followed by 500 ml 0.9% saline over 30 minutes, followed by Gemcitabine 1000 mg/m2 in 250-500 ml 0.9% saline over 30 minutes by intravenous infusions on days 1, and 8 of a 21-day cycle.
Experimental: Radiation: SIRT + chemotherapy (Cisplatin-Gemcitabine) - A single treatment of hepatic arterial injection of SIR-Spheres Y-90 resin microspheres (SIRT) followed 14-16 days later by systemic chemotherapy (ABC-02 CIS-GEM protocol) with an intention to treat with 8 cycles of cisplatin + gemcitabine, or until progression, toxicity or patient choice. Treatment may be continued beyond 8 cycles in the absence of significant disease progression, at the treating clinicians' discretion.
Treatment: Drugs: Cisplatin-gemcitabine
Systemic chemotherapy
Treatment: Devices: Radiation: SIRT + chemotherapy (cisplatin-gemcitabine)
SIR-Spheres microspheres followed by systemic chemotherapy
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Intervention code [1]
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Treatment: Drugs
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Intervention code [2]
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Treatment: Devices
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Survival at 18 Months
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Assessment method [1]
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Survival at 18 months is defined as the proportion of patients still alive 18 months from the date of randomization. The outcome was analyzed but the clinical database is not deemed to be reliable.
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Timepoint [1]
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18 months following the date of randomization.
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Secondary outcome [1]
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Liver-specific Progression Free Survival (PFS)
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Assessment method [1]
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Liver-specific PFS was defined as the number of days between randomization and the date of first tumor progression in the liver. Diagnosis of tumor progression was to be made using RECIST 1.1.
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Timepoint [1]
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From date of randomization to the first documented date of progression in the liver or date of death from any cause, assessed up to 36 months..
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Secondary outcome [2]
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Progression Free Survival (PFS) at Any Site
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Assessment method [2]
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PFS was defined as the time interval between randomization and the date of tumor progression. Diagnosis of tumor progression was to be made using RECIST 1.1. The outcome was not analyzed due to unreliability of the clinical database.
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Timepoint [2]
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From date of randomization to the date of progression at any site until the first date of documented tumor progression at any site or date of death from any cause, assessed up to 36 months.
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Secondary outcome [3]
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Objective Response Rate by RECIST 1.1 and Refined RECIST - Liver
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Assessment method [3]
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The outcome was not analyzed due to unreliability of the clinical database.
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Timepoint [3]
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From the date of first treatment until the date of date of first documented progression in the liver, assessed up to 36 months.
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Secondary outcome [4]
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Objective Response Rate by RECIST 1.1 and Refined RECIST - at Any Site
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Assessment method [4]
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The outcome was not analyzed due to unreliability of the clinical database.
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Timepoint [4]
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From the date of first treatment until progression at any site, assessed up to 36 months.
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Secondary outcome [5]
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Overall Survival
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Assessment method [5]
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The outcome was not analyzed due to unreliability of the clinical database.
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Timepoint [5]
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From date of randomization until the date of death from any cause, assessed up to 36 months.
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Secondary outcome [6]
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Liver Surgical Resection and Ablation Rate
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Assessment method [6]
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To assess the number of patients in each arm who are downstaged by protocol therapy and can proceed to liver resection or ablation. The specific assessments will be the classification of resection as R0, R1 or R2, the presence of viable tumor or fibrosis, and the nearest resection margin. The outcome was not analyzed due to unreliability of the clinical database.
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Timepoint [6]
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18 months following the date of randomization.
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Secondary outcome [7]
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Incidence of Adverse Events (Safety and Tolerability)
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Assessment method [7]
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Adverse events (AEs) as assessed by CTCAE v. 4.0. Summaries of non-serious AEs (clinical database, MedDRA 20.1) and serious adverse events (SAEs; pharmacovigilance database, MedDRA 25.1) are provided for information only in the 'Adverse Events' section - the data are deemed unreliable.
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Timepoint [7]
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Informed consent until 28 days post last dose of protocol chemotherapy.
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Eligibility
Key inclusion criteria
* Willing, able and mentally competent to provide written informed consent.
* Aged 18 years or older.
* Histologically or cytologically confirmed unresectable and non-ablatable intrahepatic cholangiocarcinoma.
* Liver-only or liver predominant intrahepatic cholangiocarcinoma. Patient are permitted to have loco-regional lymph node involvement defined as: portal LN </= to 2 cm and/or para aortic LN </= to 1.5 cm in longest diameter, and/or up to 2 indeterminate lung lesions < 1 cm if these lung lesions are positron emission tomography (PET) negative.
* Chemotherapy naïve. Adjuvant chemotherapy is not permitted.
* Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1.
* Adequate hematological function defined as:
Hemoglobin >/= 10g/dL White Blood Cell count (WBC) >/= 3.0 x 10^9/L Absolute neutrophil count (ANC) >/= 1.5 x 10^9/L Platelet count >/= 100,000/mm^3 - Adequate liver function defined as: Total bilirubin </= 30 umol/L (1.75 mg/dL) Albumin >/= 30 g/L
- Adequate renal function defined as: Serum urea and serum creatinine < 1.5 times upper limit of normal (ULN) Creatinine clearance >/= 45 ml/min (calculated with Cockcroft-Gault Equation)
* Life expectancy of at least 3 months without any active treatment
* Female patients must either be postmenopausal, sterile (surgically or radiation- or chemically-induced), or if sexually active use an acceptable method of contraception during the study.
* Male patients must be surgically sterile or if sexually active must use an acceptable method of contraception during the study.
* Considered suitable to receive either regimen in the clinical judgement of the treating investigator.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Patients with only non-measurable lesions in the liver according to RECIST criteria
* Incomplete recovery from previous liver surgery, e.g. unresolved biliary tree obstruction or biliary sepsis or inadequate liver function
* Biliary stent in situ
* Main trunk Portal Vein Thrombosis (PVT)
* Ascites, even if controlled with diuretics. (A minor peri-hepatic rim of ascites detected at imaging is acceptable).
* Mixed hepatocellular carcinoma - intrahepatic cholangiocarcinoma (HCC-ICC) disease
* History of prior malignancy. Exceptions include in-situ carcinoma of the cervix treated by cone-biopsy/resection, non-metastatic basal and/or squamous cell carcinomas of the skin, recurrent intra-hepatic cholangiocarcinoma post local treatment or any early stage (stage 1) malignancy adequately resected with curative intent at least 5 years prior to study entry
* Suspicion of any bone metastasis/metastases or central nervous system metastasis/metastases on clinical or imaging examination.
* Prior internal or external radiation delivered to the liver.
* Pregnancy; breast feeding.
* Participation within 28 days prior to randomization, in an active part of another clinical study that would compromise any of the endpoints of the study.
* Evidence of ongoing active infection that may affect treatment feasibility or outcome.
* Prior Whipple's procedure.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Stopped early
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
14/02/2017
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
29/04/2021
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Sample size
Target
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Accrual to date
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Final
89
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Recruitment in Australia
Recruitment state(s)
NSW,VIC
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Recruitment hospital [1]
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Macquarie University Hospital - North Ryde
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Recruitment hospital [2]
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Peter MacCallum Cancer Centre - Melbourne
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Recruitment postcode(s) [1]
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2109 - North Ryde
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Recruitment postcode(s) [2]
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3000 - Melbourne
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Recruitment outside Australia
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United States of America
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Washington
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Belgium
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Brussels
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France
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Clichy
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France
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Dijon
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France
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Grenoble
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France
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Lyon
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France
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Marseille
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France
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Montpellier
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France
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Nice
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France
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Pessac Cedex
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France
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Poitiers
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France
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Rennes
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France
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Villejuif
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Italy
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Pisa
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Netherlands
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Amsterdam
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Spain
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Barcelona
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Spain
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State/province [17]
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Pamplona
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United Kingdom
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London
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United Kingdom
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Manchester
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United Kingdom
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Southampton
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United Kingdom
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Wirral
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Sirtex Medical
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Address
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Ethics approval
Ethics application status
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Summary
Brief summary
The study planned to evaluate the benefit of applying Selective Internal Radiation Therapy (SIRT) using SIR-Spheres Y-90 resin microspheres prior to receiving systemic chemotherapy treatment (cisplatin-gemcitabine, or CIS-GEM) in patients with unresectable intrahepatic cholangiocarcinoma. Half of the patients were randomized to CIS-GEM chemotherapy plus SIRT, and half of the patients were randomized to CIS-GEM alone.
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Trial website
https://clinicaltrials.gov/study/NCT02807181
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Jordi Bruix, MD
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Address
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Head of the Hepatic Oncology Unit, Hospital Clinic
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Fax
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Email
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Contact person for public queries
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Contact person for scientific queries
Data sharing statement
What supporting documents are/will be available?
No Supporting Document Provided
Type
Other Details
Attachment
Study protocol
Study Protocol and Statistical Analysis Plan
https://cdn.clinicaltrials.gov/large-docs/81/NCT02807181/Prot_SAP_000.pdf
Statistical analysis plan
Study Protocol and Statistical Analysis Plan
https://cdn.clinicaltrials.gov/large-docs/81/NCT02807181/Prot_SAP_000.pdf
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results are available at
https://clinicaltrials.gov/study/NCT02807181
Download to PDF