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Subjects will be offered the opportunity to participate in a randomized, controlled, 2-arm, unblinded multicenter trial (RCT). There will be 2 study arms: the control arm receiving chemotherapy with the modified FOLFIRINOX regimen alone; and the irreversible electroporation (IRE) arm, receiving chemotherapy with the modified FOLFIRINOX regimen followed by IRE with the NanoKnife System using either an open or a percutaneous approach. All subjects will be treated with the modified FOLFIRINOX regimen for at least 3 months; randomization to either control or IRE arm will take place at the time of completion of the 3 month modified FOLFIRINOX chemotherapy regimen. Randomization will be conducted centrally. Subjects will be randomized in a 1:1 ratio and must be found to have no evidence of disease progression after completion of the 3 month modified FOLFIRINOX chemotherapy regimen in order to participate in the RCT. All radiologic assessments will be performed as consistent with the imaging protocol. All post induction and post IRE treatments are left to the discretion of the treating physician. The minimum period of follow-up will be for 24 months or until death.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| IRE | Experimental |
| |
| Control | Active Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Modified FOLFIRINOX Regimen | Drug | Chemotherapy regimen of leucovorin, fluorouracil, irinotecan, and oxaliplatin |
|
| Measure | Description | Time Frame |
|---|---|---|
| Overall Survival | Time (in months) from randomization to the date of death for any reason | Time (in months) from randomization to the date of death for any reason, assessed through at least 24 months. |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Miami Cancer Institute | Miami | Florida | 33176 | United States | ||
| University of South Florida/Tampa |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 34233640 | Derived | Narayanan G, Bilimoria MM, Hosein PJ, Su Z, Mortimer KM, Martin RCG 2nd. Multicenter randomized controlled trial and registry study to assess the safety and efficacy of the NanoKnife(R) system for the ablation of stage 3 pancreatic adenocarcinoma: overview of study protocols. BMC Cancer. 2021 Jul 7;21(1):785. doi: 10.1186/s12885-021-08474-4. |
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| NanoKnife System | Device | IRE using NanoKnife System |
|
| Tampa |
| Florida |
| 33606 |
| United States |
| Northwest Community Healthcare | Arlington Heights | Illinois | 60005 | United States |
| Norton Healthcare | Louisville | Kentucky | 40202 | United States |
| St. Luke's Cancer Center | Easton | Pennsylvania | 18045 | United States |
| University of Texas-Southwestern | Dallas | Texas | 75231 | United States |
| ID | Term |
|---|---|
| D010190 | Pancreatic Neoplasms |
| D021441 | Carcinoma, Pancreatic Ductal |
| ID | Term |
|---|---|
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D004701 | Endocrine Gland Neoplasms |
| D004066 | Digestive System Diseases |
| D010182 | Pancreatic Diseases |
| D004700 | Endocrine System Diseases |
| D044584 | Carcinoma, Ductal |
| D000230 | Adenocarcinoma |
| D002277 | Carcinoma |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009370 | Neoplasms by Histologic Type |
| D018299 | Neoplasms, Ductal, Lobular, and Medullary |
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