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This clinical trial is an exploratory clinical trial with two cohorts:
Cohort 1: aiming to conduct a preliminary evaluation of the effectiveness and safety of the Navigational Bronchoscopy System and the Bronchoscope and Accessories (manufactured by Noah) in combination with the cryoablation therapy devices for the treatment of lung malignancies.
Cohort 2: aiming to conduct a preliminary evaluation of the effectiveness and safety of the Navigational Bronchoscopy System and the Bronchoscope and Accessories (manufactured by Puli Ark) in combination with the cryoablation therapy devices for the treatment of lung malignancies.
The overall objective of this study is to conduct a preliminary evaluation of the effectiveness and safety of navigational bronchoscopy - guided cryoablation therapy of the lungs through the above two cohorts.
This clinical trial adopts a prospective, dual-center, exploratory design, aiming for a preliminary evaluation of the effectiveness and safety of the investigational medical devices Navigational Bronchoscopy System and Bronchoscope and Accessories in combination with cryoablation therapy device for the treatment of lung malignancies. The clinical trial is planned to be conducted at two clinical trial institutions, with approximately 40 subjects enrolled in total. Subjects who have signed the informed consent form (ICF), meet the conditions for this trial, meet all inclusion criteria and do not meet any exclusion criteria will be included in this study. Enrolled subjects will receive the investigational medical devices Navigational Bronchoscopy System and Bronchoscope and Accessories in combination with cryoablation therapy device for the treatment of lung malignancies on Day 0. Subjects will undergo safety and effectiveness evaluations on the following timelines: Day 1 post-treatment (within 24 hours after treatment), 1 month post-treatment (Day 30 ± 7 days after treatment), and 3 months post-treatment (Day 90 ± 14 days after treatment). After completing the follow-up visit at 3 months post-treatment (Day 90 ± 14 days post-treatment), investigators at each study site, at their discretion, will conduct subsequent treatments based on routine medical practice, and will continue follow-up to 12 months post-treatment and record relevant clinical data.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| An exploratory clinical trial with two cohorts | Experimental | Cohort1: Enrolled subjects will undergo bronchoscopy-guided cryoablation procedure for treating malignant lung nodules in Shanghai Chest Hospital, China. Cohort2: Enrolled subjects will undergo bronchoscopy-guided cryoablation procedure for treating malignant lung nodules at the Prince of Wales Hospital of the Chinese University of Hong Kong. The two cohorts differ in the manufacturer of the bronchoscope and accessories used at each site. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cryoablation Therapy | Device | Navigational Bronchoscopy System and Bronchoscope and Accessories in Combination with Cryoablation Therapy Device. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Technical success rate (ablation lesion level) | Definition of technical success: Immediately following the procedure (no more than 30 minutes after completion of all ablation deliveries), the cone-beam computerized tomography (CBCT) imaging (evaluated by treating investigator) shows that the target lesion is covered completely by the ablation zone (i.e., the ablation zone completely overlaps or encompasses target tumor plus an ablative margin (a minimum of 5 mm ablative margin). | Immediately following the procedure (no more than 30 minutes after completion of all ablation deliveries) |
| Measure | Description | Time Frame |
|---|---|---|
| Technique efficacy rate at 3 months after treatment (ablation lesion level) | Definition of technique efficacy rate: 3 months after ablation treatment, the percentage of target tumors successfully eradicated in the total number of lesions receiving ablation treatment. | 3 months after ablation treatment |
| Disease control rate |
| Measure | Description | Time Frame |
|---|---|---|
| Adverse events (AEs) / Serious Adverse Events (SAEs) | Observe whether there are AEs or SAEs throughout the trial, count the number of cases and events and calculate the incidence (%). | * Screening period/ Baseline (Day -30 to Day 0) * Treatment period / the day of ablation procedure (Day 0) * Day 1 post-treatment, within 24 hours after treatment * 1 month post-treatment * 3 months post-treatment |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Dandan Jia | Contact | +86 13436311329 | dandanjia@pulimed.com |
| Name | Affiliation | Role |
|---|---|---|
| Jiayuan Sun | Shanghai Chest Hospital | Principal Investigator |
| Calvin Ng | Chinese University of Hong Kong, Prince of Wales Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Shanghai Chest Hospital | Recruiting | Shanghai | Shanghai Municipality | 200030 | China |
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| ID | Term |
|---|---|
| D008175 | Lung Neoplasms |
| ID | Term |
|---|---|
| D012142 | Respiratory Tract Neoplasms |
| D013899 | Thoracic Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
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| ID | Term |
|---|---|
| D020680 | Bronchoscopes |
| ID | Term |
|---|---|
| D019723 | Endoscopes |
| D019719 | Diagnostic Equipment |
| D004864 | Equipment and Supplies |
| D013523 | Surgical Equipment |
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Disease control rate is defined as the proportion of target ablated lesions that achieve complete ablation and incomplete ablation as assessed by imaging in the total number of ablated lesions at 3 months follow-ups. |
| At 3 months follow-ups. |
| Navigation success rate | Criteria for successful navigation: Navigation is considered successful if lesion arrival is confirmed by the navigation system and the distance between the bronchoscope and the margin of preoperative planning target is less than 2 cm, or the actual distance is judged by the investigator to be sufficient to complete the ablation and the ablation is successful. Otherwise, navigation is considered a failure. | During the cryoablation procedure |
| Quality of life score | Quality of life is scored by the European Organization for Research and Treatment of Cancer (EORCT) Quality of Life Questionnaire-Core 30 scale (QLQ-C30) at screening period/baseline, 1 month post-treatment, and 3 months post-treatment follow-up. The minimum value for each answer result is 1, indicating "no", and the maximum value is 4, indicating "very much". Higher scores on the functional scales/items indicate better functional status. Higher scores on the symptom scales/items indicate more severe symptoms. Higher scores on the global health status/QoL scale indicate better global health status/QoL. | At screening period/baseline, 1 month post-treatment, and 3 months post-treatment follow-up |
| Device performance evaluation | Device performance of the investigational medical devices Navigational Bronchoscopy System and Bronchoscope and Accessories is evaluated by the treating investigator on the day of the ablation procedure. The highest score is 5, indicating excellent performance, while the lowest score is 1, signifying poor performance. Higher scores on the device performance evaluation indicate better device performance. | On the day of the ablation procedure |
| Device-related AEs / device-related SAEs | Observe whether there are device-related AEs or SAEs throughout the trial, count the number of cases and events and calculate the incidence (%). | * Treatment period / the day of ablation procedure (Day 0) * Day 1 post-treatment, within 24 hours after treatment * 1 month post-treatment * 3 months post-treatment |
| Complications | Observe whether there are complications during the clinical trial, count the number of cases and events and calculate the incidence (%). Complications include but not limited to: pneumothorax, pleural effusion, hemorrhage (intrapulmonary hemorrhage/hemothorax), pulmonary infection, cavity formation, and other rare complications (bronchopleural fistula, acute respiratory distress syndrome, non-target area frostbite, rib fracture, cold shock, thrombocytopenia, tumor needle tract implantation, nerve injury (brachial plexus, intercostal, phrenic, recurrent laryngeal nerves, etc.), pulmonary embolism, air embolism, cardiac tamponade, etc.) . | * Treatment period / the day of ablation procedure (Day 0) * Day 1 post-treatment, within 24 hours after treatment * 1 month post-treatment * 3 months post-treatment |
| Chinese University of Hong Kong, Prince of Wales Hospital | Not yet recruiting | Shatin | Hong Kong |
|
| D008171 |
| Lung Diseases |
| D012140 | Respiratory Tract Diseases |