Status:

TERMINATED

Electrocautery Ablation for the Prevention of Lung Cancer

Lead Sponsor:

University College, London

Collaborating Sponsors:

Cancer Research UK

Conditions:

Lung Cancer Squamous Cell

Eligibility:

All Genders

18+ years

Phase:

PHASE2

PHASE3

Brief Summary

This study evaluates whether EC treatment is effective in delaying the progression of high-grade lung lesion(s) to invasive lung cancer. Participants will be randomised to receive either electrocauter...

Detailed Description

Squamous cell carcinoma of the lung develops through a transition of progressive cytological aberration, from normal to metaplasia, mild, moderate, and severe dysplasia and then carcinoma in situ (CIS...

Eligibility Criteria

Inclusion

  • Inclusion criteria:
  • Patients with ≥1 airway HGL (defined as severe dysplasia or carcinoma in situ on histology)
  • PRE-REGISTRATION
  • Patient has a high likelihood of having airway HGLs as evaluated by investigator:
  • patient already part of existing surveillance programme or
  • HGL identified at other hospital and patient is referred to study site or
  • patient has abnormal sputa and patient is referred to study site
  • PRE-RANDOMISATION Following registration, patients undergo a baseline bronchoscopy and only those with ≥1 airway HGL(s) can continue to randomisation provided they continue to meet all the inclusion/exclusion criteria below
  • Absence of primary lung cancer as confirmed by CT thorax OR recent surgical removal of a lung cancer with clear resection margins (of cancer) confirmed OR recent successful curative SABR treatment, as confirmed by MDT
  • Male or female patients ≥18 years of age
  • No upper age limit but life expectancy thought to be at least 3 years (in the opinion of the treating clinician)
  • ECOG Performance Score 0-2
  • FEV1 ≥ 25% of predicted\*
  • DLCO/TLCO ≥ 20% of predicted (only required for registration)\*
  • Patients who are women of child-bearing potential (WOCBP) must also have a negative pregnancy test at the following time points:
  • One pregnancy test prior to registration
  • One pregnancy test within 24 hours prior to the 1st EC treatment within each EC treatment round
  • Consent to donation of biological samples for translational work. Patients will be deemed ineligible if they do not consent to donate translational samples
  • Patient is willing and able to comply to protocol procedures and attend all study visits including all bronchoscopy and EC treatment visits.
  • if spirometry is not possible (e.g. due to COVID-19) investigator assessment that the patient is sufficiently fit for bronchoscopy and EC treatment is permissible.
  • Exclusion criteria:
  • Finding of (micro)-invasive disease on histology (assessed at randomisation)
  • Patients who have one or more HGL present for ≥5 years which have remained persistent on white light or autofluorescence bronchoscopy (AFB) surveillance
  • Detection of active cancer or on systemic treatment for cancer, excluding basal cell skin cancers
  • Previous radiotherapy to the treatment area
  • ECOG Performance Score \>2
  • Patients who have one or more HGL greater than 3cm in length
  • Patients with a history of pulmonary hypertension
  • Patients who are anticoagulated for prosthetic heart valves
  • Decompensated heart disease with life expectancy less than 3 years
  • Severe liver and renal insufficiency with life expectancy less than 3 years
  • Patient unlikely to cooperate with a 3-year follow-up; medical or psychological condition at the discretion of the investigator which would not permit compliance with the protocol or meaningful signed informed consent
  • Participation in another study with an investigational medicinal product within one month prior to registration
  • Pregnant patients (confirmed by serum/urine ß-HCG)
  • Any other known condition which is assessed as an intolerable risk by the investigator upon inclusion in the study

Exclusion

    Key Trial Info

    Start Date :

    October 29 2020

    Trial Type :

    INTERVENTIONAL

    Allocation :

    ACTUAL

    End Date :

    October 11 2022

    Estimated Enrollment :

    13 Patients enrolled

    Trial Details

    Trial ID

    NCT03870152

    Start Date

    October 29 2020

    End Date

    October 11 2022

    Last Update

    October 31 2022

    Active Locations (1)

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    UCLH

    London, United Kingdom