Prospective, open label, non-controlled single arm, multi-center study The primary objective is to study the effects of the trūFreeze® Spray Cryotherapy System in a population of subjects who have been diagnosed with persistent local esophageal cancer and who are not surgical candidates or have completed or declined systemic therapy.
The use of cryotherapy delivered with the trūFreeze® System via noncontact spray ablates the cancer cells while allowing adjacent normal tissue to regenerate. When the liquid nitrogen is delivered to the malignant lesion the cancer cells undergo ablation induced by intracellular water being frozen in place such that ice crystals are formed. These ice crystals aggregate quickly causing immediate intracellular energy producing organelles to be destroyed leading to a non-viable cell. Subsequent tumor sloughing and absorption of apoptotic cells occurs with a subsequent debulking of the tumor mass. Normal tissue will regenerate as re-epithelialization occurs. The extreme cold of -196 degrees Celsius or a "hard freeze" leads to more extensive primary cell death over a shorter freeze time as compared to cryoprobes. A reduction of overall tumor obstruction in the esophageal lumen can reduce symptoms of dysphagia, delay the time until stent is needed, provide palliative care for patients for whom additional tri-modal therapies are not an option, and may increase quality of life in esophageal cancer patients. The studies conducted to date have provided documentation of the safety and effectiveness of spray cryotherapy (SCT) when used for malignancies in the esophagus. Measures of dysphagia relief have been described in peer reviewed literature. This study aims to provide much needed HRQOL information as well as additional tumor characteristics before and after SCT. A cohort of patients with locally persistent esophageal cancer will be studied in up to twelve (12) centers in the United States to provide important HRQOL data and more a comprehensive understanding of clinical tumor response post SCT. In the proposed study, the trūFreeze® System spray cryotherapy procedure will be performed during endoscopy. Each SCT procedure will be performed endoscopically at clinically indicated intervals of 6 weeks +/- 3 weeks. Total procedure dosimetry will be delivered at the discretion of the Investigator based on tumor location and patient tolerability. After each procedure at defined intervals, patients will be contacted and QOL symptom related information will be collected. If at any point an Investigator determines that a subject is not a candidate for further spray cryotherapy or is unable to tolerate additional procedures, they will be contacted via telephone to ascertain HRQOL information. Subject participation will last up to two years or until death
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
49
Subjects where trūFreeze® System spray cryotherapy is performed
Cancer Treatment Centers of America Western Regional Medical Center
Goodyear, Arizona, United States
University of California at Irvine
Orange, California, United States
Emory University
Atlanta, Georgia, United States
Change from baseline EORTC at 14 days post cryotherapy procedure
Validated Cancer Specific Quality of Life Questionnaire
Time frame: 14 days post spray cryotherapy
Change from baseline dysphagia scale at 14 days post cryotherapy procedure
Dysphagia Severity Scale
Time frame: 14 days post spray cryotherapy
Time to additional interventional procedure(s) other than spray cryotherapy (e.g. stent placement)
baseline to procedure other than spray cryotherapy
Time frame: up to 2 years post SCT procedure
Overall Survival
SCT to death
Time frame: up to 2 years post SCT procedure
Mean change in the amount of residual tumor from baseline to follow-up cryospray delivery session
Describe changes in tumor
Time frame: up to 2 years post SCT procedure
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Parkview Comprehensive Cancer Center
Fort Wayne, Indiana, United States
Spectrum Health
Grand Rapids, Michigan, United States
Dartmouth-Hotchcock Medical Center
Lebanon, New Hampshire, United States
North Shore-Long Island Jewish Medical Center
Manhasset, New York, United States
University of Rochester
Rochester, New York, United States
University of North Carolina at Chapel Hill
Chapel Hill, North Carolina, United States
Virginia Commonwealth University
Richmond, Virginia, United States