The purpose of this study is to confirm the procedural feasibility and device usability of the HybridTherm® system during bronchoscopic cryo-assisted radiofrequency ablation (RFA) performed prior to scheduled surgical resection in patients with lung cancer. The bronchoscopy session includes tumor ablation and, when clinically indicated, mediastinal lymph node staging by EBUS-TBNA.
This is a prospective, single-arm, post-market clinical investigation conducted in Switzerland to collect clinical data on the use, safety, and performance of the CE-marked HybridTherm® system during routine bronchoscopic tumor management procedures. The investigation is classified as a ClinO-MD Category A1 medical device study, as the HybridTherm® system is CE-marked and used strictly within its intended purpose under normal conditions of clinical use. The investigation is investigator-initiated and single-center, conducted at the University Hospital Zurich. The Sponsor-Investigator is responsible for the initiation, conduct, management, safety oversight, and data handling of the study in accordance with the Swiss Human Research Act (HRA), the Ordinance on Clinical Trials with Medical Devices (ClinO-MD), ISO 14155, and applicable ethical requirements. Ethics Committee approval is required prior to study initiation, and the investigation will begin only after a positive written decision from the competent cantonal ethics committee has been obtained. The HybridTherm® system is a bipolar cryo-cooled radiofrequency ablation device intended for incision, coagulation, and ablation of tissue during flexible endoscopic procedures in the tracheobronchial system. The system provides internally cooled radiofrequency energy to delay tissue desiccation and impedance rise, thereby enabling controlled energy delivery during ablation. In this investigation, the device is used during clinically indicated bronchoscopic procedures without deviation from its approved indication or standard clinical workflow. All enrolled participants undergo diagnostic bronchoscopy as part of routine clinical care, including mediastinal lymph node staging when clinically indicated. Transbronchial cryo-assisted radiofrequency ablation is performed during the same bronchoscopy session under general anesthesia. Surgical resection of the targeted lung lesion follows according to the established oncologic treatment plan and is not altered by study participation. No randomization, blinding, or comparator intervention is included. Data collected in this investigation are derived exclusively from standard-of-care procedures, routine imaging, device readouts, and histopathological assessment of resected specimens. No additional diagnostic tests, therapeutic interventions, or protocol-mandated procedures beyond routine clinical practice are introduced. All analyses are descriptive in nature and are intended to support post-market evaluation of procedural feasibility, safety, and device usability. The investigation is designed to generate clinical experience and safety data that may inform future clinical research and support the continued evaluation of bronchoscopic cryo-assisted radiofrequency ablation using the HybridTherm® system within standard treatment pathways.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
20
Transbronchial cryo-assisted radiofrequency ablation (RFA) performed using the CE-marked HybridTherm® system during routine diagnostic bronchoscopy, within the intended use of the device.
University Hospital Zurich
Zurich, Raemistrasse, Switzerland
Number of Participants with Successful Completion of Bronchoscopic Cryo-assisted RFA Using the HybridTherm® System
Successful device use, defined as the completion of ablation with the HybridTherm® system with investigator confirmation that the ablation zone achieved sufficient coverage based on intra-procedural imaging
Time frame: Day 0 (Diagnostic Bronchoscopy and RFA Procedure)
Number of Participants with Bleeding-Related Serious Adverse Events Associated with the Investigational Device and/or RFA Procedure
Number of Serious Adverse Events (SAEs) associated with bleeding related to the investigational device and/or radiofrequency ablation (RFA) procedure.
Time frame: From Day 0 (Diagnostic Bronchoscopy and RFA Procedure) through End of Study (6-7 weeks post-procedure)
Severity of Bleeding-Related Adverse Events as Assessed by the Nashville Bleeding Scale
Safety assessments for bleeding Adverse Events (AEs) related to the investigational device and/or radiofrequency ablation (RFA) procedure, graded using the Nashville bleeding scale.
Time frame: From Day 0 (Diagnostic Bronchoscopy and RFA Procedure) through End of Study (6-7 weeks post-procedure)
Total Number of Serious Adverse Events Related to the Investigational Device and/or RFA Procedure
Total number of Serious Adverse Events (SAEs) related to the investigational device and/or radiofrequency ablation (RFA) procedure.
Time frame: From Day 0 (Diagnostic Bronchoscopy and RFA Procedure) through End of Study (6-7 weeks post-procedure)
Total Number of Adverse Events Related to the Investigational Device and/or RFA Procedure
Total number of Adverse Events (AEs) related to the investigational device and/or radiofrequency ablation (RFA) procedure.
Dr. Carolin Steinack, Head of Interventional Pulmonology
CONTACT
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Time frame: From Day 0 (Diagnostic Bronchoscopy and RFA Procedure) through End of Study (6-7 weeks post-procedure)
Macroscopic and Microscopic Evidence of Ablation in the Resected Specimen
Macroscopic and microscopic evidence of ablation in the resected specimen, assessed using standard histopathological methods (hematoxylin and eosin staining).
Time frame: At Surgical Resection (7-14 Days Post-Procedure)
Percentage of Tumor Necrosis Within the Ablation Zone
Visual estimation of histopathologic ablation completeness, defined as the percentage of tumor necrosis within the ablation zone, as determined by routine pathology reporting.
Time frame: At Surgical Resection (7-14 Days Post-Procedure)
Histopathologic Complete Response (Absence of Viable Tumor Cells) Within the Ablation Zone
Evaluation of macroscopic and microscopic necrosis within the ablation zone, defined as the absence of viable tumor cells within the ablated area (histopathologic complete response, hpCR), if reported as part of routine histological assessment. If applicable, the extent of necrosis into surrounding parenchyma or margin tissue will be noted.
Time frame: At Surgical Resection (7-14 Days Post-Procedure)
Composite Descriptive Intra-Procedural Metrics During Bronchoscopic Cryo-assisted RFA
Descriptive intra-procedural metrics collected during the bronchoscopic cryo-assisted radiofrequency ablation (RFA) procedure, including total ablation time (minutes), number of cryoRFA activations (energy applications), electrical parameters of energy delivered (if available), number of probe repositionings within the lesion, and estimated ablation zone size (millimeters) derived from intraoperative imaging when obtained as part of routine clinical practice. These measures are collected for descriptive characterization of procedural performance and are not intended for separate outcome analysis.
Time frame: Day 0 (Diagnostic Bronchoscopy and RFA Procedure)