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Hilar CholangiocarcinomaPhase 4CARPNCT05551299

Treatment of Non-resectable Bile Duct Cancer with Radiofrequency Ablation or Photodynamic Therapy

A Phase 4 study testing Photosensitizer and Radiofrequency ablation (RFA) in people with Hilar Cholangiocarcinoma, run by University of Leipzig at 20 sites in Germany.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

Bile duct cancer is often diagnosed after curative options are no longer available. Stent therapy is used to keep the ducts open and can be combined with photodynamic therapy (PDT) to extend life expectancy. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Hilar Cholangiocarcinoma
What is being tested?
Photosensitizer and Radiofrequency ablation (RFA)
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
258 participants
Where
20 sitesGermany
Study dates
10 Feb 2023to Apr 2028
Phase
Phase 4
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Hilar cholangiocarcinoma (cytological or histological confirmation)
  • Surgery is not planned
  • Age ≥ 18 years
  • Written informed consent

Who cannot join

  • Tumour not accessible endoscopically
  • Known hypersensitivity to porphyrins or to any of the other ingredients of the photosensitizer chosen
  • Leukopenia (< 2000/mm3)
  • Thrombocytopenia (< 100,000 / mm³)
  • Severe, uncorrected coagulopathy (at the discretion of the physician)
  • Suspected erosion of major blood vessels, because of the risk of life-threatening mass haemorrhage exists
Show all 18Show fewer
  • Porphyria (clinician's assessment) or other light-exacerbated diseases
  • Severely impaired liver and or kidney function (at the discretion of the physician)
  • Bedridden for more than 50% of the time (similar to ECOG (Eastern Cooperative Oncology Group) grade 3)
  • Planned surgical procedure within the next 30 days
  • Concurrent eye disease that will require a slit lamp examination within the next 30 days
  • Prior radiotherapy within the last four weeks
  • Previous PDT or RFA
  • Planned liver transplantation
  • Fertile women (within two years of their last menstruation) without appropriate contraceptive measures (implanon, injections, oral contraceptives, intrauterine devices, partner with vasectomy) while participating in the trial (participants using a hormone-based method have to be informed of possible effects of the trial medication on contraception)
  • Participation in other interventional trials
  • Patients under legal supervision or guardianship
  • Pregnant or nursing women

Trial locations and contacts

20 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Albrecht Hoffmeister, Prof.Dr.med. contact

+49-341-97-12240

albrecht.hoffmeister@medizin.uni-leipzig.de

20 sites in 1 country

Germany20 sites, 19 recruiting
  • Uniklinik RWTH Aachen, Medizinische Klinik III

    Aachen, 52074

    Karim Hamesch, PD Dr., +49 241 80 80861, khamesch@ukaachen.de

    Recruiting
  • Universitätsklinikum Augsburg; III. Med. Klinik

    Augsburg, 86156

    Tobias Weber, Dr., tobias.weber@uk-augsburg.de

    Recruiting
  • Vivantes Netzwerk für Gesundheit GmbH, Klinikum Friedrichshain, Innere Medizin/Gastroenterologie

    Berlin, 10249

    Thomas Brunk, Dr., thomas.brunk@vivantes.de

    Not yet recruiting
  • Universitatsklinikum Bonn, Medizinische Klinik und Poliklinik I

    Bonn, 53127

    Dominik Kaczmarek, Dr., +49 228 287 -15263, Dominik.Kaczmarek@ukbonn.de

    Recruiting
  • Universitätsklinikum Frankfurt, Medizinische Klinik 1

    Frankfurt, 60590

    Jörg Trojan, Prof. Dr.

    Not yet recruiting
  • Universitätsklinikum Freiburg, Medizinische Klinik II, Abteilung Gastroenterologie, Hepatologie, Endokrinologie & lnfektiologie

    Freiburg im Breisgau, 79106

    Armin Küllmer, Dr.

    Recruiting
  • Universitätsmedizin Greifswald Klinik für Innere Medizin A

    Greifswald, 17475

    Ali Aghdassi, Prof., Ali.Aghdassi@med.uni-greifswald.de

    Recruiting
  • Site: Martin-Luther-Universitat Halle-Wittenberg, Universitätsklinik und Poliklinik für Innere Medizin I

    Halle, 06120

    Jonas Rosendahl, Prof. Dr., +49 345 557 2661, jonas.rosendahl@uk-halle.de

    Recruiting
  • Klinikum Hanau; Klinik für Gastroenterologie, Diabetologie und Infektiologie

    Hanau, 63450

    Likas Welsch, Dr., Lukas_Welsch@klinikum-hanau.de

    Recruiting
  • KRH Klinikum Siloah, Klinik für Gastroenterologie

    Hanover, 30459

    Daniel Vidacek, Dr., +49 511 927 2102, Daniel.Vidacek@krh.de

    Recruiting
  • Klinikum St. Georg gGmbH; Klinik für Gastroenterologie, Hepatologie, Diabetologie und Endokrinologie

    Leipzig, 04109

    Ingolf Schiefke, Prof., ingolf.schiefke@SanktGeorg.de

    Recruiting
  • University Hospital of Leipzig, Department of Gastroenterology

    Leipzig

    Albrecht Hoffmeister, Prof. Dr., ++49 - 341 - 97 12240, Albrecht.Hoffmeister@medizin.uni-leipzig.de

    Recruiting
  • RKH Kliniken Ludwigsburg- Bietigheim gGmbH, Klinik für Innere Medizin, Gastroenterologie, Hämato-Onkologie, Diabetologie und Infektiologie

    Ludwigsburg, 71640

    Andreas Wannhoff, Dr., +4971419967201, andreas.wannhoff@rkh-kliniken.de

    Recruiting
  • Universitätsmedizin Mannheim, II. Medizinische Klinik

    Mannheim, 68167

    Withdrawn
  • Universitätsklinikum Gießen und Marburg GmbH (UKGM); Klinik für Innere Medizin mit den Schwerpunkten Gastroenterologie, Endokrinologie, Stoffwechsel und klinische Infektiologie

    Marburg, 35043

    Ulrike Denzer, Prof., ulrike.denzer@uk-gm.de

    Recruiting
  • Klinikum der LMU München, Medizinische Klinik II, Campus Großhadern

    München, 81377

    Jörg Schirra, Prof. Dr., +49 89 4400 73031, joerg.schirra@med.uni-muenchen.de

    Recruiting
  • Universitlitsklinikum Munster Medizinische Klinik B (Gastroenterologie, Hepatologie, Endokrinologie, Klinische lnfektiologie)

    Münster, 48149

    Jonel Trebicka, Prof., +492518343330, Jonel.Trebicka@ukmuenster.de

    Recruiting
  • Klinikum Nürnberg Nord; Gastroenterologie/ Endokrinologie

    Nuremberg, 90419

    Alexander Dechêne, Prof., Alexander.Dechene@klinikum-nuernberg.de

    Recruiting
  • Robert-Bosch-Krankenhaus (RBK) Stuttgart; Gastroenterologie, Hepatologie und Endokrinologie

    Stuttgart, 70376

    Arthur Schmidt, arthur.schmidt@rbk.de

    Recruiting
  • Universitätsklinikum Tübingen, Medizinische Klinik I

    Tübingen, 72076

    Christoph Werner, Dr., +49 7071 2982712, christoph.werner@med.uni-tuebingen.de

    Recruiting

Other trials in Germany

About this study

Official title: Cholangiocarcinoma Treatment with Radiofrequency Ablation or Photodynamic Therapy: a Randomized Controlled Trial

Bile duct cancer is often diagnosed after curative options are no longer available. Stent therapy is used to keep the ducts open and can be combined with photodynamic therapy (PDT) to extend life expectancy. PDT requires an injection of photosensitizer after which light of a particular wavelength is applied endoscopically to kill the cancer cells. Drawbacks include not only high costs and poor availability, but foremost that patients have to avoid direct sunlight for a period of weeks. Radio frequency ablation (RFA) together with stent implantation constitutes an alternative by which the cancer cells are killed through heat, also applied endoscopically. The RFA technology is more widely available and easier to deploy. However, it has not been studied extensively and no randomized trials exist comparing the two methods. This trial will compare survival in patients with a particular bile duct cancer depending on whether they receive PDT or RFA. Moreover, data will be collected on side-effects and quality of life.

Read the detailed description

Klatskin tumours are a form of bile duct cancer. They are generally not diagnosed until quite late and a curative operation is rarely a possibility. Their anatomic location usually results in bile duct obstruction and the aim of therapy is thus to keep the ducts open. This is accomplished through endoscopic retrograde cholangiopancreatography (ERCP) by implanting stents. Stent therapy combined with photodynamic therapy (PDT) extends life expectancy. PDT requires an injection of photosensitizer that is absorbed primarily by the cancer cells. Light of a particular wavelength is then applied with ERCP to kill the cancer cells. Drawbacks include not only high costs and poor availability, but foremost that patients have to avoid direct sunlight for a period of weeks. Radio frequency ablation (RFA) together with stent implantation constitutes an alternative by which the cancer cells are killed through heat applied during ERCP. The RFA technology is more widely available and easier to deploy. However, it has not been studied extensively and no randomized trials exist comparing the two methods. This trial will compare survival in patients with Klatskin tumours depending on whether they receive PDT or RFA. Moreover, data will be collected on side-effects and quality of life.

Being tested
Photosensitizer, Radiofrequency ablation (RFA)
Keywords
Hilar Cholangiocarcinoma, Radiofrequency ablation (RFA), Photodynamic therapy (PDT), Photosensitizer, Klatskin Tumor, Bile Duct Cancer
Medical subject headings
Klatskin Tumor, Bile Duct Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • PhotosensitizerDrug

    Also called Photodynamic therapy (PDT)

    A photosensitizer, which is absorbed preferentially by tumour cells, is administered 24 - 48 hours prior to PDT. Light of a particular wavelength is then applied during endoscopic retrograde cholangiopancreatography (ERCP) to kill primarily cancer cells locally within the stenosis. Immediately after PDT treatment, new stents are inserted into all treated segments if needed.

  • Radiofrequency ablation (RFA)Procedure or surgery

    RFA is also carried out as part of an ERCP. The RFA-probe is placed within the tumour stenosis and electrical current is applied. New stents are inserted into all treated segments if needed.

Study groups in NCT05551299
Study groupRoleWhat they receive
Photodynamic therapy (PDT)ExperimentalThe index procedure in all patients at baseline includes stenting, using an endoscopic retrograde cholangio-pancreatography (ERCP) procedure. The Intervention is at least one PDT at baseline according to the clinical routine of the trial site.
Receives: Drug: Photosensitizer
Radiofrequency ablation (RFA)ExperimentalThe index procedure in all patients at baseline includes stenting, using an endoscopic retrograde cholangio-pancreatography (ERCP) procedure. The Intervention is at least one RFA at baseline according to the clinical routine of the trial site.
Receives: Procedure: Radiofrequency ablation (RFA)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Overall survival

    Hazard ratio from a Cox regression model will be used to compare randomization arms. Covariates will be stratification variables, classification of local inoperability, use of prophylactic antibiotics, Bismuth type and time between diagnosis and beginning RFA/PDT.

    Measured: through study completion, an average of 1 year

Secondary outcomes (18)
  1. Overall survival (complementary perspective: median survival time)

    Estimates of the difference in median survival time between the groups will be based on the method of Chen and Zhang (PMID: 26983640).

    Measured: through study completion, an average of 1 year

  2. Overall survival (complementary perspective: two-year overall survival)

    Kaplan-Meier estimates will be used.

    Measured: up to two years

  3. Overall survival (complementary perspective: restricted mean survival on a time horizon of two-years)

    Kaplan-Meier estimates will be used (see e.g. PMID: 15690989)

    Measured: through study completion, an average of 1 year

  4. Days alive and out of hospital up to two years

    This constitutes a basic and easy to understand measure of quality of life. Only in-hospital stays will be included in this endpoint and the day of arrival and dismissal will each be counted. The source of data will be the hospital records, epicrisis and patient disclosure.

    Measured: up to two years

  5. Quality of Life (QoL) measured using QLQ-C30 at various points in time after randomization (V2 (14 days), V3 (ca. 3 months), as a function of time after 6 months, adjusting for the baseline value)

    Prolonging life is especially worthwhile if QoL is sufficiently good. The established cancer-specific Core Quality of Life questionnaire QLQ-C30 from the EORTC (European Organisation for Research will be used. Shortly after the index therapy (V2, V3), the difference between arms will be assessed. The requirement to stay indoors may affect QoL. At later points in time, a description per arm is of interest and will be based on a weighted mean of all available questionnaires, weighting according to calendar time.

    Measured: through study completion, an average of 1 year

  6. Quality of Life (QoL) measured using FACT-Hep at various points in time after randomization (V2 (14 days), V3 (ca. 3 months), as a function of time after 6 months, adjusting for the baseline value)

    Prolonging life is especially worthwhile if QoL is sufficiently good. The Functional Assessment of Cancer Therapy - Hepatobiliary (FACT-Hep) questionnaire, containing the hepatobiliary-specific cancer subscale, will be used as a second instrument for assessing QoL. Shortly after the index therapy (V2, V3), the difference between arms will be assessed. The requirement to stay indoors may affect QoL. At later points in time, a description per arm is of interest and will be based on a weighted mean of all available questionnaires, weighting according to calendar time.

    Measured: through study completion, an average of 1 year

  7. Quality-adjusted life years (QALYs)

    Using QALYs, a weighted measure of survival will be compared between RFA and PDT that takes QoL into account. The details will be provided in a Statistical Analysis Plan.

    Measured: through study completion, an average of 1 year

  8. Stent patency based on clinician's assessment (e.g. cholangitis, cholestasis, ultrasound)

    Stent patency provides one measure of the burden of the disease and efficacy of the treatment. Mean time to stent closure/replacement/death after last stent replacement will be analysed.

    Measured: through study completion, an average of 1 year

  9. Laboratory parameter (leucocytes)

    Changes in laboratory parameters after index treatment (V3) and as a function of time will be analysed and compared between randomization arms.

    Measured: through study completion, an average of 1 year

  10. Laboratory parameter (haematocrit)

    Changes in laboratory parameters after index treatment (V3) and as a function of time will be analysed and compared between randomization arms.

    Measured: through study completion, an average of 1 year

  11. Laboratory parameter (haemoglobin)

    Changes in laboratory parameters after index treatment (V3) and as a function of time will be analysed and compared between randomization arms.

    Measured: through study completion, an average of 1 year

  12. Laboratory parameter (bilirubin)

    Changes in laboratory parameters after index treatment (V3) and as a function of time will be analysed and compared between randomization arms.

    Measured: through study completion, an average of 1 year

  13. Laboratory parameter (albumin)

    Changes in laboratory parameters after index treatment (V3) and as a function of time will be analysed and compared between randomization arms.

    Measured: through study completion, an average of 1 year

  14. Laboratory parameter (CA 19-9)

    Changes in laboratory parameters after index treatment (V3) and as a function of time will be analysed and compared between randomization arms.

    Measured: through study completion, an average of 1 year

  15. Laboratory parameter (CRP)

    Changes in laboratory parameters after index treatment (V3) and as a function of time will be analysed and compared between randomization arms.

    Measured: through study completion, an average of 1 year

  16. Laboratory parameter (ALT)

    Changes in laboratory parameters after index treatment (V3) and as a function of time will be analysed and compared between randomization arms.

    Measured: through study completion, an average of 1 year

  17. Laboratory parameter (GGT)

    Changes in laboratory parameters after index treatment (V3) and as a function of time will be analysed and compared between randomization arms.

    Measured: through study completion, an average of 1 year

  18. Pruritus as reported by patients on a scale from 0 ("no itching") to 10 ("worst imaginable itching").

    Pruritus will be analysed as a function of time.

    Measured: through study completion, an average of 1 year

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 Sep 2022
  2. Study start10 Feb 2023
  3. Primary completionApr 2028 (estimated)
  4. Study completionApr 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
258 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05551299
Sponsor's protocol ID
CARP
Other IDs
2022-500107-50-00, 434336116
Acronym
CARP
Status last verified
Mar 2025
First submitted
8 Sep 2022
Last updated
27 Mar 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Photosensitizer and Radiofrequency ablation (RFA) in people with Hilar Cholangiocarcinoma, run by University of Leipzig at 20 sites in Germany.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 18 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 27 Mar 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 20 sites in Germany. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Albrecht Hoffmeister, Prof.Dr.med. (+49-341-97-12240, albrecht.hoffmeister@medizin.uni-leipzig.de), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Overall survival (time frame: through study completion, an average of 1 year). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Mar 2025; AzTrials last refreshed its copy on 8 Nov 2026.

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