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A Phase 3, Multicenter, Prospective, Randomized, Open-label Study for Intraoperative Ureter(s) Visualization When Using ASP5354 With Near-infrared Fluorescence (NIR-F) Imaging in Adult Participants Undergoing Minimally Invasive and Open Abdominopelvic Surgeries


Description

The ureter is the tube that carries urine from the kidneys to the bladder. It is difficult for surgeons to see the ureter during abdominal surgery. This could lead to injuring the ureter which, although rare, could be serious. This study is about a potential new medical dye, called ASP5354. This dye is injected into the person at the start of surgery and is detected in the ureter. This is done by an imaging machine which has an option called near infrared fluorescence, or NIR-F. Together they show live images of specific parts of the body. In this study, ASP5354 is used with an imaging machine with a NIR-F option to show live images of the ureter during surgery. People with kidneys that work properly and those with kidney problems can take part in this study. The main goal of the study is to find out how clearly the ureter can be seen with ASP5354 during surgery in people whose kidneys work properly or who have mild kidney problems. To do this, the surgeons will inject ASP5354 into t

Trial Eligibility

Inclusion Criteria: * Participant is scheduled to undergo minimally invasive or open abdominopelvic surgery that may require ureter identification * Participant has normal renal function or has varying degrees of chronic kidney disease as defined by the National Kidney Foundation and calculated by individual estimated glomerular filtration rate (eGFR) using the modification of diet in renal disease formula * Adult normal/mild eGFR cohort: eGFR ≥ 60 mL/min * Adult moderate/severe eGFR cohort: eGFR ≥ 15 to \< 60 mL/min * Female participant is not pregnant and at least 1 of the following conditions apply: * Not a woman of childbearing potential * Woman of childbearing potential who agrees to follow the contraceptive guidance from the time of informed consent through at least 30 days after study intervention administration. * Female participant must agree not to breastfeed starting at the administration of ASP5354 through 30 days after ASP5354 administration. * Female participant must not donate ova starting at the administration of ASP5354 through 30 days after ASP5354 administration. * Male participant with female partner(s) of childbearing potential (including breastfeeding partner) must agree to use contraception through at least 30 days after ASP5354 administration. * Male participant must not donate sperm starting at the administration of ASP5354 through 30 days after ASP5354 administration. * Male participant with pregnant partner(s) must agree to remain abstinent or use a condom for the duration of the pregnancy from the start of ASP5354 administration through 30 days after ASP5354 administration. * Participant agrees not to participate in another interventional study involving unapproved study medications while participating in the present study. Exclusion Criteria: * Participant has any physical or psychiatric condition, which makes the participant unsuitable for study participation. * Participant is anticipated to require ureteral stenting during surgery. * Participant has an active urinary tract infection requiring antibiotic therapy. * Participant has moderate to severe cardiac disease that limits daily functioning (New York Heart Association Class III to IV) or other medical conditions would impact safety or study compliance. * Participant has any clinically relevant laboratory abnormality that could contraindicate surgery. * Participant has a known or suspected hypersensitivity to ASP5354, indocyanine green (ICG) or any components of the formulation used. * Participant has had previous exposure to ASP5354. * Participant has been administered ICG or other NIR-F imaging agents within 48 hours prior to ASP5354 administration, with the exception of participants who receive ICG for lymphatic mapping before the surgery. * Participant has received any investigational therapy within 28 days or 5 half-lives, whichever is longer, prior to randomization. * Participant is on hemodialysis, hemodiafiltration or peritoneal dialysis.

Study Info

Organization

Astellas Pharma Inc


Primary Outcome

Intra-participant comparison in ureter conspicuity for white light (WL) versus near -infrared fluorescence (NIR F) for participants with normal renal function or mild renal impairment.


Outcome Timeframe Up to 45 minutes after ASP5354 administration (Day 1)

NCTID NCT05999747

Phases PHASE3

Primary Purpose TREATMENT

Start Date 2024-03-19

Completion Date 2025-12-31

Enrollment Target 94

Interventions

DRUG pudexacianinium chloride

Locations Recruiting

Washington University Center

United States, Missouri, Saint Louis


University of Nevada, Las Vegas

United States, Nevada, Las Vegas


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