ClinicalTrials.gg
RecruitingNCT06175845ACTICCA-2Updated Sep 9, 2026

Endoscopic Radiofrequency Ablation for Unresectable Cholangiocarcinoma

An interventional study of Intraductal biliary radiofrequency ablation in Cholangiocarcinoma, Klatskin Tumor and Bile Duct Cancer, sponsored by Universitätsklinikum Hamburg-Eppendorf. Recruiting at 9 sites in Germany. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-09.

Primary conditionKlatskin TumorRegistry: CholangiocarcinomaReclassifiedWhy we changed it
Registry
Cholangiocarcinoma — the first condition term the registry derived for this study.
ClinicalTrials.gg
Klatskin Tumor
Why
  1. The study's listed conditions name Klatskin Tumor, a narrower term within Cholangiocarcinoma.
Confidence
High: the new condition is named in the study's own listed conditions. Of 351 hand-checked studies reclassified this way, 68% were exactly right and 84% in the right disease family; the registry's first term was right for 5% (measured 2026-10-21). How we classify →
Wrong?
Tell us the study's main condition →

Sponsored by Universitätsklinikum Hamburg-Eppendorf · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Started Aug 2024; still recruiting 2 years 2 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
130
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The goal of this clinical trial is to learn about radiofrequency ablation in patients with unresectable bile duct cancer who receive systemic chemotherapy and bile duct stenting. The main questions it aims to answer are:

  • Does radiofrequency ablation of tumorous bile duct occlusion reduce risk of complications in these patients (eg stent dysfunction, delay of chemotherapy, infections etc)?
  • Is radiofrequency ablation safe in these patients? All participants will receive standard treatment with systemic chemotherapy and bile duct stenting. Researchers will compare two groups (one group will receive additional radiofrequency ablation, the other not).
02

Conditions studied

  • Cholangiocarcinoma
  • Klatskin Tumor
  • Bile Duct Cancer
  • Liver Cancer

Keywords

  • Radiofrequency ablation
  • Intraductal
  • Biliary
  • Endoscopic retrograde cholangiography
  • Transpapillary
  • Stent dysfunction
  • Cholangitis
  • Obstruction
03

In context

Klatskin Tumor Reclassified

82 studies on the registry are indexed under Klatskin Tumor; 27 are open to participants now.

This study's planned enrollment of 130 is above the median of 55 across 56 interventional studies indexed under Klatskin Tumor.

Browse Klatskin Tumor studies →

Lead sponsor

Universitätsklinikum Hamburg-Eppendorf is the lead sponsor of 416 studies on the registry; 86 are open to participants now.

Compared within Klatskin Tumor, this study's primary condition as ClinicalTrials.gg classifies it; the registry's first condition term is Cholangiocarcinoma. The counts are of registry records indexed under each term, refreshed daily. How we classify →

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

Inclusion Criteria:

  1. Unresectable perihilar and/or ductal CCA with bile duct stenting and palliative systemic therapy as indicated by the local Multidisciplinary Team (MDT)
  2. Written
  3. (ECOG) performance status 0-1
  4. Age ≥18 years
  5. Eligibility for palliative systemic therapy based on clinical and laboratory parameters (except hyperbilirubinemia) as determined by the local MDT
  6. No prior radiofrequency ablation (RFA) for CCA
  7. No repeated bile duct stenting in the past 3 months (trial inclusion is possible upon first stent replacement or initial stent placement within past 3 months)
  8. No concomitant disease or interfering with the study procedure or efficacy outcome measures, particularly no severe or uncontrolled cardiovascular disease (congestive heart failure III or IV, unstable angina pectoris, myocardial infarction within ≤3 months, significant arrhythmias) and no psychiatric disorders precluding understanding of information of trial related topics and giving informed consent
Terms in these criteria, in plain language(4)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

NYHA class (heart failure)

The New York Heart Association’s four classes of how much heart failure limits physical activity.

I
No limits: ordinary activity causes no undue tiredness or breathlessness.
II
Slight limits: comfortable at rest, ordinary activity causes symptoms.
III
Marked limits: comfortable at rest, less than ordinary activity causes symptoms.
IV
Symptoms even at rest; any activity makes them worse.

Studies set their own limit — many outside heart failure leave out class III–IV, while heart failure studies may ask for a particular class. Check the class this study names.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
130 participants (estimated)

Study arms

  • Active comparator
    Arm A: ablation arm

    Systemic chemotherapy and bile duct stenting with intraductal RFA of malignant bile duct obstructions employing a CE-certified ablation catheter prior to stent placement.

    Procedure: Intraductal biliary radiofrequency ablation

  • No intervention
    Arm B: control arm

    Systemic chemotherapy and bile duct stenting without RFA.

Interventions

  • ProcedureIntraductal biliary radiofrequency ablation

    Radiofrequency ablation via catheter and transpapillary access of malignant bile duct obstruction

    Also known as: RFA

06

What researchers measure

Primary outcomes

  1. Time to first event, ie stent dysfunction

    • Time-to-first event (during 6 months follow up), i.e. stent dysfunction defined by bilirubin \>5 mg/dl and/or cholangitis (fever \>38.5°C and/or increase in C-reactive protein by at least 3-fold upper limit of normal and at least 20% from baseline without extrahepatic focus and absence of tumor progression) leading to premature stent replacement and/or disruption of chemotherapy (all possible events will be reviewed by a blinded and independent Endpoint Review Committee \[ERC\].)

    Time frame: 6 months

Secondary outcomes

  1. Overall survival

    Time to death or last seen alive

    Time frame: up to 30 month

  2. Satisfaction assessed by EORTC QLQ-C30 questionnaire

    The EORTC QLG Core Questionnaire (EORTC QLQ-C30) is a 30-item instrument designed to measure quality of life in cancer patients. It is composed of both multi-item scales and single-item measures. These include five functional scales, three symptom scales, a global health status / QoL scale, and six single items. Each of the multi-item scales includes a different set of items - no item occurs in more than one scale. All of the scales and single-item measures range in score from 0 to 100. A high scale score represents a higher response level.

    Time frame: 6 months

  3. Satisfaction assessed by EORTC QLQ-BIL21 questionnaire

    The EORTC QLQ-BIL21 consists of 21 questions: 3 single-item assessments relating to treatment side effects, difficulties with drainage bags/tubes and concerns regarding weight loss, in addition to 18 items grouped into 5 proposed scales: eating symptoms (4 items), jaundice symptoms (3 items), tiredness (3 items), pain symptoms (4 items) and anxiety symptoms (4 items). The response format is a four-point Likert scale.and designed to more specifically adress side effects. A high scale score represents a higher response level.

    Time frame: 6 months

  4. Incidence of Treatment-Emergent Adverse Events as assessed by CTCAE V5

    Safety events

    Time frame: 6 months

  5. Clinical event rate at 6 months

    Rate of clinical events defined as per primary outcome after 6 months follow up

    Time frame: 6 months

  6. Total days of overnight-hospital-stays

    Total days of overnight-hospital-stays

    Time frame: 6 months

07

Study locations

9 of 9 sites recruiting
08

References and documents

Publications

  • Schmidt C, Zapf A, Ozga AK, Canbay A, Denzer U, De Toni EN, Lohse AW, Schulze K, Rosch T, Stein A, Wege H, von Felden J. Radiofrequency ablation via catheter and transpapillary access in patients with cholangiocarcinoma (ACTICCA-2 trial) - a multicenter, randomized, controlled, open-label investigator-initiated trial. BMC Cancer. 2024 Aug 1;24(1):931. doi: 10.1186/s12885-024-12693-w. PubMed 39090600 ↗
09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Started Aug 2024 (actual). Primary completion is estimated for Jul 2027, 35 months after the start.

How these figures are worked out, and which studies are left out of them.

Registered
Nov 25, 2023
First posted
Dec 19, 2023
StartActual
Aug 30, 2024
Primary completionEst.
Jul 2027
CompletionEst.
Nov 2027
Last update
Sep 9, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Sep 9, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06175845
Responsible party
Johann von Felden (Principal Investigator, Universitätsklinikum Hamburg-Eppendorf) — Principal investigator
First posted
Dec 19, 2023
Start date
Aug 30, 2024
Primary completion
Jul 2027 (estimated)
Completion
Nov 2027 (estimated)
Last update
Sep 9, 2026

Study contacts

Project Manager
Contact
acticca2@aio-studien-ggmbh.de
+ 49 30 8145344 37
Johann von Felden, MD
principal investigator · Universitätsklinikum Hamburg-Eppendorf

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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