MR-guided Focused Ultrasound Treatment of Prostate Cancer: Focal Therapy for Locally Non-Advanced Disease

NCT01522118 | Completed Phase 1

• 1 other identifier: PCa-MRgFUS-I
• Study Type: interventional
• Target: 12
• Locations: 1 country
• Sites: 1

Brief Summary

Since prostate specific antigen (PSA) was introduced as a clinical screening tool for prostate cancer, more men are diagnosed with small foci of cancers instead of the advanced disease. The present choice of treatment for men with localized prostate cancer lies between active surveillance and radical therapy. Thus, the option of treating only the cancer within the prostate gland and sparing the non-cancerous tissue is quite appealing, yet very controversial. At present there are no consistent scientific data on focal therapy and its major effectiveness. Focal therapy for prostate cancer is defined as therapy that selectively ablates known disease while preserving existing functions, with the overall aim of minimizing lifetime morbidity without compromising life expectancy. The aim of the investigators study is to test if Magnetic Resonance guided Focused Ultrasound ablation can determine non-invasive necrosis of focal, locally non-advanced prostate cancer. The study i designed as Phase 1, treatment \& resection protocol. With this project the investigators further aim to evaluate the safety and identify side effects of Magnetic Resonance guided Focused Ultrasound in treating focal prostate cancer. This design will also expand knowledge of the effect of Magnetic Resonance guided Focused Ultrasound onto peri-prostatic environment and to determine if surgery can safely be adopted after this non-invasive treatment.

Conditions

Prostate Cancer

Keywords

Prostate Cancer; High Intensity Focused Ultrasound; Magnetic Resonance guided Focused Ultrasound; Non-invasive therapy; Focal Disease

Outcome Measures

Primary Outcomes (1)

• Safety

  Measure of expected or UN-expected adverse events

  One year

Secondary Outcomes (1)

• Efficacy

  18 months

Study Arms (1)

HIFU

EXPERIMENTAL

(high intensity focused ultrasound)

Device: ExAblate 2100; InSightec

Interventions

ExAblate 2100; InSightec DEVICE

Patients with biopsy proven locally non-advanced T2 prostate cancer identified at 3T MR examination including dynamic contrast enhanced (DCE-with time to peak and mean transit time evaluation) and candidate to radical prostatectomy will undergo Magnetic Resonance guided Focused Ultrasound (MRgFUS) ablation. The procedure is carried out either under general anesthesia or spinal block. MR images allow correct identification of the target as well as vital structure to avoid during energy delivery. Treatment safety and efficacy is monitored in real time using MR thermometry. Adjustments of energy direction and intensity can be made according to the real time monitoring. Pre- and post-ablative MR examinations will serve to analyze differences of DCE features of the neoplastic tissue; therapy-induced alterations will also be compared to histopathology findings from whole section prostate specimens

HIFU

Eligibility Criteria

• Age: 40 Years - 85 Years
• Sex: male
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patient of age between 40 to 85
• Patient with organ-confined Pca (cT1c and cT2a, N0, M0), diagnosed with TRUS biopsy (min:12 cores)
• Patient with PSA ≤ 10 ng/mL
• Gleason score 6 (3+3) or max 7 (3+4)
• Up to two (2) MR identifiable lesions
• No definite evidence of extracapsular extension

You may not qualify if:

• Patient under medications that can affect PSA for the last 3 months prior to MRgFUS treatment (Androgen Deprivation Treatment; alpha reductase inhibitors)
• Any rectal pathology, anomaly or previous treatment
• Identified calcification of 2 mm or more in largest diameter neighboring the rectal wall
• Bladder cancer
• Seminal vesicle/lymph node
• Prostate with multiple cystic lesions

Sponsors & Collaborators

• University of Roma La Sapienza: lead

Study Sites (1)

Department of Radiological Sciences, Sapienza University of Rome

Rome, 00100, Italy

Location

MeSH Terms

Conditions

Prostatic Neoplasms

Condition Hierarchy (Ancestors)

Genital Neoplasms, Male; Urogenital Neoplasms; Neoplasms by Site; Neoplasms; Genital Diseases, Male; Genital Diseases; Urogenital Diseases; Prostatic Diseases; Male Urogenital Diseases

Study Officials

• alessandro napoli, MD, PhD

  Department of Radiological Sciences, Sapienza University of Rome

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 1
• Allocation: NA
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Study Record Dates

• First Submitted: January 23, 2012
• First Posted: January 31, 2012
• Study Start: January 1, 2011
• Primary Completion: February 1, 2012
• Study Completion: June 1, 2012
• Last Updated: February 26, 2013

Record last verified: 2013-02

Locations

IT (1)