NCT04115254

Brief Summary

This is a master prospective Phase I-II trial evaluating feasibility and efficacy of stereotactic magnetic resonance (MR) guided adaptive radiation therapy (SMART) in patients with cancer.

  • The phase 1 study will evaluate the feasibility and safety of delivering SMART in patients with cancer.
  • Phase 2 will evaluate efficacy of SMART with specific reference to tumor control and improvement in patient reported outcome measures

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
397

participants targeted

Target at P75+ for not_applicable

Timeline
25mo left

Started Oct 2019

Longer than P75 for not_applicable

Geographic Reach
1 country

2 active sites

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress76%
Oct 2019Jun 2028

First Submitted

Initial submission to the registry

September 26, 2019

Completed
7 days until next milestone

First Posted

Study publicly available on registry

October 3, 2019

Completed
19 days until next milestone

Study Start

First participant enrolled

October 22, 2019

Completed
8.6 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 1, 2028

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

June 1, 2028

Last Updated

November 13, 2025

Status Verified

November 1, 2025

Enrollment Period

8.6 years

First QC Date

September 26, 2019

Last Update Submit

November 11, 2025

Conditions

Keywords

Magnetic Resonance Imaging (MRI)MRIdian Linear AcceleratorPancreas CancerLung CancerRenal CancerAdrenal MetastasesProstate CancerLiver MetastasesOligoprogressiveMetachronousSynchronousSpineProstate BoostPelvic Re Irradiation

Outcome Measures

Primary Outcomes (4)

  • Delivery Success Rate for SMART across multiple tumors-Phase I

    Enrolling patients and delivering SMART on the MR Linac

    1 year

  • Tumor visualization-Phase I

    Assessing tumor using MR guidance before, during and after MR-guided treatment patient

    1 Year

  • Plan creation-Phase I

    Generating adaptive plans

    1 Year

  • Rate of Improvement in Tumor Control-Phase II

    Statistical power will be defined in each cohort individually and will be specific to each disease site tested.

    1 Year

Secondary Outcomes (6)

  • Number of Patients with Acute Toxicity-Phase I

    90 Days

  • Duration of treatment-Phase 1

    90 Days

  • Number of treatment fractions-Phase1

    90 Days

  • Number of Participants with long term toxicity-Phase II

    365 Days

  • Disease Specific Survival Rate-Phase II

    365 Days

  • +1 more secondary outcomes

Study Arms (19)

PHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--Pancreatic

EXPERIMENTAL

SMART will be administered per each individual disease site standards

Radiation: MR-guided Linac

PHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--Renal

EXPERIMENTAL

SMART will be administered per each individual disease site standards

Radiation: MR-guided Linac

PHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--Central Lung

EXPERIMENTAL

SMART will be administered per each individual disease site standards

Radiation: MR-guided Linac

PHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--Adrenal Metastases

EXPERIMENTAL

SMART will be administered per each individual disease site standards

Radiation: MR-guided Linac

PHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--Liver Metastases

EXPERIMENTAL

SMART will be administered per each individual disease site standards

Radiation: MR-guided Linac

PHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--Metachronous Oligometastatic Nodes

EXPERIMENTAL

SMART will be administered per each individual disease site standards

Radiation: MR-guided Linac

PHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--Oligoprogressive Oligometastatic Nodes/Soft Tissue

EXPERIMENTAL

SMART will be administered per each individual disease site standards

Radiation: MR-guided Linac

PHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--Synchronous Oligometastatic Nodes/Soft Tissue

EXPERIMENTAL

SMART will be administered per each individual disease site standards

Radiation: MR-guided Linac

PHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--Prostate

EXPERIMENTAL

SMART will be administered per each individual disease site standards

Radiation: MR-guided Linac

PHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--Borderline Resectable Pancreas

EXPERIMENTAL

SMART will be administered per each individual disease site standards

Radiation: MR-guided Linac

PHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--Brain Metastases

EXPERIMENTAL

SMART will be administered per each individual disease site standards

Radiation: MR-guided Linac

PHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--Mesothelioma

EXPERIMENTAL

SMART will be administered per each individual disease site standards

Radiation: MR-guided Linac

PHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--Prostate Boost

EXPERIMENTAL

SMART will be administered per each individual disease site standards

Radiation: MR-guided Linac

PHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--Pelvic Re-Irradiation

EXPERIMENTAL

SMART will be administered per each individual disease site standards

Radiation: MR-guided Linac

PHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--Spine

EXPERIMENTAL

SMART will be administered per each individual disease site standards

Radiation: MR-guided Linac

PHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--Single-Fraction Kidney Tumors

EXPERIMENTAL

SMART will be administered per each individual disease site standards

Radiation: MR-guided Linac

PHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--1/3 Fraction for Oligometastatases in the Abdomen/Pelvis

EXPERIMENTAL

SMART will be administered per each individual disease site standards

Radiation: MR-guided Linac

PHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--Post-Operative Radiation Therapy in Lung Cancer

EXPERIMENTAL

SMART will be administered per each individual disease site standards

Radiation: MR-guided Linac

PHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--Mediastinal and Hilar Lymph Nodes

EXPERIMENTAL

SMART will be administered per each individual disease site standards

Radiation: MR-guided Linac

Interventions

Radiation will be delivered on an MR-guided Linear Accelerator

PHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--1/3 Fraction for Oligometastatases in the Abdomen/PelvisPHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--Adrenal MetastasesPHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--Borderline Resectable PancreasPHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--Brain MetastasesPHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--Central LungPHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--Liver MetastasesPHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--Mediastinal and Hilar Lymph NodesPHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--MesotheliomaPHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--Metachronous Oligometastatic NodesPHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--Oligoprogressive Oligometastatic Nodes/Soft TissuePHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--PancreaticPHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--Pelvic Re-IrradiationPHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--Post-Operative Radiation Therapy in Lung CancerPHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--ProstatePHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--Prostate BoostPHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--RenalPHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--Single-Fraction Kidney TumorsPHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--SpinePHASE 1: SBRT MR IMAGE GUIDANCE/ADAPTATION--Synchronous Oligometastatic Nodes/Soft Tissue

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Participants must have a confirmed malignancy requiring stereotactic body radiation therapy. See specific disease site cohorts for more details.
  • Tumor size ≤ 7cm
  • Age 18 years of older.
  • ECOG performance status ≤2 (Karnofsky ≥60%, see Appendix A)
  • Ability to understand and the willingness to sign a written informed consent document.
  • Specific eligibility requirements for each disease site with be covered in each specific cohort.

You may not qualify if:

  • History of allergic reactions attributed to gadolinium-based IV contrast.
  • \-- Note: If a patient will not receive contrast, this is not applicable
  • Pregnant women are excluded from this study.
  • Severe claustrophobia or anxiety
  • Participants who cannot undergo an MRI

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

Brigham & Women's Hospital

Boston, Massachusetts, 02115, United States

RECRUITING

Dana Farber Cancer Institute

Boston, Massachusetts, 02115, United States

RECRUITING

Related Publications (1)

  • Leeman JE, Shin KY, Droznin A, Catalano P, Cagney DN, Singer L, Oniyangi RD, Zhai K, Benham G, Chirmade S, Campbell J, Boyle S, Saranteas A, Williams CL, Huynh E, Han Z, Sudhyadhom A, Hu YH, Ferguson D, Singhrao K, Hsu SH, Bredfeldt J, Martin NE, Mancias JD, Mamon HJ, Van Dams R, Venkatachalam V, Tanguturi SK, Huynh MA, Fitzgerald KJ, Elhalawani H, Bitterman DS, Schoenfeld JD, Nguyen P, Haas-Kogan DA, Mak R. Stereotactic magnetic resonance imaging-guided adaptive radiotherapy: a pooled analysis of a master prospective trial. J Natl Cancer Inst. 2025 Nov 1;117(11):2289-2297. doi: 10.1093/jnci/djaf208.

MeSH Terms

Conditions

Pancreatic NeoplasmsLung NeoplasmsKidney NeoplasmsProstatic NeoplasmsMesotheliomaBrain Neoplasms

Condition Hierarchy (Ancestors)

Digestive System NeoplasmsNeoplasms by SiteNeoplasmsEndocrine Gland NeoplasmsDigestive System DiseasesPancreatic DiseasesEndocrine System DiseasesRespiratory Tract NeoplasmsThoracic NeoplasmsLung DiseasesRespiratory Tract DiseasesUrologic NeoplasmsUrogenital NeoplasmsFemale Urogenital DiseasesFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesKidney DiseasesUrologic DiseasesMale Urogenital DiseasesGenital Neoplasms, MaleGenital Diseases, MaleGenital DiseasesProstatic DiseasesAdenomaNeoplasms, Glandular and EpithelialNeoplasms by Histologic TypeNeoplasms, MesothelialCentral Nervous System NeoplasmsNervous System NeoplasmsBrain DiseasesCentral Nervous System DiseasesNervous System Diseases

Study Officials

  • Jonathan Leeman, MD

    Brigham and Women's Hospital

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NON RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: All participants will be assigned to one treatment arm only depending on their cancer type, and will be taken off study once treatment and follow up are complete.
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Principal Investigator

Study Record Dates

First Submitted

September 26, 2019

First Posted

October 3, 2019

Study Start

October 22, 2019

Primary Completion (Estimated)

June 1, 2028

Study Completion (Estimated)

June 1, 2028

Last Updated

November 13, 2025

Record last verified: 2025-11

Data Sharing

IPD Sharing
Will share

The Dana-Farber / Harvard Cancer Center encourages and supports the responsible and ethical sharing of data from clinical trials. De-identified participant data from the final research dataset used in the published manuscript may only be shared under the terms of a Data Use Agreement. Requests may be directed to: Dr. Jonathan Leeman (jonathane\_leeman@dfci.harvard.edu). The protocol and statistical analysis plan will be made available on Clinicaltrials.gov only as required by federal regulation or as a condition of awards and agreements supporting the research.

Shared Documents
STUDY PROTOCOL, SAP, ICF
Time Frame
Data can be shared no earlier than 1 year following the date of publication
Access Criteria
BWH - Contact the Partners Innovations team at http://www.partners.org/innovation

Locations