Targeted Cryoablation of Prostate Cancer Lesions: An Investigator-initiated Trial (PROCRY)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Osamu Ukimura, M.D., Ph.D.
- Phone Number: 5595 +81 75 251 5595
- Email: procry@koto.kpu-m.ac.jp
Study Contact Backup
- Name: Toshiko Ito-Ihara, M.D., Ph.D.
- Phone Number: 5380 +81 75 251 5380
- Email: liaison@koto.kpu-m.ac.jp
Study Locations
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Kyoto, Japan, 602-8566
- University Hospital, Kyoto Prefectural University of Medicine
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Kyoto, Japan, 616-8147
- Kyoto Miniren Chuo Hospital
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patients who have a PI-RADS category 3 or 4 lesion on MRI image at enrollment and who have a single lesion with a Gleason score 7 or 8 on histopathology of the prostate needle biopsy at enrollment; or, patients who have a PI-RADS category 4 or 5 lesion on MRI image at enrollment and who have a single lesion with a Gleason score 6 or 7 on histopathology of the prostate needle biopsy at enrollment
- Patients with prostate cancer that is clinical stage T2c or lower (T1a-T2cN0M0) according to the TNM Classification as determined during enrollment
- Patients between the ages of 20 and 85 when providing consent to participate in this trial
- Patients from whom consent is obtained prior to enrollment in this trial
Exclusion Criteria:
- Patients to have a lesion identified as PI-RADS category 4 or 5 on MRI images at enrollment and who have a single lesion with a diameter of less than 10 mm and Gleason score of 6 on the histopathology of the prostate needle biopsy at enrollment (the lesion is referred to as "non-target lesions") (the diameter of the lesion is defined as the longer one of the lesion diameter identified on MRI images at enrollment or the tumor length as measured on histopathology of prostate needle biopsy)
- Patients to have 4 or more non-target lesions (non-target lesions are defined as the lesions defined in exclusion criterion 1, or lesions with PI-RADS category 3 on MRI image at enrollment and Gleason score 6 on biopsy at enrollment)
- Patients to have a lesion with PI-RADS category 5 on MRI image at enrollment and Gleason score 8 on histopathology of prostate needle biopsy at enrollment (the lesion is referred "excluded lesions")
- Patients with a serum prostate-specific antigen (PSA) level over 20 ng/ml during enrollment
- Patients in whom the distance from the target prostate cancer lesion to an external urinary sphincter is 5 mm or less on MRI images (coronal or sagittal) obtained during enrollment
- Patients who have undergone surgery, drug therapy, or radiation therapy for prostate cancer prior to enrollment
- Patients who have received an antiandrogen for benign prostatic hyperplasia prior to enrollment
- Patients using absorbent pads or adult diapers due to urge incontinence
- Patients with active multiple cancers
- Patients for whom MRI scans are contraindicated
- Patients in whom transrectal ultrasound cannot be performed for some reason, such as a constricted rectum
- Patients with a prothrombin time<50% or platelet count<60,000/mm3 during enrollment
- Patients deemed to be ineligible by an investigator
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
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Experimental: Cryoablation Arm
Minimally invasively trans-perineal puncture of both cryo-needles and temperature-needles will be placed under real-time image guidance to the targeted area of cancer lesion or temperature-monitoring sites, respectively.
The targeted tissue surrounding the tip of cryo-needles will be freeze down to targeted temperature for killing the cancer cells, and other non-treated area will be left in the prostate for aiming of maintain QOL (quality-of-life).
The Minimally invasive cryoablation surgery will be performed under general anesthesia within one and half hour for aiming to be provided total 50 patients.
(The used device for this arm has been clinically approved for cryoablation of renal cancer in Japan.)
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Currently, the standard surgical treatment option for localized prostate cancer is total prostatectomy, which removes the entire prostate organ.
However, total prostatectomy is invasive and postoperative urinary incontinence, sexual dysfunction and local recurrence remain clinical challenges even with the introduction of robotic assistance techniques.
Cryotherapy has been approved as one of the other surgical treatment options for localized prostate cancer in the USA and Europe, but not in Japan.
This clinical trial aims to expand the indication of cryotherapy equipment, which has already been approved for insurance for renal cancer, to prostate cancer in Japan.
In this clinical trial, Focal Therapy will be performed by targeting a single localized prostate cancer lesion visualized by MRI.
By targeting cancer lesions in a minimally invasive manner, we aim to achieve both control of cancer lesions and maintenance of quality of life.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Disappearance of cancer at 6 month after cryosurgery evaluated by combination of the responses in PSA, MRI, and Prostate biopsy
Time Frame: 6 months after the cryosurgery
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Achievement of all endpoints in the three clinical parameters including 1) reduction of serum PSA value, 2) reduction of PI-RADS category for MRI-visible lesion, and 3) histological disappearance of cancer by prostate biopsy
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6 months after the cryosurgery
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Osamu Ukimura, M.D., Ph.D., Department of Urology, University Hospital, Kyoto Prefectural University of Medicine
- Study Chair: Toshiko Ito-Ihara, M.D., Ph.D., The Clinical and Translational Research Center , University Hospital, Kyoto Prefectural University of Medicine (CTREC)
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
- Prostate Cancer
- Cryotherapy
- Cryosurgery
- Focal Therapy
- Targeted Prostate Biopsy
- Localized Prostate Cancer
- QOL, Quality of Life
- CISca, Clinically Insignificant Prostate Cancer
- CSCa, Clinically Significant Prostate Cancer
- Treatment of partial prostate
- Targeted Cryoablation
- Ultrasound guided surgery
- MRI, Magnetic Resonance Imaging
- PSA, Prostate Specific Antigen
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- CTREC-URO-181202
- jRCT2052210088 (Other Identifier: Japan Registry of Clincal Trials)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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