- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03315754
Study of the Efficacy, Safety and Quality of Life After TOOKAD® Soluble (VTP) for Intermediate Risk Prostate Cancer.
Study of the Efficacy, Safety and Quality of Life After TOOKAD® Soluble Vascular Targeted Photodynamic Therapy (VTP) for Minimally Invasive Treatment of Localized Intermediate Risk Prostate Cancer.
Single center, single-arm, open-label, 60-month follow-up phase IIb clinical trial. Men with localized prostate cancer will receive TOOKAD® Soluble VTP under general anesthesia.
To evaluate the absence of biopsy detectable Gleason grade 4 or 5 prostate cancer tumors anywhere in the prostate gland on 12-month, post-treatment biopsy following TOOKAD® Soluble-VTP in men with prostate cancer Gleason score 7(3+4).
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
New York
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New York, New York, United States, 10021
- Memorial Sloan-Kettering Cancer Center
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Men over 18 years of age.
- Patients who have had a multiparametric MRI of the prostate performed and have undergone transrectal systematic biopsy plus biopsy of any volumes considered suspicious per the MRI (PIRADS version 2 score of 4 or 5) within 6 months before signing consent.
- Histologic diagnosis of prostate cancer identifying Gleason score of 3+4 on one half of the prostate gland in no more than 2 sextants of the prostate gland and not present in more than 50% of any one core taken systematically. The involvement criterion does not apply to cores taken from MRI suspicious volumes.
- Patients with concomitant Gleason score 3+3 prostate cancer in less than 50% of any core at any site will be considered eligible.
- Prostate cancer stage up to cT2a - N0/Nx - M0/Mx.
- Prostate volume ≥25 mL and ≤70 mL.
- Serum PSA ≤10 ng/mL.
- Men who are sexually active with women of childbearing potential must use contraceptive method with a failure rate of less than 1% per year. Contraception should be continued for a period of 90 days after the VTP procedure. The individual methods of contraception may be determined in consultation
- Signed Informed Consent Form.
Exclusion Criteria:
- Unwillingness to accept the treatment;
- Any prior or current treatment for prostate cancer, including surgery, radiation therapy (external or brachytherapy) or chemotherapy;
- Any surgical intervention for benign prostatic hypertrophy;
- Any condition or history of illness or surgery that might pose an additional risk to men undergoing the VTP procedure;
- Life expectancy less than 10 years;
- Participation in another clinical study involving an investigational product within 1 month before study entry;
- Inability to understand the informed consent document, to give consent voluntarily or to complete the study tasks, especially inability to understand and fulfill the health-related QOL questionnaire;
- Subjects in custody and or residing in a nursing home or rehabilitation facility;
- Biopsy proven locally advanced or metastatic prostate cancer.
- Any condition or history of illness or surgery that in the opinion of the investigator might affect the conduct and results of the study or pose additional risks to the subject (e.g., cardiac or respiratory disease precluding general anesthesia; anticoagulant treatment which cannot be temporarily withdrawn for the procedure).
- Medical conditions that preclude the use of general anesthesia;
- Any condition or history of active rectal inflammatory bowel disease or other factors which might increase the risk of fistula formation;
- Hormonal manipulation (excluding 5-alpha-reductase inhibitors) that alters androgen production within the previous 6 months;
- History of urethral stricture disease;
- History of acute urinary retention within 6 months of study entry;
- Condition requiring medication with potential photosensitizing effects (tetracyclines, quinolones, sulphonamides, phenothiazines, sulfonylurea hypoglycaemic agents, thiazide diuretics, griseofulvin, and amiodarone) if these treatments could not be stopped at least 10 days before and for 3 days after the VTP procedure or replaced by treatments without photosensitizing properties;
- Anticoagulant drugs (e.g., warfarin) that could not be withdrawn during the 10 days prior to the VTP procedure or antiplatelet drugs (e.g. aspirin) that could not be withdrawn during the 10 days prior to the VTP procedure and 3 days after VTP;
- Renal and hepatic disorders with values of >1.5 times the upper limit of normal (ULN) or blood disorders (upon clinician judgment);
- A history of sun hypersensitivity or photosensitive dermatitis.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Experimental: TOOKAD Soluble 4 mg/kg
TOOKAD® Soluble VTP treatment consist of the combination of a single, 10-minute IV infusion of TOOKAD® Soluble at the dose of 4 mg/kg, followed by the illumination of the zone to be treated with a 753-nm laser light delivered through transperineal interstitial optical fibers at a power of 150 mW/cm and light energy of 200 J/cm applied over 22 minutes and 15 seconds.
|
Vascular targeted photodynamic therapy using TOOKAD Soluble
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Participants With Negative Biopsy for Gleason Score 7 (Gleason Grade 4 or 5) Prostate Cancer on 12-month Post-treatment
Time Frame: 12 months
|
This outcome reports the percent of participants with response to treatment defined as absence of high-grade cancer (Gleason score 7 (Gleason grade 4 or 5) on bilateral biopsy at 12-month post VTP treatment.
The Gleason grading system is a histopathological scale used to evaluate the aggressiveness of prostate cancer.
The Gleason score is determined by summing the two most predominant histological patterns observed in tumor tissue, each graded on a scale from 1 (well-differentiated) to 5 (poorly differentiated).
The total Gleason score ranges from 2 to 10, with higher scores indicating more aggressive disease.
PP (per protocol) is all participants who met all key eligibility criteria at baseline and did not have any major deviations that could invalidate eligibility or the integrity/timing of the 12-month biopsy (biopsy missing/out of window, or pre-12-month salvage therapy).
ITT( intent-to treat) is all patients who undergo VTP procedure, regardless of protocol deviations
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12 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Absence of Any Prostate Cancer on Biopsy in the Treated Lobe
Time Frame: months 3, 12, 24, 36, 48 and 60
|
Binary response to treatment defined as the absence of any prostate cancer on biopsy on or before months 3, 12, 24, 36, 48 and 60 in the treated lobe.
If a subject is retreated following a positive biopsy at 3 months and subsequent biopsy shows absence of any cancer, the subject will be considered to have responded
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months 3, 12, 24, 36, 48 and 60
|
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Secondary Prostate Cancer Treatment
Time Frame: Up to 60 months
|
Use of secondary prostate cancer treatment following VTP will include surgical removal of the prostate gland, radiation treatment to the prostate gland, use of hormone or chemotherapies
|
Up to 60 months
|
|
Absence of Gleason Score 7 ( Gleason Grade 4 or 5) in Entire Prostate
Time Frame: 3, 12, 24,36,48, 60 months
|
Binary response to treatment defined as the absence of Gleason score 7 ( Gleason grade 4 or 5 ) biopsy at or before months 3, 12, 24, 36, 48 and 60.
If a subject is retreated following a positive biopsy at 3 months and subsequent biopsy shows absence of Gleason grade 4 or 5, the subject will be considered to have responded.
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3, 12, 24,36,48, 60 months
|
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Absence of Any Prostate Cancer on Biopsy
Time Frame: months 3, 12, 24, 36, 48 and 60
|
Binary response to treatment defined as the absence of any prostate cancer on biopsy on or before months 3, 12, 24, 36 and 60.
If a subject is retreated following a positive biopsy at 3 months and subsequent biopsy shows absence of any cancer, the subject will be considered to have responded
|
months 3, 12, 24, 36, 48 and 60
|
|
Absence of Gleason Score 7 (Gleason Grade 4 or 5) in the Treated Lobe
Time Frame: months 3,12, 24, 36, 48 and 60
|
Binary response to treatment defined as the absence of Gleason score 7 (Gleason grade 4 or 5) biopsy at or before months 3,12, 24, 36, 48 and 60 in the treated lobe.
If a subject is retreated following a positive biopsy at 3 months and subsequent biopsy shows absence of Gleason grade 4 or 5, the subject will be considered to have responded;
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months 3,12, 24, 36, 48 and 60
|
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Changes in Biopsy Parameters (Gleason Score)
Time Frame: 3,12,24,36,48, 60 months
|
Changes in biopsy parameters (Gleason score) between the baseline biopsy (Gleason score 7 (3+4) and months 3, 12, 24, 36, 48 , 60 biopsies.
The Gleason grading system is a histopathological scale used to assess prostate cancer aggressiveness, with total scores ranging from 2 to 10 (sum of two predominant patterns graded 1-5).
Higher scores indicate more aggressive disease.
This outcome reports the proportion of participants with absence of high-grade cancer (no Gleason score <7 (Gleason pattern < 4 or 5) in the treated lobe at each time point
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3,12,24,36,48, 60 months
|
|
The International Prostate Symptom Score (IPSS) Questionnaire
Time Frame: months 1, 3, 6, 12, 24, 36, 48 and 60
|
The International Prostate Symptom Score (IPSS) is a 7 item questionnaire assessing lower urinary tract symptom severity.
Each item is scored from 0 to 5, item scores are summed to give a total score ranging from 0 to 35.
Higher scores indicate more severe symptoms and a worse outcome.
Scores of 0-7 indicate mild, 8-19 moderate and 20-35 severe symptoms.
Patient-reported outcome measures (PROMs) impairment: urinary symptoms using IPSS prior to treatment beginning and then 1, 3, 6, 12, 24, 36, 48 and 60 months after completing treatment
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months 1, 3, 6, 12, 24, 36, 48 and 60
|
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International Index of Erectile Function (IIEF15) Questionnaire
Time Frame: months 1, 3, 6, 12, 24, 36, 48 and 60
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The International Index of Erectile Function (IIEF 15) is a 15 item questionnaire assessing male sexual function.
Item scores are summed to obtain a total score ranging s from 5 to 75.
Higher total scores indicate better sexual function and therefore a better outcome.
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months 1, 3, 6, 12, 24, 36, 48 and 60
|
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Severe Prostate Cancer Related Events
Time Frame: up to 60 months
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Severe prostate cancer-related events defined as cancer extension to T3, metastasis or prostate cancer-related death
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up to 60 months
|
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PSA
Time Frame: Months 1, 3, 6, 12, 24, 36, 48, 60
|
Serum PSA measurements in ng/mL at visit 0 (baseline) and at follow up visits at 1, 3, 6,12,24,36,48 and 60 months.
|
Months 1, 3, 6, 12, 24, 36, 48, 60
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Jonathan Coleman, MD, Memorial Sloan Kettering Cancer Center
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- CLIN1601 PCM204
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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