- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03479151
Magnetic Resonance Guided High Intensity Focused Ultrasound (MRgHIFU) for Pain Palliation of Bone Metastases (HIFU-Bone)
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The primary aim of this study is to investigate whether the ablated tissue volume indicated by immediate post-treatment Gd-T1W imaging is indicative of reduction in pain scores (response) 30 days after treatment.
The secondary aims of this study are:
- To record the proportion of patients responding to MRgHIFU treatment at Days 7, 14, 30, 60 and 90 after treatment
- To investigate whether intra-procedural PRFS metrics (thermal dose volume, temperature) are indicative of subsequent treatment response
- To investigate whether intra- or post-procedural changes in ADC or T2 are indicative of subsequent treatment response
- To record adverse events arising as a result of MRgHIFU treatment
- To evaluate the effect of MRgHIFU treatment on patients' quality of life
- To record the time to pain progression and the duration of pain response for patients in this cohort
- To estimate the costs of MRgHIFU treatment
This is an exploratory study, which will recruit n=15 patients into one single cohort. Enrolment of the target population for the study is expected to take approximately 2 years. Patients will be eligible for the study if they wish to consider MRgHIFU treatment for pain palliation of a region of bony metastatic disease that is accessible to the MRgHIFU device. After providing their written informed consent to participate in the study, patients' suitability for treatment will be determined by a combined assessment of clinical review by a pain specialist, and an MR screening investigation to establish lesion targetability. Baseline clinical and imaging metrics will be recorded. Patients who fulfill all inclusion criteria, have none of the exclusion criteria, and who give informed consent, will be scheduled for MRgHIFU treatment to the target lesion. Treatment will be delivered under sedation on a day-case basis, according to protocols already established in our prior study. During treatment delivery, the investigators will assess imaging metrics of tissue change, which may be indicative of subsequent treatment response. Treatment would be expected to take approximately 1-2 hours, and after an observation period of approximately 2-4 hours, the patient will be discharged. Before discharge, follow-up instructions will be given to the patient. Patients' clinical and imaging responses to treatment will then be assessed at follow-up appointments up to 3 months after treatment.
Study Type
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Surrey
-
Sutton, Surrey, United Kingdom, SM2 5PT
- The Royal Marsden NHS Foundation Trust
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients with painful bony metastatic disease
- Target bony metastatic lesion is painful (NRS≥4)
- Intended target region accessible for MRgHIFU treatment (usually not skull or spinal metastases above the sacrum)
- Intended target region visible on non-contrast MR imaging
Exclusion Criteria:
- MRI contra-indicated (e.g. by incompatible metal implants, claustrophobia, or because BMI precludes accommodation in the MR scanner)
- Pregnancy
- Sedation contra-indicated
- Critical anatomical structure cannot be avoided along the beam path or the at the target (can be assessed at screening)
- Internal or external fixation device along the beam path or at the target
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: MR-HIFU of painful bone metastases
Magnetic Resonance guided High Intensity Focused Ultrasound (MRgHIFU) for Pain Palliation of Bone Metastases
|
MRgHIFU treatment will be delivered using a Philips Sonalleve system, which integrates a high intensity phased array focused ultrasound transducer with our Philips 3T Achieva imaging system.
An electromechanical transducer positioning system is used to deliver spatially and temporally controlled ultrasound energy and thermal heat to tissues non-invasively.
The MR system is used to provide images to plan the therapy, and to guide and monitor the thermal ablation with thermal imaging during the treatment.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Measure the ablated tissue volume indicated by immediate post-treatment Gd-T1W imaging in responders and non-responders.
Time Frame: Day 30
|
Day 30
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
To report the treatment response rate.
Time Frame: up to 90 days
|
Days 7, 14, 30, 60 and 90
|
up to 90 days
|
To investigate whether ablated tissue volume indicated by Gd-T1W imaging at Day 30 remains stable at Days 60 and 90.
Time Frame: up to 90 days
|
up to 90 days
|
|
.To investigate whether intra-procedural PRFS metrics are different in responders and non-responders at Day 30
Time Frame: 30 days post treatment
|
PRFS Metrics include thermal dose volume, temperature
|
30 days post treatment
|
To investigate whether intra- or post-procedural changes in ADC are different in responders and non-responders.
Time Frame: Day 30
|
Day 30
|
|
To investigate whether intra- or post-procedural changes in T2 are different in responders and non-responders.
Time Frame: Day 30
|
Day 30
|
|
The rate of treatment-related adverse events
Time Frame: up to 3 months after treatment.
|
up to 3 months after treatment.
|
|
The effect of MRgHIFU treatment on patients' quality of life, recorded using Quality of Life Questionnaires (QLQ's).
Time Frame: up to 3 months after treatment.
|
using EORTC (European Organization for Research and Treatment of Cancer)- QLQ's
|
up to 3 months after treatment.
|
The costs of MRgHIFU treatment.
Time Frame: up to 3 months after treatment.
|
up to 3 months after treatment.
|
Collaborators and Investigators
Investigators
- Principal Investigator: Nandita deSouza, Professor, Institute of Cancer Research, United Kingdom
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
- 17/LO/1689 CCR 4733
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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