- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04543903
Neoadjuvant Interstitial Brachytherapy Using Diffusing Alpha Emitters Radiation Therapy in Men With Prostate Cancer
A Feasibility of Neoadjuvant Interstitial Brachytherapy (Ibt) Using Diffusing Alpha Emitters Radiation Therapy (Dart) Seeds in Men With Prostate Cancer
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The study is planned as a prospective, open-label, one arm, single center trial, designed to assess the feasibility and safety of intratumoral DaRT seeds implantation for the treatment of local prostate cancer prior to surgery.
This approach combines the advantages of local intratumoral irradiation of the tumor, as used in conventional brachytherapy, with the power of the alpha radiation emitting atoms, that will be introduced in quantities considerably lower than radiation therapy already used in patients.
Prostate lesions with histopathological confirmation of adenocarcinoma will be treated using DaRT seeds in a neo-adjuvant setting.
Feasibility will be assessed by the successful delivery of DaRT seeds into the intratumoral environment. In addition, objective response rate will be assessed both by imaging and pathology.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Ester Deutsch
- Phone Number: +972-2-3737-212
- Email: EsterD@alphatau.com
Study Contact Backup
- Name: Liron Dimnik
- Phone Number: +972-2-3737-210
- Email: LironD@alphatau.com
Study Locations
-
-
-
Haifa, Israel, 3109601
- Recruiting
- Rambam Health Care Campus
-
Contact:
- Tomer Charas, MD
- Phone Number: +972-4-777-6505
- Email: t_charas@rmc.gov.il
-
Principal Investigator:
- Tomer Charas, MD
-
Haifa, Israel, 3436212
- Recruiting
- Carmel Medical Center
-
Contact:
- Yuval Freifeld, MD
- Phone Number: +972-523453511
- Email: yuvalfrei@gmail.com
-
Tel Aviv, Israel
- Not yet recruiting
- Tel Aviv Medical Center
-
Contact:
- Ofer Yossepowitch, MD
- Phone Number: 03-6973265
- Email: ofery@tlvmc.gov.il
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Pathologically confirmed, previously untreated, resectable prostate adenocarcinoma
- Ability to provide tissue sample from the target or its vicinity, either from an archive or undergo another biopsy to provide a fresh sample
- Medically fit for surgery
- Targetable lesion must be technically amenable for complete coverage (including 3-5mm margins) by the DaRT seeds
- Targetable lesion by either PSMA PET-CT according to PERCIST v1.0 OR by multiparametric MRI according RECIST v1.1
- Patients must be willing to undergo imaging before and after treatment with DaRT (prior to surgery)
- Lesion size ≤ 3 cm in the longest diameter
- Age ≥ 18 years old
- ECOG Performance Status Scale ≤ 1
- Subjects' life expectancy is more than 6 months
- WBC ≥ 3500/μl, granulocyte ≥ 1500/μl
- Platelet count ≥ 100,000/μl
- Calculated or measured creatinine clearance ≥ 60 cc/min
- AST and ALT ≤ 2.5 X ULN
- INR <1.4 for patients not on Warfarin
- Subjects are willing and able to sign an informed consent form
Exclusion Criteria:
- Documented evidence of distant metastases
- Prior TURP or prostate surgery
- Prior pelvic radiation
- Any prior pelvic malignancy or other malignancy in the last 5 years, except for cured non-melanoma skin cancer
- Inability to undergo MRI (i.e. permanent implanted device incompatible with MRI)
- Known hypersensitivity to any of the components of the treatment.
- Clinically significant cardiovascular disease, e.g. cardiac failure of New York Heart Association classes III-IV, uncontrolled coronary artery disease, cardiomyopathy, uncontrolled arrhythmia, uncontrolled hypertension, or history of myocardial infarction in the last 12 months.
- Any medical or psychiatric illness which in the opinion of the investigator would compromise the patient's ability to tolerate this treatment or interfere with the study endpoints.
- Patients must agree to use adequate contraception (vasectomy or barrier method of birth control) prior to study entry, for the duration of study participation and for 3 months after DaRT implant procedure
- Volunteers participating in another interventional study in the past 30 days which might conflict with the endpoints of this study or the evaluation of response or toxicity of DaRT.
- High probability of protocol non-compliance (in opinion of investigator)
- Subjects not willing to sign an informed consent
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: DaRT Seeds
Intratumoral Diffusing alpha-emitters Radiation Therapy (DaRT) Seeds
|
An intratumoral insertion of a seed(s), loaded with Radium-224, securely fixed in the seeds.
The seeds release by recoil into the tumor short-lived alpha-emitting atoms.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Feasibility of intratumoral DaRT seeds implantation
Time Frame: Study visit 'Day 0'
|
To evaluate the feasibility of intratumoral insertion of DaRT seeds into prostate adenocarcinoma in the neoadjuvant setting.
Feasibility will defined as the successful delivery of DaRT.
|
Study visit 'Day 0'
|
Safety of intratumoral DaRT seeds implantation
Time Frame: Study visit 'Day 0'
|
To evaluate the safety of intratumoral insertion of DaRT seeds into prostate adenocarcinoma in the neoadjuvant setting. To evaluate the safety of intratumoral insertion of DaRT seeds into prostate adenocarcinoma in the neoadjuvant setting by the frequency and severity of acute adverse events related to DaRT. Adverse events will be assessed and graded according to Common Terminology and Criteria for adverse events (CTCAE) version 5.0. |
Study visit 'Day 0'
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Pathological ORR
Time Frame: Week 4-6
|
To asses the percentage of patients whose cancer shrinks or disappears after treatment using a biopsy from removed prostate.
|
Week 4-6
|
Radiological ORR
Time Frame: 1 Week prior to surgery
|
Radiological response rate according to PSMA-PET/ multiparametric MRI (SUV change/T2 weighting) through comparison with baseline imaging as assessed by RECIST or PERCIST.
|
1 Week prior to surgery
|
Change in quality of life
Time Frame: Screening. Day 22.
|
Change in disease related QoL using the EPIC questionnaires from baseline to prior to surgery
|
Screening. Day 22.
|
Change in quality of life
Time Frame: Screening. Day 22.
|
Change in disease related QoL using the IPSS questionnaires from baseline to prior to surgery
|
Screening. Day 22.
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Assess DNA damage and repair
Time Frame: Day 40 - 60
|
Assess DNA damage and repair (biomarker analysis: γH2AX foci, TUNEL, RAD51, RAD50, BRCA1, XRCC2, XRCC6) from baseline to surgery following DaRT seeds insertion.
|
Day 40 - 60
|
Assess immune infiltration
Time Frame: Day 40 - 60
|
Assess immune cell infiltration (biomarker analysis: CD34, TILs) from baseline to surgery following DaRT seeds insertion.
|
Day 40 - 60
|
Biochemical response evaluation
Time Frame: Day 19-25, Day 68-82
|
Biochemical response evaluation based on PSA levels
|
Day 19-25, Day 68-82
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Tomer Charas, M.D, Radiotherapy unit at Rambam Health Care Campus, Israel
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- CTP-PRST-02
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
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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