PRISTINE Trial: PRoton Beam Therapy In Seminoma - Toxicity INvestigation and Evaluation of Outcome (PRISTINE)
Stage II seminoma is a type of cancer that is usually highly curable and most often affects young men.
Radiotherapy is an effective treatment, but it can sometimes cause side effects in the long term and, rarely, increase the risk of developing another cancer later in life.For this reason, more targeted treatments are being explored, such as proton therapy (PBT). This type of radiotherapy uses protons to better focus the treatment on the tumor while reducing exposure to the surrounding healthy tissues.The goal is to treat the cancer effectively while minimizing side effects as much as possible.
調査の概要
研究の種類
入学 (推定)
段階
- 適用できない
連絡先と場所
研究連絡先
- 名前:Ciro Franzese, MD, Radiation Oncologist
- 電話番号:+39 0282247454
- メール:ciro.franzese@hunimed.eu
研究連絡先のバックアップ
- 名前:Laura Bonavita, Master degree
- 電話番号:+39 0282247026
- メール:laura.bonavita@humanitas.it
参加基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
説明
Inclusion Criteria:
- Age ≥ 18 years
- Male gender
- ECOG Performance status 0 - 1
- Histologically confirmed diagnosis of testicular seminoma
- Stage IIA - IIB disease with metastatic involvement limited to retroperitoneal lymph nodes measuring ≤3 cm in greatest diameter
- Prior radical orchiectomy
- Clinical indication for radiotherapy
- Written informed consent provided
Exclusion Criteria:
- Non-seminomatous germ cell tumor histology
- Incomplete definitive surgical orchiectomy, including diagnostic biopsy alone
- Prior or concurrent second malignancy other than non-melanoma skin cancer, unless disease free for a minimum of five years
- Prior radiotherapy to the abdominal or pelvic region
- Known severe, active co-morbidity
- Inability or refusal to provide informed consent
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:なし
- 介入モデル:単一グループの割り当て
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
実験的:Protontherapy Treatment
patient will be treated with protontherapy instead of radiotherapy
|
patients will be treated with protontherapy instead of radiotherapy with photon as standard of care
|
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Treatment toxicities
時間枠:from enrollment to two years follow up
|
Incidence of Grade ≥2 late treatment-related toxicity defined according to CTCAE v6.0 criteria
|
from enrollment to two years follow up
|
|
Progression free survival
時間枠:from enrollment to 12 months from treatment
|
Progression free survival within 12 months after radiotherapy defined defined as radiological progression and/or biochemical evidence of relapse, or death from any cause.
|
from enrollment to 12 months from treatment
|
|
Modeled excess absolute risk (EAR) of secondary malignancies
時間枠:from treatment to two years follow up
|
estimated from individual organ dosimetry using validated dose-response models (exploratory, model-based component)
|
from treatment to two years follow up
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Overall survival
時間枠:from treatment to three years follow up
|
Overall survival at 3 years post-treatment defined by survival status of patients at each time point
|
from treatment to three years follow up
|
|
Quality of life outcomes
時間枠:from treatment to two years follow up
|
evaluation of quality of life of patients through the completion of questionnarie QLQ-C30.
Question with a scale from 1 to 4 (1 low quality of life - 4 high quality of life)
|
from treatment to two years follow up
|
|
Values of circulating hsa-miR-371a-3p in patient treated with Proton Therapy
時間枠:from treatment to two years follow up
|
Evaluation of the change in circulating hsa-miR-371a-3p concentration (mg/dL) before and after experimental treatment.
This tumor marker is being investigated as a potential biomarker for the early diagnosis of testicular cancer, and the aim is to analyze how it may be influenced by proton therapy by comparing it with standardized reference values.
|
from treatment to two years follow up
|
|
Correlation between miRNA clearance/persistance and outcomes
時間枠:from treatment to two years follow up
|
analysis of plasma samples to evaluate the concentration of miRNA in plasma and how this could be linked to treatment outcomes
|
from treatment to two years follow up
|
|
Quantification of immune cell populations according to cell type
時間枠:from treatment to two years follow up
|
Evaluation of of systemic immune modulation through the analysis of concentration in plasma samples of immune cells
|
from treatment to two years follow up
|
|
Quality of life outcomes
時間枠:from treatment to two years follow up
|
evaluation of quality of life of patients through the completion of questionnarie QLQ-TC26.
Question with a scale from 1 to 4 (1 low quality of life - 4 high quality of life).
|
from treatment to two years follow up
|
|
Quality of life outcomes
時間枠:From treatment to two years follow up
|
evaluation of quality of life of patients through the completion of questionnarie QLQ-AYA.
Question with a scale from 1 to 4 (1 low quality of life - 4 high quality of life).
|
From treatment to two years follow up
|
協力者と研究者
出版物と役立つリンク
一般刊行物
- Aziz Z, Wagner S, Agyekum A, Pumpalova YS, Prest M, Lim F, Rustgi S, Kastrinos F, Grady WM, Hur C. Cost-Effectiveness of Liquid Biopsy for Colorectal Cancer Screening in Patients Who Are Unscreened. JAMA Netw Open. 2023 Nov 1;6(11):e2343392. doi: 10.1001/jamanetworkopen.2023.43392.
- Marelli G, Morina N, Puccio S, Iovino M, Pandini M, Portale F, Carvetta M, Mishra D, Diana E, Meregalli G, Paraboschi E, Cibella J, Peano C, Basso G, De Simone G, Camisaschi C, Magrini E, Sartori G, Karimi E, Colombo P, Lazzeri M, Casale P, Morosi L, Martano G, Asselta R, Bonavita E, Matsunami H, Bertoni F, Walsh L, Lugli E, Di Mitri D. Chemosensor receptors are lipid-detecting regulators of macrophage function in cancer. Nat Immunol. 2025 Jul;26(7):1182-1197. doi: 10.1038/s41590-025-02191-x. Epub 2025 Jun 30.
- Li X, Ding R, Liu Z, Teixeira WMS, Ye J, Tian L, Li H, Guo S, Yao K, Ma Z, Liu Z. A predictive system comprising serum microRNAs and radiomics for residual retroperitoneal masses in metastatic nonseminomatous germ cell tumors. Cell Rep Med. 2024 Dec 17;5(12):101843. doi: 10.1016/j.xcrm.2024.101843. Epub 2024 Dec 12.
- Alsyouf M, Nappi L, Nichols C, Daneshmand S. Plasma Micro-RNA 371 Expression in Early-Stage Germ Cell Tumors: Are We Ready to Move Toward Biology-Based Decision Making? J Clin Oncol. 2023 May 10;41(14):2478-2482. doi: 10.1200/JCO.22.02002. Epub 2023 Feb 9. No abstract available.
- Konneh B, Lafin JT, Howard J, Gerald T, Amini A, Savelyeva A, Woldu SL, Lewis CM, Jia L, Margulis V, Coleman N, Scarpini C, Frazier AL, Murray MJ, Amatruda JF, Bagrodia A. Evaluation of miR-371a-3p to predict viable germ cell tumor in patients with pure seminoma receiving retroperitoneal lymph node dissection. Andrology. 2023 May;11(4):634-640. doi: 10.1111/andr.13317. Epub 2022 Nov 2.
- Nestler T, Schoch J, Belge G, Dieckmann KP. MicroRNA-371a-3p-The Novel Serum Biomarker in Testicular Germ Cell Tumors. Cancers (Basel). 2023 Aug 3;15(15):3944. doi: 10.3390/cancers15153944.
- Tulik P, Maciak M, Tulik M. A dosimetric comparison of 3D-CRT, IMRT and IMAT treatment techniques - assessment from radiation protection point of view. Rep Pract Oncol Radiother. 2024 Mar 18;29(1):69-76. doi: 10.5603/rpor.99025. eCollection 2024.
- Pursley J, Remillard K, Depauw N, Lee G, Grassberger C, Paganetti H, Efstathiou JA, Kamran SC. Radiation Therapy for Stage IIA/B Seminoma: Modeling Secondary Cancer Risk for Protons and VMAT versus 3D Photons. Cancers (Basel). 2024 Feb 15;16(4):784. doi: 10.3390/cancers16040784.
- Maxwell R, Chang Y, Paul C, Vaughn DJ, Christodouleas JP. Cancer Control, Toxicity, and Secondary Malignancy Risks of Proton Radiation Therapy for Stage I-IIB Testicular Seminoma. Adv Radiat Oncol. 2023 May 2;8(5):101259. doi: 10.1016/j.adro.2023.101259. eCollection 2023 Sep-Oct.
- Ronde HS, Kronborg C, Hoyer M, Hansen J, Bak ME, Agergaard SN, Als AB, Agerbaek M, Lauritsen J, Meidahl Petersen P, Dysager L, Kallehauge JF. Dose comparison of robustly optimized intensity modulated proton therapy (IMPT) vs IMRT and VMAT photon plans for testicular seminoma. Acta Oncol. 2023 Oct;62(10):1222-1229. doi: 10.1080/0284186X.2023.2254925. Epub 2023 Sep 8.
- Xiang M, Chang DT, Pollom EL. Second cancer risk after primary cancer treatment with three-dimensional conformal, intensity-modulated, or proton beam radiation therapy. Cancer. 2020 Aug 1;126(15):3560-3568. doi: 10.1002/cncr.32938. Epub 2020 May 19.
- Giannatempo P, Nicolai N. What is the best way to treat patients with stage IIA or IIB seminoma? Lancet Oncol. 2022 Nov;23(11):1349-1350. doi: 10.1016/S1470-2045(22)00625-8. Epub 2022 Oct 10. No abstract available.
- Classen J, Schmidberger H, Meisner C, Souchon R, Sautter-Bihl ML, Sauer R, Weinknecht S, Kohrmann KU, Bamberg M. Radiotherapy for stages IIA/B testicular seminoma: final report of a prospective multicenter clinical trial. J Clin Oncol. 2003 Mar 15;21(6):1101-6. doi: 10.1200/JCO.2003.06.065.
研究記録日
主要日程の研究
研究開始 (推定)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
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