Clinical Trials /

Focal Salvage HDR Brachytherapy for Locally Recurrent Prostate Cancer in Patients Treated With Prior Radiotherapy

NCT03312972

Description:

This purpose of this study is to evaluate the safety and effectiveness of a technique called focal high-dose-rate (HDR) brachytherapy as treatment for prostate cancer that has come back in the prostate after prior radiotherapy. The study will examine the safety and efficacy of the treatment. The type of radiation that participants in this research will receive is targeted directly at the areas of the prostate where recurrent disease is evident, while avoiding treatment of the normal appearing prostate. This involves the placement of a radioactive material in the affected area of the prostate temporarily, where it remains for a short period of time, and then is subsequently removed using a minimally invasive technique called HDR Brachytherapy.

Related Conditions:
  • Prostate Adenocarcinoma
Recruiting Status:

Recruiting

Phase:

Phase 1/Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Focal Salvage HDR Brachytherapy for Locally Recurrent Prostate Cancer in Patients Treated With Prior Radiotherapy
  • Official Title: F-SHARP: A Phase I/II Trial of Focal Salvage High-dose-rate BRachytherapy for Locally Recurrent Prostate Cancer in Patients Treated With Prior Radiotherapy

Clinical Trial IDs

  • ORG STUDY ID: 209557
  • NCT ID: NCT03312972

Conditions

  • Locally Recurrent Prostate Cancer

Purpose

This purpose of this study is to evaluate the safety and effectiveness of a technique called focal high-dose-rate (HDR) brachytherapy as treatment for prostate cancer that has come back in the prostate after prior radiotherapy. The study will examine the safety and efficacy of the treatment. The type of radiation that participants in this research will receive is targeted directly at the areas of the prostate where recurrent disease is evident, while avoiding treatment of the normal appearing prostate. This involves the placement of a radioactive material in the affected area of the prostate temporarily, where it remains for a short period of time, and then is subsequently removed using a minimally invasive technique called HDR Brachytherapy.

Detailed Description

      The goal of any radiation treatment plan is to achieve maximal disease response with minimal
      toxicity. HDR brachytherapy offers a promising definitive treatment option in the setting of
      Locally Recurrent Prostate Cancer after prior definitive radiation, based on the limited data
      described above, with achievement of biochemical disease control in a large percentage of
      patients with relatively low toxicity. With focal HDR brachytherapy, the investigators can
      treat the isolated areas of disease, while avoiding normal prostate tissue, with the goal of
      further improving toxicity rates. The investigators hypothesize that using single fraction,
      focal HDR brachytherapy performed with one single implant for the treatment of LRPC is
      feasible and without excess toxicity, and can be safely delivered. This should allow for
      better patient convenience and cost and improved treatment dosimetry and planning, as it will
      decrease the risk of catheter displacement between fractions, which will hopefully correlate
      to less GU and non-GU acute toxicity. The primary objective is to determine the acute and
      late GU and GI toxicity of single fraction focal HDR salvage brachytherapy (primary
      endpoint).
    

Trial Arms

NameTypeDescriptionInterventions
HDR BrachytherapyExperimentalDay 1: HDR Brachytherapy implant, Up to 30 Gray (Gy) to target lesion

    Eligibility Criteria

            Inclusion Criteria:
    
              -  Biopsy proven locally recurrent adenocarcinoma of the prostate after the completion of
                 definitive radiation therapy for initially diagnosed prostate cancer.
    
                   -  Biopsy must be performed within 182 days of trial registration
    
                   -  Biopsy should be a standard sextant biopsy AND either a targeted MR/ultrasound
                      guided biopsy or saturation biopsy or both.
    
              -  Initial cancer diagnosis that fits these specific criteria:
    
                   -  Stages T1-T3a
    
                   -  Nx or N0
    
                   -  Mx or M0
    
              -  Eligible initial definitive radiotherapy modalities include:
    
              -  External beam radiotherapy, with photon or proton beam therapy
    
                   -  Conventional or moderately hypofractionated radiotherapy
    
                   -  Extremely hypofractionated external beam radiotherapy (Stereotactic body
                      radiation therapy)
    
              -  Definitive Brachytherapy:
    
                   -  Low-dose rate
    
                   -  High-dose rate
    
              -  Locally recurrent disease confined to the prostate +/- seminal vesicles and
                 immediately adjacent tissue, as evaluated by the following:
    
                   -  History/Physical examination
    
                   -  Radiographically node negative disease (N0), as defined by CT or MR of pelvis +/-
                      abdomen within 6 months of registration.
    
                   -  No evidence of bone metastases (M0) on bone scan within 6 months of registration.
    
                   -  Fluciclovine-PET is encouraged, but not required
    
              -  Patients receiving ADT are eligible as long as they meet the other eligibility
                 criteria. However, the duration of all ADT must be documented.
    
              -  Current ECOG Performance status Scale 0-2
    
              -  Current International Prostate Symptom Score (IPSS) < 20
    
              -  The patient must be medically suitable to receive general anesthesia.
    
              -  The patient must be able and willing to sign a study-specific written informed consent
                 form before study entry.
    
            Exclusion Criteria:
    
              -  Preregistration GI or GU toxicity (for any reason) grade ≥ 3 as defined in CTCAE
                 version 4.03. That is, grade ≥ 3 GU or GI toxicity after first course of radiotherapy
    
              -  Patients receiving any other investigational agents.
    
              -  Uncontrolled inter-current illness including, but not limited to, ongoing or active
                 infection, severely symptomatic congestive heart failure, cardiac arrhythmia, recent
                 myocardial infarction in last 6 months, or psychiatric illness/social situations that
                 could limit compliance with study requirements.
    
              -  Patients who have received chemotherapy or immunotherapy within one month prior to
                 study enrollment, other than ADT
          
    Maximum Eligible Age:N/A
    Minimum Eligible Age:18 Years
    Eligible Gender:Male
    Healthy Volunteers:No

    Primary Outcome Measures

    Measure:Toxicity rate
    Time Frame:24 months
    Safety Issue:
    Description:The primary outcome in this study is the number of acute or chronic grade 3-5 toxicities as described by the Common Terminology Criteria for Adverse Events (CTCAE) version 4.03.

    Details

    Phase:Phase 1/Phase 2
    Primary Purpose:Interventional
    Overall Status:Recruiting
    Lead Sponsor:Loyola University

    Trial Keywords

    • Cancer
    • HDR Brachytherapy
    • Prostate Cancer

    Last Updated

    July 25, 2019