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Safety and Tolerability Study Using WST11 In Patients With Localized Prostate Cancer

Primary Purpose

Prostate Cancer

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
WST 11 -mediated -VTP
Sponsored by
Steba Biotech S.A.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Prostate Cancer focused on measuring Prostatic disease, genital neoplasm, male, Urogenital neoplasm, Genital disease, male, Male urogenital disease, Neoplasms, Neoplasm by site, prostatic neoplasm, Carcinoma

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)MaleDoes not accept healthy volunteers

Inclusion Criteria:

  • At least 18 years of age
  • Diagnosed with localized, prostate cancer and who have been offered curative therapy (radical prostatectomy; cryotherapy; brachytherapy; External Beam RadioTherapy (EBRT), and refused
  • Localized prostate cancer stage T1C up to T2A based on biopsy performed at least 6 weeks prior to enrollment
  • Gleason score ≤ 3+3 with ≤50% of sampled cores positive, and each positive core having a tumour length of ≤5 mm
  • Prostate Specific Antigen (PSA) < 10 ng/mL
  • No prior treatment for prostate cancer
  • Signed Informed Consent Form

Exclusion Criteria:

  • Any condition or history of illness or surgery that, in the opinion of the investigator and/or the Sponsor, might confound the results of the study or pose additional risks to the patient.
  • All patients whose current pre-operative cardiac evaluation does not show their fitness for a procedure requiring general anesthesia;
  • Patients with a prior history of viral or alcoholic hepatitis, and other patients felt to be at risk for hepatotoxicity including concomitant use of potentially hepatotoxic medications or dietary supplements;
  • Patients with a history of inflammatory bowel disease or other factors which may increase the risk of fistula formation;
  • Patients who have received any hormonal manipulation (excluding 5-alpha reductase inhibitors) or androgen supplements within the previous 6 months;
  • Patients previously treated by radiation therapy (external therapy or brachytherapy) or chemotherapy or any therapy for prostate cancer;
  • Patients who have received or are receiving chemotherapy for prostate carcinoma or other significant cancer;
  • Patients who have undergone previous TURP (trans-urethral resection of the prostate);
  • Patients with a history of urethral stricture disease
  • Patients with a history of acute urinary retention
  • Patients who are currently (within 10 days before the treatment procedure) receiving any medications having potential photosensitizing effects (e.g. tetracyclines, sulfonamides, phenothiazines, sulfonylurea hypoglycemic agents, thiazide diuretics and griseofulvin)
  • Patients who are currently receiving anticoagulant drugs (within 10 days before the treatment procedure) (e.g.: coumadin, warfarin)
  • Patient who stopped long term treatment of acetylsalicylic acid (aspirin) or other anti platelets agents within 10 days prior to the treatment procedure;
  • Patient suspected of Disseminated Intravascular Coagulation (DIC) as defined by the presence of three out of the five following criteria: platelets decrease, increase of PT, increase of aPTT, fibrinogen decrease, D-Dimer increase; from the normal laboratory ranges;
  • Patient with a history of vasculitis or collagen vascular disease;
  • History of non compliance with medical therapy and medical recommendations or an unwillingness or inability to complete patient self-administered questionnaires;
  • Participation in a clinical study or receipt of an investigational treatment within the past 3 months;
  • A history of porphyria;
  • A history of sun hypersensitivity or photosensitive dermatitis;
  • Renal disorders (blood creatinine > 1.5 x ULN) or known post mictional residue > 150cc
  • Hepatic disorders (transaminases > ULN, bilirubin > ULN, GGT > ULN). In case of slight abnormalities, another exam could be performed. If the results are within normal ranges, then the patient can be included;
  • Hematological disorders (white cells < 2500/mm3, neutrophils < 1500/mm3, platelets, < 140.000/mm3, Hb ≤ 10 g/dL);
  • Patients with contra-indication to MRI (such as pace maker, metal prosthesis, etc.).

Sites / Locations

  • UCLA - Jonsson Comprehensive Cancer Center
  • Midtown Urology & Midtown Urology Surgical Center
  • Washington University School of Medicine- Barnes-Jewish Hospital
  • NYU Urology Associates
  • Memorial Sloan-Kettering Cancer Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

WST11 (TOOKAD® Soluble)

Arm Description

WST11-mediated-VTP The WST11-mediated VTP procedure will consist of a single, 10 min, IV administration of WST11 at doses of either 2mg/kg, 4 mg/kg or 6 mg/kg, followed by light activation delivered through one or more transperineal interstitial optical fibers using 753 nm laser light at escalating fixed energy doses

Outcomes

Primary Outcome Measures

Prostate Biopsy
Arm/Group Title: WST 11(TOOKAD® Soluble) Arm/Group Description To define the study drug and light dosage combination to achieve negative biopsy in the treated lobe
Prostate Biopsies
Number of patients who had a negative biopsy at Month-6

Secondary Outcome Measures

Pharmacokinetic Parameters-Cmax
For each dose group, several pharmacokinetics parameters have been calculated.
Percentage of Prostatic Necrosis at Day 7 as Observed on the 7-Day MRI
The adjusted prostate necrosis percentage was defined as follows: The Day 7 necrosis percentage is the proportion, expressed in %, of Day 7 prostate necrosis volume by planimetry in the treated lobe compared with half the prostate volume by planimetry, considering the average between the baseline volume and Day 7 volume;
International Index of Erectile Functions (IIEF) Results
The International Index of Erectile Functions questionnaire is 15 questions patients auto questionnaire. The results presented are those of the erectile function domain which comprise 6 questions. Possible scores range is 1 to 30 . Best score is 30, worst score is 1.
International Prostate Symptom Score (IPSS) Results
The International Prostate Symptom Score (IPSS) is a 7 questions patients auto-questionnaire about urinary symptoms. the possible scores range are 0 to 35 . Best score is 0 worst score is 35
Pharmacokinetic Parameters-Tmax
For each dose group, several pharmacokinetics parameters have been calculated.
Pharmacokinetic Parameters -T1/2
For each dose group, several pharmacokinetics parameters have been calculated.

Full Information

First Posted
July 24, 2009
Last Updated
January 24, 2019
Sponsor
Steba Biotech S.A.
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1. Study Identification

Unique Protocol Identification Number
NCT00946881
Brief Title
Safety and Tolerability Study Using WST11 In Patients With Localized Prostate Cancer
Official Title
A Prospective, Multicenter Phase I/II Safety and Tolerability Study of Unilateral Vascular-Targeted Photodynamic Therapy Using WST11 in Patients With Localized Prostate Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
October 2017
Overall Recruitment Status
Completed
Study Start Date
July 2009 (undefined)
Primary Completion Date
July 2012 (Actual)
Study Completion Date
August 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Steba Biotech S.A.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The aim of this study is to determine the optimal treatment conditions (WST11 dose and light energy dose) to achieve ablation in one lobe of the prostate and to evaluate the safety and quality of life of WST11 medicated Vascular-Targeted Photodynamic therapy (VTP) in men with localized prostate cancer.
Detailed Description
This study is designed as a multicenter, phase I/II, prospective, open-labeled, single intravenous (IV) dose, clinical trial in patients with localized prostate cancer. The study population will be men who have been offered curative therapy (radical prostatectomy; cryotherapy; brachytherapy; External Beam RadioTherapy (EBRT), and refused. Patients must have already had a previous biopsy showing a histologically proven carcinoma of the prostate. The identification and the location of the tumor will be done using both dynamic contrast Magnetic resonance Imaging (MRI) and biopsy. Only unilateral treatment with WST11-medicated VTP will be performed during the study. Treatment will consist of a single, 10 minute, IV administration of WST11 at doses of 2mg/kg, 4 mg/kg or 6 mg/kg, followed by either light activation delivered through transperineal interstitial optical fibers for 20 minutes using 753 nm laser light at escalating fixed energy doses of 200 J/cm or 300 J/cm by escalating power at each energy to 167 mW/cm or 250 mW/cm respectively. A brachytherapy-like template is used for the placement of the transparent implant catheters which are positioned in the prostate under transrectal ultrasound image guidance. The illumination fiber(s) are then inserted into the implant catheters. If the safety profile for a given WST11 and light dose is acceptable, additional patients may be treated with multiple fibers at that WST11 treatment dose. For cases where the Month 6 biopsy is positive, the patient will be offered the opportunity to be retreated with WST11

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Prostate Cancer
Keywords
Prostatic disease, genital neoplasm, male, Urogenital neoplasm, Genital disease, male, Male urogenital disease, Neoplasms, Neoplasm by site, prostatic neoplasm, Carcinoma

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
30 (Actual)

8. Arms, Groups, and Interventions

Arm Title
WST11 (TOOKAD® Soluble)
Arm Type
Experimental
Arm Description
WST11-mediated-VTP The WST11-mediated VTP procedure will consist of a single, 10 min, IV administration of WST11 at doses of either 2mg/kg, 4 mg/kg or 6 mg/kg, followed by light activation delivered through one or more transperineal interstitial optical fibers using 753 nm laser light at escalating fixed energy doses
Intervention Type
Drug
Intervention Name(s)
WST 11 -mediated -VTP
Other Intervention Name(s)
TOOKAD Soluble
Intervention Description
The WST11-mediated VTP procedure will consist of a single, 10 min, IV administration of WST11 at doses of either 2mg/kg, 4 mg/kg or 6 mg/kg, followed by light activation delivered through one or more transperineal interstitial optical fibers for 20 minutes using 753 nm laser light at escalating fixed energy doses of 200 J/cm and 300 J/cm, by escalating power at each energy to 167 mW/cm and 250 mW/cm, respectively. A brachytherapy-like template is used for the placement of the optical fiber(s) that are positioned in the prostate areas of interest under trans-rectal ultrasound image guidance.
Primary Outcome Measure Information:
Title
Prostate Biopsy
Description
Arm/Group Title: WST 11(TOOKAD® Soluble) Arm/Group Description To define the study drug and light dosage combination to achieve negative biopsy in the treated lobe
Time Frame
Month 6
Title
Prostate Biopsies
Description
Number of patients who had a negative biopsy at Month-6
Time Frame
Month-6
Secondary Outcome Measure Information:
Title
Pharmacokinetic Parameters-Cmax
Description
For each dose group, several pharmacokinetics parameters have been calculated.
Time Frame
T0, 5 min,10 min, 4 h, 8 h, post dose
Title
Percentage of Prostatic Necrosis at Day 7 as Observed on the 7-Day MRI
Description
The adjusted prostate necrosis percentage was defined as follows: The Day 7 necrosis percentage is the proportion, expressed in %, of Day 7 prostate necrosis volume by planimetry in the treated lobe compared with half the prostate volume by planimetry, considering the average between the baseline volume and Day 7 volume;
Time Frame
Day 7
Title
International Index of Erectile Functions (IIEF) Results
Description
The International Index of Erectile Functions questionnaire is 15 questions patients auto questionnaire. The results presented are those of the erectile function domain which comprise 6 questions. Possible scores range is 1 to 30 . Best score is 30, worst score is 1.
Time Frame
Month 1-Month 3- Month 6- Month 12
Title
International Prostate Symptom Score (IPSS) Results
Description
The International Prostate Symptom Score (IPSS) is a 7 questions patients auto-questionnaire about urinary symptoms. the possible scores range are 0 to 35 . Best score is 0 worst score is 35
Time Frame
Month 1, Month 3 , Month 6 , Month 12
Title
Pharmacokinetic Parameters-Tmax
Description
For each dose group, several pharmacokinetics parameters have been calculated.
Time Frame
T0, 5 min,10 min, 4 h, 8 h, post dose
Title
Pharmacokinetic Parameters -T1/2
Description
For each dose group, several pharmacokinetics parameters have been calculated.
Time Frame
T0, 5 min,10 min, 4 h, 8 h, post dose

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: At least 18 years of age Diagnosed with localized, prostate cancer and who have been offered curative therapy (radical prostatectomy; cryotherapy; brachytherapy; External Beam RadioTherapy (EBRT), and refused Localized prostate cancer stage T1C up to T2A based on biopsy performed at least 6 weeks prior to enrollment Gleason score ≤ 3+3 with ≤50% of sampled cores positive, and each positive core having a tumour length of ≤5 mm Prostate Specific Antigen (PSA) < 10 ng/mL No prior treatment for prostate cancer Signed Informed Consent Form Exclusion Criteria: Any condition or history of illness or surgery that, in the opinion of the investigator and/or the Sponsor, might confound the results of the study or pose additional risks to the patient. All patients whose current pre-operative cardiac evaluation does not show their fitness for a procedure requiring general anesthesia; Patients with a prior history of viral or alcoholic hepatitis, and other patients felt to be at risk for hepatotoxicity including concomitant use of potentially hepatotoxic medications or dietary supplements; Patients with a history of inflammatory bowel disease or other factors which may increase the risk of fistula formation; Patients who have received any hormonal manipulation (excluding 5-alpha reductase inhibitors) or androgen supplements within the previous 6 months; Patients previously treated by radiation therapy (external therapy or brachytherapy) or chemotherapy or any therapy for prostate cancer; Patients who have received or are receiving chemotherapy for prostate carcinoma or other significant cancer; Patients who have undergone previous TURP (trans-urethral resection of the prostate); Patients with a history of urethral stricture disease Patients with a history of acute urinary retention Patients who are currently (within 10 days before the treatment procedure) receiving any medications having potential photosensitizing effects (e.g. tetracyclines, sulfonamides, phenothiazines, sulfonylurea hypoglycemic agents, thiazide diuretics and griseofulvin) Patients who are currently receiving anticoagulant drugs (within 10 days before the treatment procedure) (e.g.: coumadin, warfarin) Patient who stopped long term treatment of acetylsalicylic acid (aspirin) or other anti platelets agents within 10 days prior to the treatment procedure; Patient suspected of Disseminated Intravascular Coagulation (DIC) as defined by the presence of three out of the five following criteria: platelets decrease, increase of PT, increase of aPTT, fibrinogen decrease, D-Dimer increase; from the normal laboratory ranges; Patient with a history of vasculitis or collagen vascular disease; History of non compliance with medical therapy and medical recommendations or an unwillingness or inability to complete patient self-administered questionnaires; Participation in a clinical study or receipt of an investigational treatment within the past 3 months; A history of porphyria; A history of sun hypersensitivity or photosensitive dermatitis; Renal disorders (blood creatinine > 1.5 x ULN) or known post mictional residue > 150cc Hepatic disorders (transaminases > ULN, bilirubin > ULN, GGT > ULN). In case of slight abnormalities, another exam could be performed. If the results are within normal ranges, then the patient can be included; Hematological disorders (white cells < 2500/mm3, neutrophils < 1500/mm3, platelets, < 140.000/mm3, Hb ≤ 10 g/dL); Patients with contra-indication to MRI (such as pace maker, metal prosthesis, etc.).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Samir Taneja, Professor
Organizational Affiliation
Department of Urology, New York University Cancer Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
UCLA - Jonsson Comprehensive Cancer Center
City
Los Angeles
State/Province
California
ZIP/Postal Code
90095
Country
United States
Facility Name
Midtown Urology & Midtown Urology Surgical Center
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30308
Country
United States
Facility Name
Washington University School of Medicine- Barnes-Jewish Hospital
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
NYU Urology Associates
City
New York
State/Province
New York
ZIP/Postal Code
10016
Country
United States
Facility Name
Memorial Sloan-Kettering Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Undecided
IPD Sharing Plan Description
The data are available in case report form for each patient
Citations:
PubMed Identifier
27291652
Citation
Taneja SS, Bennett J, Coleman J, Grubb R, Andriole G, Reiter RE, Marks L, Azzouzi AR, Emberton M. Final Results of a Phase I/II Multicenter Trial of WST11 Vascular Targeted Photodynamic Therapy for Hemi-Ablation of the Prostate in Men with Unilateral Low Risk Prostate Cancer Performed in the United States. J Urol. 2016 Oct;196(4):1096-104. doi: 10.1016/j.juro.2016.05.113. Epub 2016 Jun 9.
Results Reference
result
PubMed Identifier
25712310
Citation
Azzouzi AR, Barret E, Bennet J, Moore C, Taneja S, Muir G, Villers A, Coleman J, Allen C, Scherz A, Emberton M. TOOKAD(R) Soluble focal therapy: pooled analysis of three phase II studies assessing the minimally invasive ablation of localized prostate cancer. World J Urol. 2015 Jul;33(7):945-53. doi: 10.1007/s00345-015-1505-8. Epub 2015 Feb 25.
Results Reference
derived

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Safety and Tolerability Study Using WST11 In Patients With Localized Prostate Cancer

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