search
Back to results

IRay to Treat Polypoidal Choroidal Vasculopathy (PCV) Secondary to Age-Related Macular Degeneration (AMD

Primary Purpose

Polypoidal Chorodial Vasculopathy, Age Related Macular Degeneration

Status
Unknown status
Phase
Not Applicable
Locations
Italy
Study Type
Interventional
Intervention
Iray
Sponsored by
Oraya Therapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Polypoidal Chorodial Vasculopathy focused on measuring AMD, PCV, Iray, radiation, retina, macula, radiotherapy

Eligibility Criteria

50 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Patients with PCV, naïve or previously treated with Lucentis injections and Photodynamic therapy (PDT) using Visudyne.
  • Must have a total lesion size of <12 disc areas and a PCV lesion with the greatest linear dimension of <6 mm, but not greater than 3 mm from the center of the fovea to the furthest point on lesion perimeter (determined by ICG).
  • The distance from the center of the fovea to the nearest edge of the optic disc should be not less than 3 mm. (This distance is confirmed by Oraya software prior to treatment.).
  • Must have provided informed consent, documented it in writing, and have been given a copy of the signed informed consent form.
  • Must be willing and able to return for scheduled visits for the 2-year duration of the study.
  • Must be at least 50 years of age.
  • Women must be post-menopausal ≥1 year or surgically sterilized, or a pregnancy screen must be performed prior to the study and a reliable form of contraception, approved by the investigator, must be maintained during the study.
  • Must have best corrected visual acuity of 75 to 25 letters (inclusive) in the study eye and at least 20 letters in the fellow eye (if both eyes meet all the study criteria, then the eye with the worst vision should be selected as the study eye).

Exclusion Criteria:

  • CNV due to causes other than AMD or PCV, including ocular histoplasmosis syndrome, angioid streaks, multifocal choroiditis, choroidal rupture, or pathologic myopia (spherical equivalent -8 diopters).
  • A globe axial length of <20 mm or >26 mm.
  • Evidence of diabetes or with retinal findings consistent with diabetic retinopathy or retinopathy for any other cause.
  • Hypertension that is not controlled with anti-hypertensive medication.
  • Prior or concurrent therapies for age related macular degeneration or PCV, including submacular surgery, subfoveal thermal laser photocoagulation (with or without photographic evidence), or transpupillary thermotherapy (TTT).
  • History of radiation to the head in the region of the study eye.
  • Previous posterior vitrectomy at any time, YAG capsulotomy or cataract surgery within 3 months, or any other surgery in the study eye within 6 months prior to the screening visit.
  • Intravitreal device in the study eye.
  • Concomitant disease in the study eye which might interfere with the effect of assessment of the study treatment, including uveitis, acute ocular or periocular infection, retinal vasculopathies (including retinal vein occlusions, etc.) or intraocular pressure >30 mmHg uncontrollable with medications.
  • History of rhegmatogenous retina detachment, optic neuritis or intraocular tumors in the study eye.
  • Inadequate pupillary dilation, significant media opacities, or other conditions in the study eye, including cataract, which may interfere with visual acuity or the evaluation of the posterior segment. Subjects likely to need cataract surgery during the 1 year study period should also not be enrolled.
  • Known serious allergies to fluorescein or indocyanine green dye used in angiography.
  • Subjects must not have subretinal hemorrhage or Retinal Pigment Epithelium tear involving the center of the foveal avascular zone.
  • Known sensitivity or allergy to Lucentis, or any other drug used in the study, such as topical anesthetic, cycloplegic mydriatics, or lubricating eye gel.
  • Contraindication or sensitivity to contact lens application (i.e. corneal dystrophies and recurrent corneal erosions). 16. Currently receiving chemotherapy, having completed a course within the 90 days preceding study enrollment, or expecting to begin chemotherapy while participating in the study.
  • Current participation in another PCV drug or device clinical trial.
  • History of use of drugs with known retinal toxicity, including: chloroquine (Aralen - antimalarial), hydroxychloriquine (Plaquenil - antimalarial), phenothiazines (Thorazine, Stelazine, Mellaril, Prolixin, Trilafon, etc., - tranquilizing antipsychotic medications) and these patients are exhibiting signs of retinal toxicity.
  • Concurrent use of systemic anti-VEGF agents.
  • Any other condition, which in the judgment of the investigator would prevent the subject from granting consent or completing the study, such as dementia, mental illness (including generalized anxiety disorder, claustrophobia, etc.), or inability to position in the device (due to musculoskeletal problems, etc.).
  • History of other significant, uncontrolled disease including cardiovascular, nervous system, pulmonary, renal, hepatic, endocrine or gastrointestinal, metabolic dysfunction, any clinical finding giving reasonable suspicion of a disease or condition that contraindicates the use of intravitreal ranibizumab or that might affect interpretation of the results of the study or render the subject at high risk for treatment complication

Sites / Locations

  • Università Vita-Salute Istituto Scientifico San Raffaele

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Iray plus Lucentis

Arm Description

open label arm in which all subjects recieve a single 16 gy dose of radiation plus an injection of Lucentis.

Outcomes

Primary Outcome Measures

Lesion change as measured with fluorescein angiography.
Change in the proportion of the lesion which is active at 12 months.

Secondary Outcome Measures

Number of Lucentis injections
Number of Lucentis injections during 12 months
Visual Acuity change
Mean change in visual acuity
Polyp changes
Change in total lesion and polyp size & number of polyps

Full Information

First Posted
January 19, 2012
Last Updated
October 31, 2012
Sponsor
Oraya Therapeutics, Inc.
search

1. Study Identification

Unique Protocol Identification Number
NCT01516294
Brief Title
IRay to Treat Polypoidal Choroidal Vasculopathy (PCV) Secondary to Age-Related Macular Degeneration (AMD
Official Title
A Pilot, Single-center, Interventional Clinical Trial in Which Subjects With Polypoidal Choroidal Vasculopathy (PCV) Secondary to Age-Related Macular Degeneration (AMD) Will Receive Low Voltage Stereotactic Radiotherapy (IRay®) Treatment and Lucentis® Treatment as Needed.
Study Type
Interventional

2. Study Status

Record Verification Date
October 2012
Overall Recruitment Status
Unknown status
Study Start Date
January 2012 (undefined)
Primary Completion Date
March 2013 (Anticipated)
Study Completion Date
March 2014 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Oraya Therapeutics, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study will evaluate the efficacy of IRay treatment in patients with Polypoidal Choroidal Vasculopathy (PCV)secondary to AMD as determined by the change in the proportion of lesion activity and lesion size at 12 months.
Detailed Description
This is a single-center, interventional clinical trial in which subjects will receive 16 Gy of IRay treatment and Lucentis, followed by Lucentis treatment as needed to evaluate the efficacy of IRay treatment in patients with PCV as determined by the change in the proportion of lesion activity and lesion size at 12 months.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Polypoidal Chorodial Vasculopathy, Age Related Macular Degeneration
Keywords
AMD, PCV, Iray, radiation, retina, macula, radiotherapy

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
12 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Iray plus Lucentis
Arm Type
Experimental
Arm Description
open label arm in which all subjects recieve a single 16 gy dose of radiation plus an injection of Lucentis.
Intervention Type
Radiation
Intervention Name(s)
Iray
Intervention Description
The Oraya IRay stereotactic radiotherapy device will be used to deliver a 16 Gy dose of radiation to the macula. The radiotherapy will be delivered in a single session utilizing three sequential beams, each depositing 5.3 Gy at the macula through calculated scleral entry points, crossing the pars plana region of the eye, and overlapping at the same region of the macula.
Primary Outcome Measure Information:
Title
Lesion change as measured with fluorescein angiography.
Description
Change in the proportion of the lesion which is active at 12 months.
Time Frame
Baseline and 12 months
Secondary Outcome Measure Information:
Title
Number of Lucentis injections
Description
Number of Lucentis injections during 12 months
Time Frame
baseline and 12 months
Title
Visual Acuity change
Description
Mean change in visual acuity
Time Frame
Baseline and 12 months
Title
Polyp changes
Description
Change in total lesion and polyp size & number of polyps
Time Frame
Baseline and 12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients with PCV, naïve or previously treated with Lucentis injections and Photodynamic therapy (PDT) using Visudyne. Must have a total lesion size of <12 disc areas and a PCV lesion with the greatest linear dimension of <6 mm, but not greater than 3 mm from the center of the fovea to the furthest point on lesion perimeter (determined by ICG). The distance from the center of the fovea to the nearest edge of the optic disc should be not less than 3 mm. (This distance is confirmed by Oraya software prior to treatment.). Must have provided informed consent, documented it in writing, and have been given a copy of the signed informed consent form. Must be willing and able to return for scheduled visits for the 2-year duration of the study. Must be at least 50 years of age. Women must be post-menopausal ≥1 year or surgically sterilized, or a pregnancy screen must be performed prior to the study and a reliable form of contraception, approved by the investigator, must be maintained during the study. Must have best corrected visual acuity of 75 to 25 letters (inclusive) in the study eye and at least 20 letters in the fellow eye (if both eyes meet all the study criteria, then the eye with the worst vision should be selected as the study eye). Exclusion Criteria: CNV due to causes other than AMD or PCV, including ocular histoplasmosis syndrome, angioid streaks, multifocal choroiditis, choroidal rupture, or pathologic myopia (spherical equivalent -8 diopters). A globe axial length of <20 mm or >26 mm. Evidence of diabetes or with retinal findings consistent with diabetic retinopathy or retinopathy for any other cause. Hypertension that is not controlled with anti-hypertensive medication. Prior or concurrent therapies for age related macular degeneration or PCV, including submacular surgery, subfoveal thermal laser photocoagulation (with or without photographic evidence), or transpupillary thermotherapy (TTT). History of radiation to the head in the region of the study eye. Previous posterior vitrectomy at any time, YAG capsulotomy or cataract surgery within 3 months, or any other surgery in the study eye within 6 months prior to the screening visit. Intravitreal device in the study eye. Concomitant disease in the study eye which might interfere with the effect of assessment of the study treatment, including uveitis, acute ocular or periocular infection, retinal vasculopathies (including retinal vein occlusions, etc.) or intraocular pressure >30 mmHg uncontrollable with medications. History of rhegmatogenous retina detachment, optic neuritis or intraocular tumors in the study eye. Inadequate pupillary dilation, significant media opacities, or other conditions in the study eye, including cataract, which may interfere with visual acuity or the evaluation of the posterior segment. Subjects likely to need cataract surgery during the 1 year study period should also not be enrolled. Known serious allergies to fluorescein or indocyanine green dye used in angiography. Subjects must not have subretinal hemorrhage or Retinal Pigment Epithelium tear involving the center of the foveal avascular zone. Known sensitivity or allergy to Lucentis, or any other drug used in the study, such as topical anesthetic, cycloplegic mydriatics, or lubricating eye gel. Contraindication or sensitivity to contact lens application (i.e. corneal dystrophies and recurrent corneal erosions). 16. Currently receiving chemotherapy, having completed a course within the 90 days preceding study enrollment, or expecting to begin chemotherapy while participating in the study. Current participation in another PCV drug or device clinical trial. History of use of drugs with known retinal toxicity, including: chloroquine (Aralen - antimalarial), hydroxychloriquine (Plaquenil - antimalarial), phenothiazines (Thorazine, Stelazine, Mellaril, Prolixin, Trilafon, etc., - tranquilizing antipsychotic medications) and these patients are exhibiting signs of retinal toxicity. Concurrent use of systemic anti-VEGF agents. Any other condition, which in the judgment of the investigator would prevent the subject from granting consent or completing the study, such as dementia, mental illness (including generalized anxiety disorder, claustrophobia, etc.), or inability to position in the device (due to musculoskeletal problems, etc.). History of other significant, uncontrolled disease including cardiovascular, nervous system, pulmonary, renal, hepatic, endocrine or gastrointestinal, metabolic dysfunction, any clinical finding giving reasonable suspicion of a disease or condition that contraindicates the use of intravitreal ranibizumab or that might affect interpretation of the results of the study or render the subject at high risk for treatment complication
Facility Information:
Facility Name
Università Vita-Salute Istituto Scientifico San Raffaele
City
Milano
Country
Italy

12. IPD Sharing Statement

Learn more about this trial

IRay to Treat Polypoidal Choroidal Vasculopathy (PCV) Secondary to Age-Related Macular Degeneration (AMD

We'll reach out to this number within 24 hrs