Intervention Trial Evaluating Focal Therapy Using High Intensity Focused Ultrasound for the Treatment of Prostate Cancer
Primary Purpose
Prostate Cancer
Status
Unknown status
Phase
Phase 2
Locations
Switzerland
Study Type
Interventional
Intervention
Focal Therapy Using High Intensity Focused Ultrasound
Sponsored by
About this trial
This is an interventional treatment trial for Prostate Cancer
Eligibility Criteria
Inclusion Criteria:
- Histologically proven prostate cancer on trans-rectal or transperineal template prostate biopsies
Template biopsy:
- unilateral disease (Gleason ≤4+3)
- bilateral disease: presence of clinically significant cancer in both sides (Gleason ≤4+3) OR clinically insignificant disease with a burden of >50% of biopsy cores taken on that side, OR bilateral clinically insignificant disease and <50% of biopsy cores positive on any one side but with dominant disease burden on one side
- Stage T1-T2cN0M0 disease, as determined by local guidelines (radiological T3a permitted)
- Serum PSA ≤15
- Life expectancy of ≥10 years
- Signed informed consent by patient
- An understanding of the German language sufficient to understand written and verbal information about the trial and consent process
Exclusion Criteria:
- Men who have had androgen suppression/hormone treatment within the previous 12 months for their prostate cancer
- Men with evidence of metastatic disease or nodal disease outside the prostate on bone scan or cross-sectional imaging
- Men with an inability to tolerate a transrectal ultrasound
- Men with latex allergies as the HIFU probe is covered with a latex condom sheath prior to insertion into the back passage
- Men who have undergone prior significant rectal surgery preventing insertion of trans-rectal HIFU probe (decided on the type of surgery in individual cases)
- Men who have had previous HIFU, cryosurgery, thermal or microwave therapy to the prostate.
- Men who have undergone a Transurethral Resection of the Prostate (TURP) for symptomatic lower urinary tract symptoms within 6 months. These patients may be included within the trial if deferred from consenting and screening until at least 6 months following the TURP.
- Men not fit for major surgery as assessed by a Consultant Anaesthetist
- Men unable to have pelvic MRI scanning (severe claustrophobia, permanent cardiac pacemaker, metallic implant etc likely to contribute significant artefact to images)
- Presence of metal implants/stents in the urethra
- Presence of prostatic calcification and cysts (on transrectal ultrasound) whose location will interfere with effective delivery of HIFU therapy
- Men with renal impairment with a glomerular filtration rate of <35ml/min (unable to tolerate Gadolinium dynamic contrast enhanced MRI).
Sites / Locations
- Klinik für Urologie, Universitätsspital ZürichRecruiting
Arms of the Study
Arm 1
Arm Type
Other
Arm Label
Focal Therapy Using High Intensity Focused Ultrasound
Arm Description
Outcomes
Primary Outcome Measures
Oncological safety
To determine the proportion of men who are free of clinically significant prostate cancer in the treated area AND are free of clinically significant prostate cancer in the untreated area 36 months after focal therapy using HIFU
Oncological safety
To determine the proportion of men who are free of any prostate cancer in the treated area AND are free of clinically significant prostate cancer in the untreated area 36 months after focal therapy using HIFU
Secondary Outcome Measures
Biochemical failure
To analyse the rate of biochemical recurrence by measuring PSA values following focal therapy using HIFU:
biochemical recurrence defined according to the Phoenix Consensus OR
by PSA velocity >1 ng/ml/year OR PSA doubling time </=3 years
Sensitivity and specificity of MRI imaging
To determine the clinical validity (area under the receiver operating characteristics curve (AUC), sensitivity, specificity, negative and positive predictive values, inter-observer variability) of
multi-parametric MR-imaging to predict presence of clinically significant prostate cancer on transperineal template prostate mapping biopsies prior to focal therapy
MR-imaging changes to predict presence of residual/recurrent clinically significant prostate cancer on biopsy
Health care costs
To determine the costs of treatment and longitudinal morbidity associated with complications at 36 months compared to other treatments of localized prostate cancer.
Erectile function
Rate of erectile dysfunction and time to return of erectile function (measured by the IIEF-15)
Orgasmic function
Rate of loss of ejaculation and orgasm (measured by the IIEF-15)
Sexual function
Rate of pain during intercourse
Erectile function
Number of men using phosphodiesterase-5 inhibitors to maintain erectile function (measured by the IIEF-15)
Continence
Rate of urinary incontinence (pad free, leak free and padfree alone) (determined by the UCLA-EPIC urinary continence questionnaire)
Continence
Time to return of continence (pad free, leak free and padfree alone) (determined by the UCLA-EPIC urinary continence questionnaire)
Lower urinary tract symptoms
Rate of lower urinary tract symptoms (as determined by IPSS scores)
Bowel function
Rate of bowel toxicity (determined by the UCLA-EPIC Bowel questionnaire )
Anxiety
Anxiety levels (measured by the Hospital Anxiety and Depression Scale and Memorial Anxiety Scale for Prostate Cancer
Quality of life
General health related quality of life (measured using FACT-P Version 4 )
General histological outcome
To determine the histological outcomes at 6, 12 and 36 months
Secondary intervention
Rate of secondary prostate cancer intervention (prostatectomy, radiotherapy, androgen ablation)
Full Information
NCT ID
NCT02265159
First Posted
September 29, 2014
Last Updated
October 26, 2016
Sponsor
University of Zurich
Collaborators
University College, London
1. Study Identification
Unique Protocol Identification Number
NCT02265159
Brief Title
Intervention Trial Evaluating Focal Therapy Using High Intensity Focused Ultrasound for the Treatment of Prostate Cancer
Official Title
Intervention Trial Evaluating Focal Therapy Using High Intensity Focused Ultrasound for the Treatment of Prostate Cancer
Study Type
Interventional
2. Study Status
Record Verification Date
October 2016
Overall Recruitment Status
Unknown status
Study Start Date
May 2014 (undefined)
Primary Completion Date
May 2020 (Anticipated)
Study Completion Date
May 2020 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Zurich
Collaborators
University College, London
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
The investigators aim to evaluate cancer control, genitourinary, rectal and overall health-related quality of life outcomes and effectiveness of focal therapy for localised prostate cancer using High Intensity Focused Ultrasound (HIFU).
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Prostate Cancer
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2, Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
100 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Focal Therapy Using High Intensity Focused Ultrasound
Arm Type
Other
Intervention Type
Procedure
Intervention Name(s)
Focal Therapy Using High Intensity Focused Ultrasound
Other Intervention Name(s)
Focal HIFU
Primary Outcome Measure Information:
Title
Oncological safety
Description
To determine the proportion of men who are free of clinically significant prostate cancer in the treated area AND are free of clinically significant prostate cancer in the untreated area 36 months after focal therapy using HIFU
Time Frame
36 months
Title
Oncological safety
Description
To determine the proportion of men who are free of any prostate cancer in the treated area AND are free of clinically significant prostate cancer in the untreated area 36 months after focal therapy using HIFU
Time Frame
36 months
Secondary Outcome Measure Information:
Title
Biochemical failure
Description
To analyse the rate of biochemical recurrence by measuring PSA values following focal therapy using HIFU:
biochemical recurrence defined according to the Phoenix Consensus OR
by PSA velocity >1 ng/ml/year OR PSA doubling time </=3 years
Time Frame
36 months
Title
Sensitivity and specificity of MRI imaging
Description
To determine the clinical validity (area under the receiver operating characteristics curve (AUC), sensitivity, specificity, negative and positive predictive values, inter-observer variability) of
multi-parametric MR-imaging to predict presence of clinically significant prostate cancer on transperineal template prostate mapping biopsies prior to focal therapy
MR-imaging changes to predict presence of residual/recurrent clinically significant prostate cancer on biopsy
Time Frame
36 months
Title
Health care costs
Description
To determine the costs of treatment and longitudinal morbidity associated with complications at 36 months compared to other treatments of localized prostate cancer.
Time Frame
36 months
Title
Erectile function
Description
Rate of erectile dysfunction and time to return of erectile function (measured by the IIEF-15)
Time Frame
36 months
Title
Orgasmic function
Description
Rate of loss of ejaculation and orgasm (measured by the IIEF-15)
Time Frame
36 months
Title
Sexual function
Description
Rate of pain during intercourse
Time Frame
36 months
Title
Erectile function
Description
Number of men using phosphodiesterase-5 inhibitors to maintain erectile function (measured by the IIEF-15)
Time Frame
36 months
Title
Continence
Description
Rate of urinary incontinence (pad free, leak free and padfree alone) (determined by the UCLA-EPIC urinary continence questionnaire)
Time Frame
36 months
Title
Continence
Description
Time to return of continence (pad free, leak free and padfree alone) (determined by the UCLA-EPIC urinary continence questionnaire)
Time Frame
36 months
Title
Lower urinary tract symptoms
Description
Rate of lower urinary tract symptoms (as determined by IPSS scores)
Time Frame
36 months
Title
Bowel function
Description
Rate of bowel toxicity (determined by the UCLA-EPIC Bowel questionnaire )
Time Frame
36 months
Title
Anxiety
Description
Anxiety levels (measured by the Hospital Anxiety and Depression Scale and Memorial Anxiety Scale for Prostate Cancer
Time Frame
36 months
Title
Quality of life
Description
General health related quality of life (measured using FACT-P Version 4 )
Time Frame
36 months
Title
General histological outcome
Description
To determine the histological outcomes at 6, 12 and 36 months
Time Frame
36 months
Title
Secondary intervention
Description
Rate of secondary prostate cancer intervention (prostatectomy, radiotherapy, androgen ablation)
Time Frame
36 months
10. Eligibility
Sex
Male
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
99 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Histologically proven prostate cancer on trans-rectal or transperineal template prostate biopsies
Template biopsy:
unilateral disease (Gleason ≤4+3)
bilateral disease: presence of clinically significant cancer in both sides (Gleason ≤4+3) OR clinically insignificant disease with a burden of >50% of biopsy cores taken on that side, OR bilateral clinically insignificant disease and <50% of biopsy cores positive on any one side but with dominant disease burden on one side
Stage T1-T2cN0M0 disease, as determined by local guidelines (radiological T3a permitted)
Serum PSA ≤15
Life expectancy of ≥10 years
Signed informed consent by patient
An understanding of the German language sufficient to understand written and verbal information about the trial and consent process
Exclusion Criteria:
Men who have had androgen suppression/hormone treatment within the previous 12 months for their prostate cancer
Men with evidence of metastatic disease or nodal disease outside the prostate on bone scan or cross-sectional imaging
Men with an inability to tolerate a transrectal ultrasound
Men with latex allergies as the HIFU probe is covered with a latex condom sheath prior to insertion into the back passage
Men who have undergone prior significant rectal surgery preventing insertion of trans-rectal HIFU probe (decided on the type of surgery in individual cases)
Men who have had previous HIFU, cryosurgery, thermal or microwave therapy to the prostate.
Men who have undergone a Transurethral Resection of the Prostate (TURP) for symptomatic lower urinary tract symptoms within 6 months. These patients may be included within the trial if deferred from consenting and screening until at least 6 months following the TURP.
Men not fit for major surgery as assessed by a Consultant Anaesthetist
Men unable to have pelvic MRI scanning (severe claustrophobia, permanent cardiac pacemaker, metallic implant etc likely to contribute significant artefact to images)
Presence of metal implants/stents in the urethra
Presence of prostatic calcification and cysts (on transrectal ultrasound) whose location will interfere with effective delivery of HIFU therapy
Men with renal impairment with a glomerular filtration rate of <35ml/min (unable to tolerate Gadolinium dynamic contrast enhanced MRI).
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Daniel Eberli, PD Dr. PhD
Phone
+41 44 255 95 49
Email
Daniel.Eberli@usz.ch
First Name & Middle Initial & Last Name or Official Title & Degree
Ashkan Mortezavi, Dr.
Phone
+41 44 255 11 11
Email
Ashkan.Mortezavi@usz.ch
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Daniel Eberli, PD Dr. PhD
Organizational Affiliation
Klinik für Urologie, Universitätsspital Zürich
Official's Role
Principal Investigator
Facility Information:
Facility Name
Klinik für Urologie, Universitätsspital Zürich
City
Zürich
ZIP/Postal Code
8044
Country
Switzerland
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Daniel Eberli, PD Dr. PhD
Phone
+41 44 255 95 49
Email
Daniel.Eberli@usz.ch
First Name & Middle Initial & Last Name & Degree
Ashkan Mortezavi, Dr.
Phone
+41 44 255 11 11
Email
Ashkan.Mortezavi@usz.ch
First Name & Middle Initial & Last Name & Degree
Daniel Eberli, PD Dr. PhD
First Name & Middle Initial & Last Name & Degree
Tullio Sulser, Prof.
First Name & Middle Initial & Last Name & Degree
Ashkan Mortezavi, Dr.
12. IPD Sharing Statement
Learn more about this trial
Intervention Trial Evaluating Focal Therapy Using High Intensity Focused Ultrasound for the Treatment of Prostate Cancer
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