Alpha Radiation Emitters Device for the Treatment of Newly Diagnosed Breast Carcinoma Patients With Distant Metastases
Primary Purpose
Breast Carcinoma, Metastatic Breast Cancer, Invasive Breast Cancer
Status
Recruiting
Phase
Not Applicable
Locations
Russian Federation
Study Type
Interventional
Intervention
Device: Radiation: Diffusing Alpha Radiation Emitters Therapy (DaRT)
Sponsored by
About this trial
This is an interventional treatment trial for Breast Carcinoma focused on measuring Breast carcinoma, Metastatic breast cancer, Invasive breast cancer, Alpha radiation, Luminal A, Luminal B, Triple negative, HER2, Breast cancer, Breast metastases
Eligibility Criteria
Inclusion Criteria:
- Subjects with histopathological confirmation of primary (or recurrent) invasive breast carcinoma and distant metastatic disease at diagnosis.
- Target tumor size ≤ 3.0 cm (T1-2b category);
- Morphological type: invasive breast cancer
- Luminal-type A (ER+, PR+, Her2/neu +1), HER+, luminal-type B (ER +/-, PR +/-, Her2/neu+1), or Triple negative breast carcinoma
- Measurable disease according to RECIST v1.1.
- Subjects over 45 years old.
- Subjects' ECOG Performance Status Scale is < 2.
- Subjects' life expectancy more than 6 months.
- Platelet count ≥100,000/mm3.
- International normalized ratio of prothrombin time ≤1.8.
- Creatinine ≤1.9 mg/dL.
- Women of childbearing potential (WOCBP) will have evidence of negative pregnancy test.
- Subjects are willing to sign an informed consent form.
Exclusion Criteria:
- T4 category with skin involvement.
- Regional lymph node metastases.
- Ductal carcinoma in situ.
- Inflammatory breast carcinoma.
- Patients with pre-irradiation of the breast.
- Acute infection disease.
- The presence of HIV, RW, HbsAg, HCV in the acute stage.
- Pregnancy or lactation.
- Serious competing (somatic) diseases incompatible according to the researcher with brachytherapy.
- Mental illness.
- Patients undergoing immunosuppressive and/or systemic corticosteroid treatment
- Volunteers participating in another interventional study in the past 30 days which might conflict with the endpoints of this study or the evaluation of response or toxicity of DaRT.
- High probability of protocol non-compliance (in opinion of investigator).
- Patients with significant comorbidities that the treating physician deems may conflict with the endpoints of the study (e.g., poorly controlled autoimmune diseases, vasculitis, etc.)
- Subjects not willing to sign an informed consent.
Sites / Locations
- A. Tsyb Medical Radiological Research CenterRecruiting
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
DaRT Seeds
Arm Description
Intratumoral Diffusing alpha-emitters Radiation Therapy (DaRT) Seeds
Outcomes
Primary Outcome Measures
Tumor response to DaRT
Assessment of the rate of malignant breast tumors response using the Response Evaluation Criteria in Solid Tumors (RECIST) (Version 1.1).
Adverse Events
Assessment of the frequency, severity and causality of acute adverse events related to the DaRT treatment using the Common Terminology and Criteria for adverse events (CTCAE) version 5.0
Secondary Outcome Measures
Change in tumor volume.
Assessment of the reduction in tumor volume SUVmax based on CT/PET - CT measured tumor volume.
DaRT seeds placement
Assessment of the DaRT seed placement by localization of the DaRT seed in the tumor using CT imaging.
Change in quality of life: EORTC-QLQ-C30
Assessment of patient reported health-related Quality of Life (QoL) outcomes after DaRT treatment, using QoL questionnaires EORTC-QLQ-C30. Scale range in score from 0 (best) to 100(worst).
Progression free survival
Time elapsed from response to disease progression.
Pathological remissions.
Assessment of (complete) pathological remissions using histopathology examination
Abscopal effects.
Assessment of abscopal effects on existing distant metastases based on PET-CT measured tumor volume.
Change in quality of life: BR23
Assessment of patient reported health-related Quality of Life (QoL) outcomes after DaRT treatment, using QoL questionnaires BR23. Scale range in score from 0 (best) to 100(worst).
Abscopal effects
Assessment of abscopal effects on existing distant metastases based on PET-CT measured SUVmax decrease compared to the primary measurement (the baseline measurement).
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03970967
Brief Title
Alpha Radiation Emitters Device for the Treatment of Newly Diagnosed Breast Carcinoma Patients With Distant Metastases
Official Title
A Safety and Effectiveness Study of Intratumoral Diffusing Alpha Radiation Emitters for the Treatment of Newly Diagnosed Breast Carcinoma Patients With Distant Metastases
Study Type
Interventional
2. Study Status
Record Verification Date
February 2022
Overall Recruitment Status
Recruiting
Study Start Date
November 28, 2019 (Actual)
Primary Completion Date
August 2026 (Anticipated)
Study Completion Date
October 2027 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Alpha Tau Medical LTD.
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
A unique approach for cancer treatment employing intratumoral diffusing alpha radiation emitter device for newly Diagnosed Breast Carcinoma patients with distant metastases
Detailed Description
This will be a prospective, open label, single arm, controlled study, assessing the safety and efficacy of diffusing alpha emitters radiation therapy (DaRT) delivered through radioactive sources [Ra-224 containing stainless-steel 316LVM tubes- (Alpha DaRT seeds)] inserted into malignant breast lesions.
This approach combines the advantages of local intratumoral irradiation of the tumor, as used in conventional brachytherapy, with the power of the alpha radiation emitting atoms, that will be introduced in quantities considerably lower than radiation therapy already used in patients.
Histopathological confirmed invasive breast tumors with no involvement of skin will be treated using DaRT seeds.
The primary effectiveness endpoint of the study is the tumor response to DaRT treatment assessed using the Response Evaluation Criteria in Solid Tumors (RECIST) (Version 1.1) 9-11 weeks after DaRT seed insertion.
Safety will be assessed by the cumulative frequency, severity and causality of acute adverse events related to the DaRT treatment of adverse events (AEs) observed including the follow-up period.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Carcinoma, Metastatic Breast Cancer, Invasive Breast Cancer, Distant Metastases.Pathology
Keywords
Breast carcinoma, Metastatic breast cancer, Invasive breast cancer, Alpha radiation, Luminal A, Luminal B, Triple negative, HER2, Breast cancer, Breast metastases
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
30 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
DaRT Seeds
Arm Type
Experimental
Arm Description
Intratumoral Diffusing alpha-emitters Radiation Therapy (DaRT) Seeds
Intervention Type
Device
Intervention Name(s)
Device: Radiation: Diffusing Alpha Radiation Emitters Therapy (DaRT)
Intervention Description
An intratumoral insertion of radioactive sources [Ra-224 containing stainless-steel 316LVM tubes- (Alpha DaRT seeds)]. The seeds release by recoil into the tumor short-lived alpha-emitting atoms.
Primary Outcome Measure Information:
Title
Tumor response to DaRT
Description
Assessment of the rate of malignant breast tumors response using the Response Evaluation Criteria in Solid Tumors (RECIST) (Version 1.1).
Time Frame
9-11 weeks post DaRT insertion.
Title
Adverse Events
Description
Assessment of the frequency, severity and causality of acute adverse events related to the DaRT treatment using the Common Terminology and Criteria for adverse events (CTCAE) version 5.0
Time Frame
Day 0 - 6 months (+/-14 days)
Secondary Outcome Measure Information:
Title
Change in tumor volume.
Description
Assessment of the reduction in tumor volume SUVmax based on CT/PET - CT measured tumor volume.
Time Frame
9-11 weeks after DaRT insertion.
Title
DaRT seeds placement
Description
Assessment of the DaRT seed placement by localization of the DaRT seed in the tumor using CT imaging.
Time Frame
Day of insertion.
Title
Change in quality of life: EORTC-QLQ-C30
Description
Assessment of patient reported health-related Quality of Life (QoL) outcomes after DaRT treatment, using QoL questionnaires EORTC-QLQ-C30. Scale range in score from 0 (best) to 100(worst).
Time Frame
Day 0, 30, 70, 6 months (+/-14 days).
Title
Progression free survival
Description
Time elapsed from response to disease progression.
Time Frame
6 months (+/-14 days).
Title
Pathological remissions.
Description
Assessment of (complete) pathological remissions using histopathology examination
Time Frame
12 weeks after DaRT seed insertion.
Title
Abscopal effects.
Description
Assessment of abscopal effects on existing distant metastases based on PET-CT measured tumor volume.
Time Frame
9-11 weeks after DaRT insertion.
Title
Change in quality of life: BR23
Description
Assessment of patient reported health-related Quality of Life (QoL) outcomes after DaRT treatment, using QoL questionnaires BR23. Scale range in score from 0 (best) to 100(worst).
Time Frame
Day 0, 30, 70, 6 months (+/-14 days).
Title
Abscopal effects
Description
Assessment of abscopal effects on existing distant metastases based on PET-CT measured SUVmax decrease compared to the primary measurement (the baseline measurement).
Time Frame
9-11 weeks after DaRT insertion.
10. Eligibility
Sex
All
Minimum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Subjects with histopathological confirmation of primary (or recurrent) invasive breast carcinoma and distant metastatic disease at diagnosis.
Target tumor size ≤ 3.0 cm (T1-2b category);
Morphological type: invasive breast cancer
Luminal-type A (ER+, PR+, Her2/neu +1), HER+, luminal-type B (ER +/-, PR +/-, Her2/neu+1), or Triple negative breast carcinoma
Measurable disease according to RECIST v1.1.
Subjects over 45 years old.
Subjects' ECOG Performance Status Scale is < 2.
Subjects' life expectancy more than 6 months.
Platelet count ≥100,000/mm3.
International normalized ratio of prothrombin time ≤1.8.
Creatinine ≤1.9 mg/dL.
Women of childbearing potential (WOCBP) will have evidence of negative pregnancy test.
Subjects are willing to sign an informed consent form.
Exclusion Criteria:
T4 category with skin involvement.
Regional lymph node metastases.
Ductal carcinoma in situ.
Inflammatory breast carcinoma.
Patients with pre-irradiation of the breast.
Acute infection disease.
The presence of HIV, RW, HbsAg, HCV in the acute stage.
Pregnancy or lactation.
Serious competing (somatic) diseases incompatible according to the researcher with brachytherapy.
Mental illness.
Patients undergoing immunosuppressive and/or systemic corticosteroid treatment
Volunteers participating in another interventional study in the past 30 days which might conflict with the endpoints of this study or the evaluation of response or toxicity of DaRT.
High probability of protocol non-compliance (in opinion of investigator).
Patients with significant comorbidities that the treating physician deems may conflict with the endpoints of the study (e.g., poorly controlled autoimmune diseases, vasculitis, etc.)
Subjects not willing to sign an informed consent.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Naama Barel
Phone
+972-3-618-24770
Email
Naamab@alphatau.com
First Name & Middle Initial & Last Name or Official Title & Degree
Aleksandr Obukhov, Dr.
Email
obuxov_al@mail.ru
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Aleksandr Obukhov
Organizational Affiliation
A. Tsyb Medical Radiological Research Centre, (A. Tsyb MRRC), Obninsk, Russia
Official's Role
Principal Investigator
Facility Information:
Facility Name
A. Tsyb Medical Radiological Research Center
City
Obninsk
State/Province
Kaluga Region
ZIP/Postal Code
249036
Country
Russian Federation
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Aleksandr Obukhov, MD
Phone
+9264837984
Email
obuxov_al@mail.ru
First Name & Middle Initial & Last Name & Degree
Natalia B. Borysheva, PhD
Phone
+79109109899
Email
borysheva@yandex.ru
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Alpha Radiation Emitters Device for the Treatment of Newly Diagnosed Breast Carcinoma Patients With Distant Metastases
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