Retreatment With Intratumoral Diffusing Alpha Radiation Emitters
Primary Purpose
Skin Cancer, Mucosal Neoplasm of Oral Cavity, Soft Tissue Neoplasm
Status
Recruiting
Phase
Not Applicable
Locations
Israel
Study Type
Interventional
Intervention
Radiation: Diffusing Alpha Radiation Emitters Therapy (DaRT)
Sponsored by
About this trial
This is an interventional treatment trial for Skin Cancer focused on measuring Squamous Cell Carcinoma, SCC, Skin Cancer, Skin metastasis, HNSCC, Carcinoma, Squamous, CMN, Basal cell carcinoma, Superficial sarcoma, Kaposi sarcoma, Alpha radiation, Cutaneous lesion, Tongue cancer, Lip cancer, Brachytherapy, Recurrent disease, Persistent lesion
Eligibility Criteria
Inclusion Criteria:
- Subjects with histopathological confirmation of either recurrent or persistent disease following DaRT treatment.
- Subjects with a tumor size ≤ 5 centimeters in the longest diameter.
- Target lesion technically amenable for full coverage with the Alpha DaRT seeds.
- Brachytherapy indication validated by a multidisciplinary team.
- Measurable disease according to RECIST v1.1.
- Subjects over 18 years old.
- Subjects' ECOG Performance Status Scale is < 2.
- Subjects' life expectancy is more than 6 months.
- Platelet count ≥100,000/mm3.
- AST and ALT ≤ 2.5 X ULN
- WBC ≥ 3500/μl, granulocyte ≥ 1500/μl
- International normalized ratio of prothrombin time ≤1.4 for patients not on Warfarin
- Creatinine ≤2.3 mg/dL.
- Women of childbearing potential (WOCBP) will have evidence of negative pregnancy test before the Ra-224 implantation and are required to use an acceptable contraceptive method to prevent pregnancy for 3 months after brachytherapy.
- Subjects are willing to sign an informed consent form.
Exclusion Criteria:
- Patients undergoing systemic immunosuppressive therapy excepting intermittent, brief use of systemic corticosteroids
- Known hypersensitivity to any of the components of the treatment.
- Clinically significant cardiovascular disease, e.g. cardiac failure of New York Heart Association classes III-IV, uncontrolled coronary artery disease, cardiomyopathy, uncontrolled arrhythmia, uncontrolled hypertension, or history of myocardial infarction in the last 12 months.
- Patients with uncontrolled intercurrent illnesses including, but not limited to an active infection requiring systemic therapy or a known psychiatric or substance abuse disorder(s) that would interfere with cooperation with the requirements of the trial or interfere with the study endpoints.
- Has a known additional malignancy that is progressing or requires active treatment. Exceptions include basal cell carcinoma of the skin or squamous cell carcinoma of the skin that has undergone potentially curative therapy or in situ cervical cancer.
- Patients must agree to use adequate contraception (vasectomy or barrier method of birth control) prior to study entry, for the duration of study participation and for 3 months after discontinuing therapy.
- 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)
- Subjects not willing to sign an informed consent
- Women who are pregnant or breastfeeding.
Sites / Locations
- Sharett institute, Hadassah University Hospital - Ein-KeremRecruiting
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
Assessed using the Response Evaluation Criteria in Solid Tumors (RECIST) (Version 1.1)
Adverse events
Frequency, severity and causality of acute adverse events related to the DaRT treatment. Adverse events will be assessed and graded according to Common Terminology and Criteria for adverse events (CTCAE) version 5.0.
Secondary Outcome Measures
Change in tumor volume
Based on imaging
Local control rate
Will be assessed as the number of complete responses, partial responses and stable disease divided by the total numbers of tumors treated.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT04540588
Brief Title
Retreatment With Intratumoral Diffusing Alpha Radiation Emitters
Official Title
A Safety and Efficacy Study of Retreatment With Intratumoral Diffusing Alpha Radiation Emitters
Study Type
Interventional
2. Study Status
Record Verification Date
July 2023
Overall Recruitment Status
Recruiting
Study Start Date
December 22, 2020 (Actual)
Primary Completion Date
January 1, 2025 (Anticipated)
Study Completion Date
January 1, 2026 (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 superficial cutaneous, mucosal or soft tissue neoplasia
Detailed Description
This will be a prospective, open label, single arm, controlled study, assessing the safety and efficacy of re-treatment with diffusing alpha emitters radiation therapy (DaRT) delivered through radioactive seeds inserted into the tumor.
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.
Superficial lesions with histopathological confirmation of either recurrent or persistent disease following DaRT treatment. .
Reduction in tumor size 70 days after DaRT insertion will be assessed. Safety will be assessed by the incidence, severity and frequency of all Adverse Events (AE).
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Skin Cancer, Mucosal Neoplasm of Oral Cavity, Soft Tissue Neoplasm
Keywords
Squamous Cell Carcinoma, SCC, Skin Cancer, Skin metastasis, HNSCC, Carcinoma, Squamous, CMN, Basal cell carcinoma, Superficial sarcoma, Kaposi sarcoma, Alpha radiation, Cutaneous lesion, Tongue cancer, Lip cancer, Brachytherapy, Recurrent disease, Persistent lesion
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
39 (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)
Radiation: Diffusing Alpha Radiation Emitters Therapy (DaRT)
Other Intervention Name(s)
DaRT
Intervention Description
An intratumoral insertion of a seed(s), loaded with Radium-224, securely fixed in the seeds. The seeds release by recoil into the tumor short-lived alpha-emitting atoms.
Primary Outcome Measure Information:
Title
Tumor response to DaRT
Description
Assessed using the Response Evaluation Criteria in Solid Tumors (RECIST) (Version 1.1)
Time Frame
9-11 weeks post DaRT insertion
Title
Adverse events
Description
Frequency, severity and causality of acute adverse events related to the DaRT treatment. Adverse events will be assessed and graded according to Common Terminology and Criteria for adverse events (CTCAE) version 5.0.
Time Frame
From conscent up to 9-11 weeks post DaRT insertion
Secondary Outcome Measure Information:
Title
Change in tumor volume
Description
Based on imaging
Time Frame
9-11 weeks post DaRT insertion
Title
Local control rate
Description
Will be assessed as the number of complete responses, partial responses and stable disease divided by the total numbers of tumors treated.
Time Frame
9-11 weeks post DaRT insertion
Other Pre-specified Outcome Measures:
Title
Adverse Events
Description
Incidence of all Adverse Events (AE) related and unrelated to the study treatment.
Time Frame
From conscent up to 9-11 weeks post DaRT insertion
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Subjects with histopathological confirmation of either recurrent or persistent disease following DaRT treatment.
Subjects with a tumor size ≤ 5 centimeters in the longest diameter.
Target lesion technically amenable for full coverage with the Alpha DaRT seeds.
Brachytherapy indication validated by a multidisciplinary team.
Measurable disease according to RECIST v1.1.
Subjects over 18 years old.
Subjects' ECOG Performance Status Scale is < 2.
Subjects' life expectancy is more than 6 months.
Platelet count ≥100,000/mm3.
AST and ALT ≤ 2.5 X ULN
WBC ≥ 3500/μl, granulocyte ≥ 1500/μl
International normalized ratio of prothrombin time ≤1.4 for patients not on Warfarin
Creatinine ≤2.3 mg/dL.
Women of childbearing potential (WOCBP) will have evidence of negative pregnancy test before the Ra-224 implantation and are required to use an acceptable contraceptive method to prevent pregnancy for 3 months after brachytherapy.
Subjects are willing to sign an informed consent form.
Exclusion Criteria:
Patients undergoing systemic immunosuppressive therapy excepting intermittent, brief use of systemic corticosteroids
Known hypersensitivity to any of the components of the treatment.
Clinically significant cardiovascular disease, e.g. cardiac failure of New York Heart Association classes III-IV, uncontrolled coronary artery disease, cardiomyopathy, uncontrolled arrhythmia, uncontrolled hypertension, or history of myocardial infarction in the last 12 months.
Patients with uncontrolled intercurrent illnesses including, but not limited to an active infection requiring systemic therapy or a known psychiatric or substance abuse disorder(s) that would interfere with cooperation with the requirements of the trial or interfere with the study endpoints.
Has a known additional malignancy that is progressing or requires active treatment. Exceptions include basal cell carcinoma of the skin or squamous cell carcinoma of the skin that has undergone potentially curative therapy or in situ cervical cancer.
Patients must agree to use adequate contraception (vasectomy or barrier method of birth control) prior to study entry, for the duration of study participation and for 3 months after discontinuing therapy.
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)
Subjects not willing to sign an informed consent
Women who are pregnant or breastfeeding.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Adi Cohen
Phone
+972-2-3737-212
Email
adic@alphatau.com
First Name & Middle Initial & Last Name or Official Title & Degree
Naama Barel
Phone
+972-2-3737-210
Email
naamab@alphatau.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Aron Popovtzer, M.D
Organizational Affiliation
Sharett institute, Hadassah Medical Center - Ein-Kerem
Official's Role
Principal Investigator
Facility Information:
Facility Name
Sharett institute, Hadassah University Hospital - Ein-Kerem
City
Jerusalem
ZIP/Postal Code
91120
Country
Israel
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Aron Popovtzer, MD
12. IPD Sharing Statement
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Retreatment With Intratumoral Diffusing Alpha Radiation Emitters
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