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Hypo-Combi Trial: Hypofractionated EBRT Plus HDR-BT Boost for Prostate Cancer (Hypo-Combi)

Primary Purpose

Prostate Adenocarcinoma, Radiation Toxicity

Status
Active
Phase
Phase 1
Locations
Cyprus
Study Type
Interventional
Intervention
External beam radiation therapy, High-dose-rate brachytherapy
Goserelin 10.8 mg
Sponsored by
German Oncology Center, Cyprus
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Prostate Adenocarcinoma focused on measuring HDR-Brachytherapy, EBRT, Prostate cancer

Eligibility Criteria

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

Inclusion Criteria:

  • The patient must consent to be in the study and must have signed an approved consent form
  • Age > 18 years old.
  • Life expectancy of at least five years, excluding his diagnosis of prostate cancer.
  • Histopathologically proven primary adenocarcinoma of the prostate
  • The patient must be registered within 180 days following the histopathological confirmation of the malignancy
  • Prostate volume < 80ml
  • International Prostate Symptom Score (IPSS) < 18
  • Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2
  • Patients with a history of non-prostate malignancies are eligible if they have been disease-free for 5 or more years prior to enrolment, are deemed by their physician to be at low risk for recurrence and they did not need pelvic radiotherapy as part of their treatment. Patients with the following cancers are eligible if diagnosed and treated within the past 5 years: carcinoma in situ of the colon, melanoma in situ, and basal cell and squamous cell carcinoma of the skin.

Exclusion Criteria:

  • Histopathological confirmation or suspicion in conventional or molecular imaging of regional or distant metastases
  • Prior pelvic radiotherapy
  • Known autoimmune disorders (e.g. inflammatory bowel disease, lupus, scleroderma)
  • Prior TURP
  • MRI non compatible metal implants
  • Pre-existing fistulae
  • Contraindication for general and spinal anaesthesia
  • Inability to be placed in lithotomy position
  • Any treatment with radiation therapy, chemotherapy, immunotherapy, biotherapy and/or hormonal therapy for the currently diagnosed prostate cancer prior to registration.
  • History of non-prostate malignancy, apart from patients that have been disease-free for 5 or more years prior to randomization and are deemed by their physician to be at low risk for recurrence.
  • Psychiatric or addictive disorders or other conditions that, in the opinion of the investigator, would preclude the patient from meeting the study requirements.

Sites / Locations

  • German Oncology Center

Arms of the Study

Arm 1

Arm Type

Other

Arm Label

Hypofractionated EBRT plus HDR-BT boost

Arm Description

Primarily hypofractionated EBRT consisting of 12 x 3 Gy/fraction, TD 36 Gy will be administered. Followed by HDR-BT boost of the prostate, TD 14 Gy.

Outcomes

Primary Outcome Measures

Rate of acute and early late genitourinary, gastrointestinal and sexual toxicity
RTOG/EORTC questionnaires will be collected and evaluated for GU/GI toxicity. International Prostate Symptom Score will be assessed for lower urinary tract symptomatology and IIEF-5 for erectile function.

Secondary Outcome Measures

Rate of biochemical control
Evaluation of 2- and 5-year biochemical control based on the Phoenix criteria
Rate of overall survival
Evaluation of 2- and 5-year overall survival rate
Rate of prostate cancer-specific survival
Evaluation of 2- and 5-year prostate cancer-specific survival rate
Rate of distant metastasis-free survival
Evaluation of 2- and 5-year distant metastasis-survival rate
Rate of treatment-related symptoms on Quality of Life assessed by Expanded Prostate Cancer Index Composite for Clinical Practice (EPIC-CP) questionnaire
Record quality of life (QOL) issues related to treatment-related symptoms and overall satisfaction. Expanded Prostate Cancer Index Composite for Clinical Practice (EPIC-CP) questionnaire will be used. Minimum score is 0 points and maximum score is 60 points, with lower points meaning better quality of life and higher point score meaning, alternatively, worse outcome.
18F-PSMA PET/CT Vs conventional imaging for identification of pelvic nodal or distant secondaries
Evaluation of the accuracy of first-line imaging for identifying either pelvic nodal or distant-metastatic disease defined by the receiver-operating curve using a predefined reference-standard including histopathology, imaging, and biochemistry at 6-month follow-up and compare to 18F-PSMA PET/CT

Full Information

First Posted
June 29, 2021
Last Updated
March 3, 2023
Sponsor
German Oncology Center, Cyprus
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1. Study Identification

Unique Protocol Identification Number
NCT05003752
Brief Title
Hypo-Combi Trial: Hypofractionated EBRT Plus HDR-BT Boost for Prostate Cancer
Acronym
Hypo-Combi
Official Title
Hypo-Combi Trial: Combined Hypofractionated External Beam Radiation Therapy (EBRT) Plus Interstitial High-Dose-Rate Brachytherapy (HDR-BT) Boost for Intermediate/High Risk Prostate Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
August 1, 2021 (Actual)
Primary Completion Date
December 31, 2022 (Actual)
Study Completion Date
August 1, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
German Oncology Center, Cyprus

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Hypo-Combi Trial: A Prospective Phase I/II Study of Combined Hypofractionated External Beam Radiation Therapy (EBRT) plus Interstitial High-Dose-Rate Brachytherapy (HDR-BT) for Intermediate/High Risk Prostate Cancer
Detailed Description
The Phase I/II trial will prospectively assess the acute, early late and late gastrointestinal (GI), genitourinary (GU) and sexual toxicity of combined hypofractionated external beam radiation therapy (EBRT) plus high dose-rate brachytherapy (HDR-BT) schedule (total dose of EBRT 36 Gy/ in 12 fractions of 3 Gy plus HDR-BT with a total physical dose of 14 Gy in a single fraction) for patients with unfavourable intermediate/high risk (based on NCCN stratification guidelines) organ-confined prostate cancer, not requiring pelvic irradiation.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Prostate Adenocarcinoma, Radiation Toxicity
Keywords
HDR-Brachytherapy, EBRT, Prostate cancer

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
40 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Hypofractionated EBRT plus HDR-BT boost
Arm Type
Other
Arm Description
Primarily hypofractionated EBRT consisting of 12 x 3 Gy/fraction, TD 36 Gy will be administered. Followed by HDR-BT boost of the prostate, TD 14 Gy.
Intervention Type
Radiation
Intervention Name(s)
External beam radiation therapy, High-dose-rate brachytherapy
Intervention Description
Combined hypofractionated external beam radiation therapy (EBRT) plus high dose-rate brachytherapy (HDR-BT) schedule (total dose of EBRT 36 Gy/ in 12 fractions of 3 Gy plus HDR-BT with a total physical dose of 14 Gy in a single fraction)
Intervention Type
Drug
Intervention Name(s)
Goserelin 10.8 mg
Other Intervention Name(s)
Androgen deprivation therapy (upon indication)
Intervention Description
Androgen deprivation will be administered based on NCCN guidelines in patients with unfavorable intermediate/high risk organ-confined prostate cancer
Primary Outcome Measure Information:
Title
Rate of acute and early late genitourinary, gastrointestinal and sexual toxicity
Description
RTOG/EORTC questionnaires will be collected and evaluated for GU/GI toxicity. International Prostate Symptom Score will be assessed for lower urinary tract symptomatology and IIEF-5 for erectile function.
Time Frame
up to 2 years
Secondary Outcome Measure Information:
Title
Rate of biochemical control
Description
Evaluation of 2- and 5-year biochemical control based on the Phoenix criteria
Time Frame
2 years, 5 years
Title
Rate of overall survival
Description
Evaluation of 2- and 5-year overall survival rate
Time Frame
2 years, 5 years
Title
Rate of prostate cancer-specific survival
Description
Evaluation of 2- and 5-year prostate cancer-specific survival rate
Time Frame
2 years, 5 years
Title
Rate of distant metastasis-free survival
Description
Evaluation of 2- and 5-year distant metastasis-survival rate
Time Frame
2 years, 5 years
Title
Rate of treatment-related symptoms on Quality of Life assessed by Expanded Prostate Cancer Index Composite for Clinical Practice (EPIC-CP) questionnaire
Description
Record quality of life (QOL) issues related to treatment-related symptoms and overall satisfaction. Expanded Prostate Cancer Index Composite for Clinical Practice (EPIC-CP) questionnaire will be used. Minimum score is 0 points and maximum score is 60 points, with lower points meaning better quality of life and higher point score meaning, alternatively, worse outcome.
Time Frame
2 years, 5 years
Title
18F-PSMA PET/CT Vs conventional imaging for identification of pelvic nodal or distant secondaries
Description
Evaluation of the accuracy of first-line imaging for identifying either pelvic nodal or distant-metastatic disease defined by the receiver-operating curve using a predefined reference-standard including histopathology, imaging, and biochemistry at 6-month follow-up and compare to 18F-PSMA PET/CT
Time Frame
2 years

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: The patient must consent to be in the study and must have signed an approved consent form Age > 18 years old. Life expectancy of at least five years, excluding his diagnosis of prostate cancer. Histopathologically proven primary adenocarcinoma of the prostate The patient must be registered within 180 days following the histopathological confirmation of the malignancy Prostate volume < 80ml International Prostate Symptom Score (IPSS) < 18 Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2 Patients with a history of non-prostate malignancies are eligible if they have been disease-free for 5 or more years prior to enrolment, are deemed by their physician to be at low risk for recurrence and they did not need pelvic radiotherapy as part of their treatment. Patients with the following cancers are eligible if diagnosed and treated within the past 5 years: carcinoma in situ of the colon, melanoma in situ, and basal cell and squamous cell carcinoma of the skin. Exclusion Criteria: Histopathological confirmation or suspicion in conventional or molecular imaging of regional or distant metastases Prior pelvic radiotherapy Known autoimmune disorders (e.g. inflammatory bowel disease, lupus, scleroderma) Prior TURP MRI non compatible metal implants Pre-existing fistulae Contraindication for general and spinal anaesthesia Inability to be placed in lithotomy position Any treatment with radiation therapy, chemotherapy, immunotherapy, biotherapy and/or hormonal therapy for the currently diagnosed prostate cancer prior to registration. History of non-prostate malignancy, apart from patients that have been disease-free for 5 or more years prior to randomization and are deemed by their physician to be at low risk for recurrence. Psychiatric or addictive disorders or other conditions that, in the opinion of the investigator, would preclude the patient from meeting the study requirements.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Iosif Strouthos, MD PhD
Organizational Affiliation
German Oncology Center, Cyprus
Official's Role
Principal Investigator
Facility Information:
Facility Name
German Oncology Center
City
Limassol
ZIP/Postal Code
4108
Country
Cyprus

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
Data regarding this study will be presented at international meetings. Manuscripts will be submitted to peer-reviewed Journals

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Hypo-Combi Trial: Hypofractionated EBRT Plus HDR-BT Boost for Prostate Cancer

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