search
Back to results

Clinical Study to Assess the Safety and Efficacy of the SpectraCure P18 System

Primary Purpose

Recurrent Prostate Cancer

Status
Recruiting
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
Verteporfin
SpectraCure P18 System
Sponsored by
SpectraCure AB
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Recurrent Prostate Cancer

Eligibility Criteria

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

Phase 1 Inclusion Criteria:

  1. Males > 18 years who have gone through external or internal, high dose rate (brachy) radiation therapy for localized prostate cancer with histopathologically verified local recurrence.
  2. Prostate volume less than 50 cm3 defined by transrectal ultrasound
  3. Subject not eligible for surgery or curative radiotherapy
  4. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
  5. Expected survival ≥ 8 months
  6. Sufficient bone marrow reserve as indicated by; granulocyte count ≥ 1500/mm3, platelet count ≥ 100,000/mm3
  7. Adequate renal function as defined by creatinine ≤ 1.5 mg /dl
  8. Adequate hepatic function, based on a total bilirubin ≤ 1.5 mg/dl, serum glutamate-oxaloacetate transaminase (SGOT) ≤ 3 times the upper limit of normal, and alanine transaminase (ALT) ≤ 3 times the upper limit of normal
  9. Signed Informed Consent

Phase 1 Exclusion Criteria:

  1. Patients with locally advanced (AJCC 7th edition T3/T4) or metastatic disease
  2. Patients who have been treated with seed implantation brachytherapy
  3. Gleason score ≥ 8 at initial diagnosis
  4. Less than 1 week since surgery (excluding minimal procedures, e.g. vascular access device insertion)
  5. Concomitant infection
  6. Subjects with other severe concurrent disease that in the judgement of the investigator would make the subject inappropriate for entry into this study
  7. Mental incapacity or psychiatric illness that would interfere with the subject's ability to understand and give informed consent or to complete follow-up visits according to the judgement of the investigator
  8. Contraindication for photosensitizer
  9. Porphyria or other diseases exacerbated by light
  10. Known hypersensitivity to verteporfin for injection (VFI) or to any of the excipients
  11. Known allergies to porphyrins
  12. Tumours known to be eroding into a major blood vessel in or adjacent to the illumination site
  13. On-going therapy with a photosensitizing agent
  14. Enrolment in another therapeutic clinical study within 3 months prior to randomization and throughout the study.
  15. Subjects with a history of CTCAE v4 grade 3 or greater or persistent (>1 separate episode or symptoms lasting more than 3 months after initiation of medical intervention) grade 2 proctitis attributed to radiation.

Phase 2 Inclusion Criteria:

  1. Subjects > 18 years who have gone through external or internal, high dose-rate (brachy) radiation therapy for localized prostate cancer with histopathologically verified local recurrence.
  2. Treatment target volume less than 50 cm3.
  3. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
  4. Expected survival ≥ 12 months.
  5. Sufficient bone marrow reserve as indicated by; granulocyte count ≥ 1500/mm3, platelet count ≥ 100,000/mm3.
  6. Adequate renal function as defined by creatinine ≤ 1.5 mg /dl.
  7. Adequate hepatic function, based on a total bilirubin ≤ 1.5 mg/dl, serum glutamate- oxaloacetate transaminase (SGOT) ≤ 3 times the upper limit of normal, and alanine transaminase (ALT) ≤ 3 times the upper limit of normal.
  8. Signed Informed Consent.

Phase 2 Exclusion Criteria:

  1. Subjects with locally advanced (AJCC 7th edition T3/T4), regional pelvic lymph node metastasis, or metastatic disease defined by PSMA PET.
  2. Subjects who have been treated with seed implantation brachytherapy.
  3. Less than 1 week since surgery (excluding minimal procedures, e.g. vascular access device insertion).
  4. Concomitant infection.
  5. Subjects with other severe concurrent disease that in the judgement of the investigator would make the subject inappropriate for entry into this study.
  6. Mental incapacity or psychiatric illness that would interfere with the subject's ability to understand and give informed consent or to complete follow-up visits according to the judgement of the investigator.
  7. Contraindication for photosensitizer.
  8. Porphyria or other diseases exacerbated by light.
  9. Known hypersensitivity to verteporfin for injection (VFI) or to any of the excipients.
  10. Known allergies to porphyrins.
  11. Tumours known to be eroding into a major blood vessel in or adjacent to the illumination site.
  12. On-going therapy with a photosensitizing agent.
  13. Enrolment in another therapeutic clinical study within 3 months prior to randomization and throughout the study.
  14. Subjects with a history of CTCAE v4 grade 3 or greater or persistent (>1 separate episode or symptoms lasting more than 3 months after initiation of medical intervention) grade 2 proctitis attributed to radiation.
  15. Contraindication for MRI/Gadolinium contrast such as: implants, severe renal impairment (glomerular filtration rate [GFR] <30 mL/min/1.73m2, or previous contrast reactions.
  16. On-going or planned hormone therapy.

Sites / Locations

  • Memorial Sloan Kettering Cancer CenterRecruiting
  • Keith Cengel
  • Princess Margaret Cancer CentreRecruiting
  • Skåne University Hospital
  • Reader in Urology, University College London & Honorary Consultant Urological Surgeon, University College London Hospitals TrustRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

PDT and verteporfin dose finding

Arm Description

Verteporfin and Interstitial Photodynamic Therapy are the interventions in this dose titration study. The interventions will be light dose (as laser) using the SpectraCure P18 System and drug intervention with verteporfin as a photosensitizer. The study will be conducted as a dose titration study to determine the light and drug threshold dose using the SpectraCure P18 System (Interstitial multiple diode lasers and IDOSE® Software) and verteporfin for injection (VFI). The light is delivered to the tumor via optical fibers and each dose arm will receive Interventional Photodynamic Therapy of Prostate Cancer combined with the drug verteporfin as a photosensitizer .

Outcomes

Primary Outcome Measures

Number of participants with treatment related adverse events as assesses by CTCAE v4.0 related to protocol therapy.
Dose limiting toxicities are defined as grade 3 non-hematologic or grade 4 hematologic toxicities that are possibly, probably or definitely related to PDT.
Percentage of subjects with negative biopsies.
Histopathologically tumor-free.

Secondary Outcome Measures

Damage to the periprostatic tissues including the rectal wall mediated by PDT
Potential damage to the periprostatic tissue will be evaluated by contrast-enhanced and not-contrast enhanced MRI.
Performance of SpectraCure P18 system
Performance of the SpectraCure P18 system will be evaluated by light dose-volume histograms for the light dose coverage
Adequacy of effectiveness
Effectivity will be evaluated by MRI to determine the extent of necrosis in the prostate
Percentage of subjects with remaining localized tumour.
Evaluated by MRI.
Percentage of subjects with biochemical failure.
Failure defined as a rise in PSA level of 2.0 ng/mL or more, over and above the nadir.
Percentage of subjects with extra prostatic or distant disease.
Evaluated by PSMA PET.

Full Information

First Posted
February 13, 2017
Last Updated
April 26, 2023
Sponsor
SpectraCure AB
search

1. Study Identification

Unique Protocol Identification Number
NCT03067051
Brief Title
Clinical Study to Assess the Safety and Efficacy of the SpectraCure P18 System
Official Title
Open-label Clinical Study to Assess the Safety and Efficacy of the SpectraCure P18 System (Interstitial Multiple Diode Lasers and IDOSE® Software) and Verteporfin for Injection (VFI) for the Treatment of Recurrent Prostate Cancer
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Recruiting
Study Start Date
March 21, 2017 (Actual)
Primary Completion Date
July 31, 2024 (Anticipated)
Study Completion Date
December 31, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
SpectraCure AB

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
Yes

5. Study Description

Brief Summary
The rationale for the study is to obtain safety and efficacy data as well as to establish dose parameters for the SpectraCure P18 System with IDOSE®, with verteporfin for injection (VFI) as photosensitizer for the treatment of recurrent prostate cancer.
Detailed Description
In 2011, more than 200,000 men in North America alone were diagnosed with cancer of the prostate, which makes it one of the most common cancer types. It affects the lives of the subjects in many ways. After treatment the subjects PSA levels are being closely monitored to detect potential recurrence. A high number of subjects will get recurrent prostate cancer. The treatment options for recurrent cancer are more limited than for primary tumors as secondary treatment partly depends on which treatment the subject has previously undergone. Treatment of recurrent prostate cancer may, depending on the standard treatment of the primary disease, include the following: Radiation therapy. Prostatectomy for subjects initially treated with radiation therapy. Hormone therapy. Pain medication, external radiation therapy, internal radiation therapy with radioisotopes such as strontium-89, or other treatments as palliative therapy to lessen bone pain. The objectives of this study is to demonstrate that the use of the SpectraCure P18 System (Interstitial multiple diode lasers and IDOSE® Software) and verteporfin for injection (VFI) is a safe treatment for recurrent prostate cancer.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Recurrent Prostate Cancer

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Sequential Assignment
Model Description
As result of the accelerated titration design with light dose and verteporfin for injection (VFI), the final number of subjects depends on the outcome of the titration. If all dose levels enroll and complete at the minimum number of subjects, the number of subjects is 12 (1 each at dose levels 1-3, 3 each at dose levels 4-6). If all dose levels enroll and complete at the maximum number of subjects, the number of subjects is 36 (6 subjects at each dose level 1-6). The range is thus 12-36 subjects for the dose-escalation phase. 25-30 subjects will be treated in an expanded cohort.
Masking
None (Open Label)
Allocation
N/A
Enrollment
66 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
PDT and verteporfin dose finding
Arm Type
Experimental
Arm Description
Verteporfin and Interstitial Photodynamic Therapy are the interventions in this dose titration study. The interventions will be light dose (as laser) using the SpectraCure P18 System and drug intervention with verteporfin as a photosensitizer. The study will be conducted as a dose titration study to determine the light and drug threshold dose using the SpectraCure P18 System (Interstitial multiple diode lasers and IDOSE® Software) and verteporfin for injection (VFI). The light is delivered to the tumor via optical fibers and each dose arm will receive Interventional Photodynamic Therapy of Prostate Cancer combined with the drug verteporfin as a photosensitizer .
Intervention Type
Drug
Intervention Name(s)
Verteporfin
Other Intervention Name(s)
Visudyne
Intervention Description
In the last decade a clinical interest of developing new methods for minimally invasive treatments of organ-confined prostatic malignancies has been pursued. In this study the drug verteporfin for injection (VFI) is to be used with the SpectraCure P18 System (Interstitial multiple diode lasers and IDOSE® Software).
Intervention Type
Device
Intervention Name(s)
SpectraCure P18 System
Intervention Description
Interstitial Photodynamic therapy is provided with the the SpectraCure P18 system
Primary Outcome Measure Information:
Title
Number of participants with treatment related adverse events as assesses by CTCAE v4.0 related to protocol therapy.
Description
Dose limiting toxicities are defined as grade 3 non-hematologic or grade 4 hematologic toxicities that are possibly, probably or definitely related to PDT.
Time Frame
Within 4 weeks of treatment in each cohort.
Title
Percentage of subjects with negative biopsies.
Description
Histopathologically tumor-free.
Time Frame
6 months following PDT.
Secondary Outcome Measure Information:
Title
Damage to the periprostatic tissues including the rectal wall mediated by PDT
Description
Potential damage to the periprostatic tissue will be evaluated by contrast-enhanced and not-contrast enhanced MRI.
Time Frame
5-9 days following PDT
Title
Performance of SpectraCure P18 system
Description
Performance of the SpectraCure P18 system will be evaluated by light dose-volume histograms for the light dose coverage
Time Frame
Dose-volume histograms will be evaluated at month 12
Title
Adequacy of effectiveness
Description
Effectivity will be evaluated by MRI to determine the extent of necrosis in the prostate
Time Frame
Within 1 week of treatment
Title
Percentage of subjects with remaining localized tumour.
Description
Evaluated by MRI.
Time Frame
12 months following PDT.
Title
Percentage of subjects with biochemical failure.
Description
Failure defined as a rise in PSA level of 2.0 ng/mL or more, over and above the nadir.
Time Frame
12 months following PDT.
Title
Percentage of subjects with extra prostatic or distant disease.
Description
Evaluated by PSMA PET.
Time Frame
12 months following PDT.

10. Eligibility

Sex
Male
Gender Based
Yes
Gender Eligibility Description
Males with recurrent prostate cancer
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Phase 1 Inclusion Criteria: Males > 18 years who have gone through external or internal, high dose rate (brachy) radiation therapy for localized prostate cancer with histopathologically verified local recurrence. Prostate volume less than 50 cm3 defined by transrectal ultrasound Subject not eligible for surgery or curative radiotherapy Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 Expected survival ≥ 8 months Sufficient bone marrow reserve as indicated by; granulocyte count ≥ 1500/mm3, platelet count ≥ 100,000/mm3 Adequate renal function as defined by creatinine ≤ 1.5 mg /dl Adequate hepatic function, based on a total bilirubin ≤ 1.5 mg/dl, serum glutamate-oxaloacetate transaminase (SGOT) ≤ 3 times the upper limit of normal, and alanine transaminase (ALT) ≤ 3 times the upper limit of normal Signed Informed Consent Phase 1 Exclusion Criteria: Patients with locally advanced (AJCC 7th edition T3/T4) or metastatic disease Patients who have been treated with seed implantation brachytherapy Gleason score ≥ 8 at initial diagnosis Less than 1 week since surgery (excluding minimal procedures, e.g. vascular access device insertion) Concomitant infection Subjects with other severe concurrent disease that in the judgement of the investigator would make the subject inappropriate for entry into this study Mental incapacity or psychiatric illness that would interfere with the subject's ability to understand and give informed consent or to complete follow-up visits according to the judgement of the investigator Contraindication for photosensitizer Porphyria or other diseases exacerbated by light Known hypersensitivity to verteporfin for injection (VFI) or to any of the excipients Known allergies to porphyrins Tumours known to be eroding into a major blood vessel in or adjacent to the illumination site On-going therapy with a photosensitizing agent Enrolment in another therapeutic clinical study within 3 months prior to randomization and throughout the study. Subjects with a history of CTCAE v4 grade 3 or greater or persistent (>1 separate episode or symptoms lasting more than 3 months after initiation of medical intervention) grade 2 proctitis attributed to radiation. Phase 2 Inclusion Criteria: Subjects > 18 years who have gone through external or internal, high dose-rate (brachy) radiation therapy for localized prostate cancer with histopathologically verified local recurrence. Treatment target volume less than 50 cm3. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. Expected survival ≥ 12 months. Sufficient bone marrow reserve as indicated by; granulocyte count ≥ 1500/mm3, platelet count ≥ 100,000/mm3. Adequate renal function as defined by creatinine ≤ 1.5 mg /dl. Adequate hepatic function, based on a total bilirubin ≤ 1.5 mg/dl, serum glutamate- oxaloacetate transaminase (SGOT) ≤ 3 times the upper limit of normal, and alanine transaminase (ALT) ≤ 3 times the upper limit of normal. Signed Informed Consent. Phase 2 Exclusion Criteria: Subjects with locally advanced (AJCC 7th edition T3/T4), regional pelvic lymph node metastasis, or metastatic disease defined by PSMA PET. Subjects who have been treated with seed implantation brachytherapy. Less than 1 week since surgery (excluding minimal procedures, e.g. vascular access device insertion). Concomitant infection. Subjects with other severe concurrent disease that in the judgement of the investigator would make the subject inappropriate for entry into this study. Mental incapacity or psychiatric illness that would interfere with the subject's ability to understand and give informed consent or to complete follow-up visits according to the judgement of the investigator. Contraindication for photosensitizer. Porphyria or other diseases exacerbated by light. Known hypersensitivity to verteporfin for injection (VFI) or to any of the excipients. Known allergies to porphyrins. Tumours known to be eroding into a major blood vessel in or adjacent to the illumination site. On-going therapy with a photosensitizing agent. Enrolment in another therapeutic clinical study within 3 months prior to randomization and throughout the study. Subjects with a history of CTCAE v4 grade 3 or greater or persistent (>1 separate episode or symptoms lasting more than 3 months after initiation of medical intervention) grade 2 proctitis attributed to radiation. Contraindication for MRI/Gadolinium contrast such as: implants, severe renal impairment (glomerular filtration rate [GFR] <30 mL/min/1.73m2, or previous contrast reactions. On-going or planned hormone therapy.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Johannes Swartling
Phone
+46 (0) 46 16 20 70
Email
jsw@spectracure.com
Facility Information:
Facility Name
Memorial Sloan Kettering Cancer Center
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
James Eastham, MD
Facility Name
Keith Cengel
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104-6205
Country
United States
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Keith Cengel, MD
First Name & Middle Initial & Last Name & Degree
Sally Mcnulty, RN
Facility Name
Princess Margaret Cancer Centre
City
Toronto
State/Province
Ontario
ZIP/Postal Code
ON M5G 2M9
Country
Canada
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Neil Fleshner, MD
First Name & Middle Initial & Last Name & Degree
Nathan Perlis, MD
Phone
416-946-4501
Ext
3381
Facility Name
Skåne University Hospital
City
Malmö
State/Province
Skåne
Country
Sweden
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Emelie Winell, RN
First Name & Middle Initial & Last Name & Degree
Anders Bjartell, Prof
Facility Name
Reader in Urology, University College London & Honorary Consultant Urological Surgeon, University College London Hospitals Trust
City
London
ZIP/Postal Code
W1W 7TS
Country
United Kingdom
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Caroline Moore, Prof
First Name & Middle Initial & Last Name & Degree
Rebecca Scott, RN

12. IPD Sharing Statement

Learn more about this trial

Clinical Study to Assess the Safety and Efficacy of the SpectraCure P18 System

We'll reach out to this number within 24 hrs