Clinical trial NCT06451614: SpaceIT Hydrogel System for Perirectal Spacing
Official title: SpaceIT Hydrogel System for Perirectal Spacing in Subjects With Low to Intermediate Risk Prostate Cancer Undergoing External Beam Radiotherapy (EBRT)
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Prostate Cancer
Lead sponsor: Boston Scientific Corporation
Sponsor class: INDUSTRY
First posted: 2024-06-11
Enrollment: 230
Sex: MALE
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: To evaluate the safety and effectiveness of the SpaceIT™ Hydrogel System in patients undergoing External Beam Radiotherapy (EBRT) for the treatment of prostate cancer.

Detailed description: HYDROSPACE study is a prospective, randomized, multicenter study to evaluate the safety and effectiveness of SpaceIT in patients undergoing External Beam Radiotherapy (EBRT) for the treatment of prostate cancer.

Subjects randomized to the investigational arm will receive SpaceIT Hydrogel System

Subjects randomized to the control arm will receive a commercially marketed Boston Scientific perirectal hydrogel spacer, SpaceOAR System or SpaceOAR Vue Hydrogel

Eligibility criteria: Inclusion Criteria:

Subjects must meet the following criteria to be eligible for participation in the study:

1. Age ≥18 years old
2. Subjects must have had pathologically confirmed (by routine hematoxylin and eosin \[H\&E\] staining) invasive adenocarcinoma of the prostate and planning to undergo EBRT
3. Subjects must meet ALL of the following:

   1. Clinical stage T1-T2c (AJCC Ver. 8) tumor AND
   2. Gleason Score 7 or less as determined from a biopsy taken within 12 months of the Baseline visit AND
   3. Demonstrated blood prostate specific antigen (PSA) levels ≤20 ng/ml as measured within 6 months of the Baseline visit and prior to commencing androgen deprivation therapy (ADT)
4. Subject is able to provide written informed consent, approved by the appropriate Institutional Review Board/Ethics Committee/Research Ethics Board (IRB/EC/REB) of the respective clinical site

Exclusion Criteria:

1. Prostate \> 80 cc
2. Subjects who are planning to undergo brachytherapy or focal boost
3. Subjects who have magnetic resonance imaging (MRI) evidence of gross posterior extracapsular extension (ECE) of the prostate cancer Note: MRI must be taken within 6 months prior to the Baseline visit
4. Subjects who have metastatic disease, other ongoing cancers which are being treated during the study or subjects for whom pelvic lymph node radiotherapy is planned
5. Subjects with any prior invasive solid tumor malignancy or hematologic malignancy (except non-melanomatous skin cancer) unless the subject has been disease free and treatment free for a minimum of 3 years
6. History of radical prostatectomy, other ablative anti-prostate cancer therapy (e.g., cryotherapy, high intensity focused ultrasound, irreversible electroporation) or previous pelvic irradiation (including prior prostate brachytherapy) at any time prior to screening
7. History of transurethral prostate surgery (e.g., Transurethral Needle Ablation (TUNA), Transurethral Microwave Therapy (TUMT), Transurethral Resection of the Prostate (TURP)) if performed within 1 year prior to screening
8. History of prior pelvic surgery requiring low anterior or abdominoperineal resections or rectal surgery
9. History of or current perirectal disease that may interfere with interpretation of study outcomes, including anal or perianal diseases such as fistula
10. Bleeding hemorrhoids requiring medical intervention within the prior three months
11. Diagnosed active bleeding disorder or a clinically significant coagulopathy, defined as PTT \> 70s or aPTT\>35s or INR \> 1.4, or platelet count \< 100,000 per mm3 Note: Subjects on anticoagulants may be included if the anticoagulant medication can be held for index procedure
12. Active inflammatory or infectious process involving the perineum, GI or urinary tract based on positive diagnosis or suspected diagnosis in the presence of fever \>38⁰ C, WBC \> 12,000/uL
13. Inability to undergo pelvic MRI or presence of implants causing severe artifact (e.g. bilateral arthroplasty) that interferes with imaging interpretation for this study at Investigator discretion
14. If a subject was enrolled in another investigational drug or device trial that had not completed the primary endpoint or that clinically interfered with this study
15. Unable to comply with the study requirements or follow-up schedule
16. Any condition the Investigator believed would interfere with the intent of the study or would make participation not in the best interest of the patient
17. Known PEG (polyethylene glycol) sensitivity or allergy
18. Known iodine sensitivity or allergy
19. ADT, if applicable, cannot or was not started 15-60 days prior to the pre-index procedure RT planning imaging and is planned to continue for a total planned duration greater than 6 months

Primary outcomes:
measure: Primary Safety Endpoint - Acute Grade 3 or greater adverse events.
timeFrame: 90 Days from hydrogel placement procedure
measure: Primary Effectiveness Endpoint - 25% reduction in the volume of the rectum receiving 90% of the prescribed radiation dose
timeFrame: 10 days post procedure
Secondary outcomes:
measure: Additional Safety Endpoint - Adverse Device Effects (ADEs) requiring additional procedures and/or medications
timeFrame: Up to 24 months
measure: Additional Safety Endpoint - Incidence of acute Grade 2 or greater gastrointestinal (GI) and genitourinary (GU) adverse events (AEs)
timeFrame: Up to 90 days
measure: Additional Safety Endpoint - Incidence of late Grade 2 or greater GI and GU adverse events (AEs)
timeFrame: 91 days up to 24 Months
measure: Additional Effectiveness Endpoint - Visualization of hydrogel
timeFrame: 10 days post procedure
measure: Additional Effectiveness Endpoint - Space Creation
timeFrame: 10 days post procedure
measure: Additional Effectiveness Endpoint - Absorption
timeFrame: 12 Month post hydrogel placement
measure: Additional Effectiveness Endpoint - Change in radiation dose distributions to the organs at risk
timeFrame: 10 days post procedure
measure: Additional Effectiveness Endpoint - Mean and Maximum Rectal Radiation doses
timeFrame: 10 days post procedure
measure: Additional Effectiveness Endpoint - Quality of Life Questionnaire: EQ-5D-5L
timeFrame: Baseline up to 24 months
measure: Additional Effectiveness Endpoint - Ease of hydrogel administration
timeFrame: 10 days post procedure
measure: Additional Effectiveness Endpoint - Space Maintenance
timeFrame: 3 Months post hydrogel placement procedure
measure: Additional Effectiveness Endpoint - Quality of Life Questionnaire: Expanded Prostate Cancer Index Composite (EPIC-26)
timeFrame: Baseline up to 24 months
measure: Additional Effectiveness Endpoint - Quality of Life Questionnaire, Work Productivity and Activity Impairment Questionnaire: General Health (WPAI:GH)
timeFrame: Baseline up to 24 months
Other outcomes:
Locations:
city: Los Angeles
country: United States
facility: Ronald Reagan UCLA Medical Center
state: California
city: Miami
country: United States
facility: Baptist Hospital of Miami
state: Florida
city: Orlando
country: United States
facility: Orlando Health Cancer Institute
state: Florida
city: Atlanta
country: United States
facility: Emory University Hospital
state: Georgia
city: Chicago Ridge
country: United States
facility: Associated Urological Specialists
state: Illinois
city: Glenview
country: United States
facility: UroPartners
state: Illinois
city: Springfield
country: United States
facility: Springfield Clinic, LLC
state: Illinois
city: Kansas City
country: United States
facility: University of Kansas Hospital
state: Kansas
city: New York
country: United States
facility: Integrated Medical Professionals
state: New York
city: New York
country: United States
facility: Perlmutter Cancer Center - NYU Langone
state: New York
city: Bala-Cynwyd
country: United States
facility: MidLantic Urology
state: Pennsylvania
city: Philadelphia
country: United States
facility: Perelman Center for Advanced Medicine
state: Pennsylvania
city: Greer
country: United States
facility: Gibbs Cancer Center and Research Institute
state: South Carolina
city: Austin
country: United States
facility: Midtown Urology Associates
state: Texas
city: Houston
country: United States
facility: Houston Metro Urology
state: Texas
city: Kirkland
country: United States
facility: Evergreen Hospital Medical Center
state: Washington
Study officials:
affiliation: Springfield Clinic
name: Brian Baumann, MD
role: PRINCIPAL_INVESTIGATOR
References: