Clinical trial NCT05241236: MRI/Ultrasound Fusion Guided Laser Ablation of Prostate Cancer
Official title: Office Based MRI/Ultrasound Guided Prostate Cancer Ablation: Outcomes Registry
Study type: OBSERVATIONAL
Overall status: RECRUITING
Conditions: Neoplasms Prostate
Cancer of the Prostate
Keywords: Prostate
PSA
FUSION
Ultrasound
MRI
Cancer
Laser
Outcomes
Recurrence
QOL, Quality of Life
Urinary function
Sexual Function
Lead sponsor: Urological Research Network, LLC
Sponsor class: OTHER
First posted: 2022-02-15
Enrollment: 5000
Sex: MALE
Minimum age (years): 50
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: As written in Initial Section

Brief summary: This serves as a registration trial. It aims to record short, intermediate, and long-term outcomes of patients treated with targeted laser ablation of biopsy confirmed prostate cancer. Outcomes will be categorized as: 1- Procedure Related, 2- Perioperative - Adverse Events that may occur within 90 days, 3-Oncologic: Recurrence of cancer in treatment area, de-novo tumors, conversion to radical surgery, radiation or cryoablation, emergence of metastasis, 4- Functional: Sexual and Urinary function following treatment

Detailed description: CLINICAL REGISTRY OBSERVATION NATURE

This serves as a registration trial evaluating short, intermediate, and long-term outcomes of patients treated with targeted laser ablation of biopsy confirmed prostate cancer. The primary outcome measure is 1-year oncological control of the targeted ablated area. The following secondary aims are sought: PROCEDURE RELATED: tolerability, feasibility, pain during this office-based procedure. PERIOPERATIVE: Adverse Events (AEs) and Series AEs profile during the initial 90 days after the procedure. ONCOLOGIC - In addition to primary aim, determine risk and rate of emergence of de-novo tumors (so called Outfield Recurrence) at the 1 year fusion biopsy mark and overtime. Will also observe rate of progression locally and systemically. Conversion to whole gland treatment - surgery extraction, radiation or whole gland cryoablation is of particular interest as is the initiation of androgen suppression (castration). Moreover, the investigators will evaluate the impact of MRI in assessing tumor locations and of software registration guiding the location and extent of ablation of the laser ablation over fixed time intervals. Finally, incidence of metastatic disease - non castrate and castrate - as well as cancer specific and overall survival at 5, 10 and 15 years post procedure. FUNCTIONAL OUTCOMES - determine urinary function and sexual function including incidence of ejaculation, and climacturia at months 3, 6 and 12. These outcomes will then measured yearly for the extent of the study

Eligibility criteria: Inclusion Criteria:

* Men between 50 and 65 years of age with a clinical diagnosis of prostate cancer with Low or Intermediate risk prostate cancer, and \<50% positive core rate by prostate lobe
* Men older than 65 years of age with clinical diagnosis of prostate cancer \<50% positive core rate by prostate lobe
* Absence of extra-capsular extension
* Absence of seminal vesicle invasion
* Absence of regional or distant metastatic disease
* Multiparametric MRI of the prostate performed either before the biopsy or \>10 weeks after prostate biopsy
* Treated with Cryotherapy of the prostate
* Treatment based on co-registration between MP-MRI and Prostate Ultrasound

Exclusion Criteria:

* Prior treatment of prostate cancer in the form of surgery.
* Performance status greater than 0 based on ECOG criteria
* Mental status impairment

Primary outcomes:
measure: Primary Oncological Control
timeFrame: 1 Year
Secondary outcomes:
measure: Perioperative Outcomes
timeFrame: 90 days
measure: Urinary Function
timeFrame: 5 years
measure: Sexual Function
timeFrame: 5 years
measure: Radiological Cancer Control
timeFrame: 5 Years
Other outcomes:
measure: Rate of Conversion to Whole gland treatment - Salvage Treatment
timeFrame: 10 years
measure: Rate of development of metastasis
timeFrame: 10 years
Locations:
city: Miami Lakes
country: United States
facility: Urological Research Network
state: Florida
Study officials:
affiliation: UROLOGICAL RESEARCH NETWORK
name: FERNANDO J BIANCO, MD
role: PRINCIPAL_INVESTIGATOR
affiliation: UROLOGICAL RESEARCH NETWORK
name: EUSEBIO LUNA, MD
role: STUDY_DIRECTOR
affiliation: UROLOGICAL RESEARCH NETWORK
name: Isabel H Lopez, MD
role: STUDY_DIRECTOR
References:
citation: Moore CM, Kasivisvanathan V, Eggener S, Emberton M, Futterer JJ, Gill IS, Grubb Iii RL, Hadaschik B, Klotz L, Margolis DJ, Marks LS, Melamed J, Oto A, Palmer SL, Pinto P, Puech P, Punwani S, Rosenkrantz AB, Schoots IG, Simon R, Taneja SS, Turkbey B, Ukimura O, van der Meulen J, Villers A, Watanabe Y; START Consortium. Standards of reporting for MRI-targeted biopsy studies (START) of the prostate: recommendations from an International Working Group. Eur Urol. 2013 Oct;64(4):544-52. doi: 10.1016/j.eururo.2013.03.030. Epub 2013 Mar 20.
citation: Costa DN, Pedrosa I, Donato F Jr, Roehrborn CG, Rofsky NM. MR Imaging-Transrectal US Fusion for Targeted Prostate Biopsies: Implications for Diagnosis and Clinical Management. Radiographics. 2015 May-Jun;35(3):696-708. doi: 10.1148/rg.2015140058. Epub 2015 Mar 18.
citation: Barentsz JO, Richenberg J, Clements R, Choyke P, Verma S, Villeirs G, Rouviere O, Logager V, Futterer JJ; European Society of Urogenital Radiology. ESUR prostate MR guidelines 2012. Eur Radiol. 2012 Apr;22(4):746-57. doi: 10.1007/s00330-011-2377-y. Epub 2012 Feb 10.
citation: Eldred-Evans D, Neves JB, Simmons LAM, Kanthabalan A, McCartan N, Shah TT, Arya M, Charman SC, Freeman A, Moore CM, Punwani S, Emberton M, Ahmed HU. Added value of diffusion-weighted images and dynamic contrast enhancement in multiparametric magnetic resonance imaging for the detection of clinically significant prostate cancer in the PICTURE trial. BJU Int. 2020 Mar;125(3):391-398. doi: 10.1111/bju.14953. Epub 2019 Dec 11.
citation: Simmons LAM, Kanthabalan A, Arya M, Briggs T, Barratt D, Charman SC, Freeman A, Hawkes D, Hu Y, Jameson C, McCartan N, Moore CM, Punwani S, van der Muelen J, Emberton M, Ahmed HU. Accuracy of Transperineal Targeted Prostate Biopsies, Visual Estimation and Image Fusion in Men Needing Repeat Biopsy in the PICTURE Trial. J Urol. 2018 Dec;200(6):1227-1234. doi: 10.1016/j.juro.2018.07.001. Epub 2018 Jul 11.
citation: Hamid S, Donaldson IA, Hu Y, Rodell R, Villarini B, Bonmati E, Tranter P, Punwani S, Sidhu HS, Willis S, van der Meulen J, Hawkes D, McCartan N, Potyka I, Williams NR, Brew-Graves C, Freeman A, Moore CM, Barratt D, Emberton M, Ahmed HU. The SmartTarget Biopsy Trial: A Prospective, Within-person Randomised, Blinded Trial Comparing the Accuracy of Visual-registration and Magnetic Resonance Imaging/Ultrasound Image-fusion Targeted Biopsies for Prostate Cancer Risk Stratification. Eur Urol. 2019 May;75(5):733-740. doi: 10.1016/j.eururo.2018.08.007. Epub 2018 Dec 6.
citation: Bonmati E, Hu Y, Villarini B, Rodell R, Martin P, Han L, Donaldson I, Ahmed HU, Moore CM, Emberton M, Barratt DC. Technical Note: Error metrics for estimating the accuracy of needle/instrument placement during transperineal magnetic resonance/ultrasound-guided prostate interventions. Med Phys. 2018 Apr;45(4):1408-1414. doi: 10.1002/mp.12814. Epub 2018 Mar 9.
citation: Orczyk C, Barratt D, Brew-Graves C, Peng Hu Y, Freeman A, McCartan N, Potyka I, Ramachandran N, Rodell R, Williams NR, Emberton M, Ahmed HU. Prostate Radiofrequency Focal Ablation (ProRAFT) Trial: A Prospective Development Study Evaluating a Bipolar Radiofrequency Device to Treat Prostate Cancer. J Urol. 2021 Apr;205(4):1090-1099. doi: 10.1097/JU.0000000000001567. Epub 2020 Dec 14.
citation: Simmons LAM, Kanthabalan A, Arya M, Briggs T, Barratt D, Charman SC, Freeman A, Gelister J, Hawkes D, Hu Y, Jameson C, McCartan N, Moore CM, Punwani S, Ramachandran N, van der Meulen J, Emberton M, Ahmed HU. The PICTURE study: diagnostic accuracy of multiparametric MRI in men requiring a repeat prostate biopsy. Br J Cancer. 2017 Apr 25;116(9):1159-1165. doi: 10.1038/bjc.2017.57. Epub 2017 Mar 28.
citation: Bianco FJ, Martinez-Salamanca JI. Focalyx Dx, Bx, Tx et Apps: A novel contemporary fusion paradigm for the management of prostate cancer. Arch Esp Urol. 2016 Jul;69(6):353-63.
citation: Linares-Espinos E, Carneiro A, Martinez-Salamanca JI, Bianco F, Castro-Alfaro A, Cathelineau X, Valerio M, Sanchez-Salas R. New technologies and techniques for prostate cancer focal therapy. Minerva Urol Nefrol. 2018 Jun;70(3):252-263. doi: 10.23736/S0393-2249.18.03094-1. Epub 2018 Apr 16.
citation: Gross MD, Sedrakyan A, Bianco FJ, Carroll PR, Daskivich TJ, Eggener SE, Ehdaie B, Fisher B, Gorin MA, Hunt B, Jiang H, Klein EA, Marinac-Dabic D, Montgomery JS, Polascik TJ, Priester AM, Rastinehad AR, Viviano CJ, Wysock JS, Hu JC. SPARED Collaboration: Patient Selection for Partial Gland Ablation in Men with Localized Prostate Cancer. J Urol. 2019 Nov;202(5):952-958. doi: 10.1097/JU.0000000000000357. Epub 2019 Oct 9.
citation: Reis LO, Andrade DL, Bianco FJ Jr. Super active surveillance for low-risk prostate cancer | Opinion: Yes. Int Braz J Urol. 2019 Mar-Apr;45(2):210-214. doi: 10.1590/S1677-5538.IBJU.2019.02.02. No abstract available.
citation: Ahdoot M, Lebastchi AH, Turkbey B, Wood B, Pinto PA. Contemporary treatments in prostate cancer focal therapy. Curr Opin Oncol. 2019 May;31(3):200-206. doi: 10.1097/CCO.0000000000000515.
citation: Lodeizen O, de Bruin M, Eggener S, Crouzet S, Ghai S, Varkarakis I, Katz A, Dominguez-Escrig JL, Pahernik S, de Reijke T, de la Rosette J. Ablation energies for focal treatment of prostate cancer. World J Urol. 2019 Mar;37(3):409-418. doi: 10.1007/s00345-018-2364-x. Epub 2018 Jun 25.
citation: Lindner U, Lawrentschuk N, Trachtenberg J. Focal laser ablation for localized prostate cancer. J Endourol. 2010 May;24(5):791-7. doi: 10.1089/end.2009.0440.
citation: Chao B, Llukani E, Lepor H. Two-year Outcomes Following Focal Laser Ablation of Localized Prostate Cancer. Eur Urol Oncol. 2018 Jun;1(2):129-133. doi: 10.1016/j.euo.2018.03.011. Epub 2018 May 15.
citation: Oto A, Sethi I, Karczmar G, McNichols R, Ivancevic MK, Stadler WM, Watson S, Eggener S. MR imaging-guided focal laser ablation for prostate cancer: phase I trial. Radiology. 2013 Jun;267(3):932-40. doi: 10.1148/radiol.13121652. Epub 2013 Feb 25.