Focal Radiation Therapy for the Treatment of Low or Intermediate-Risk Prostate Cancer

Prostate Adenocarcinoma Clinical Trial

Official title:

Focal Radiation Therapy (FRaT) Trial in Patients With Low/Intermediate-Risk Prostate Cancer

Clinical Trial Details — Status: Withdrawn

Administrative data

• NCT number: NCT04399824
• Other study ID #: 20-000051
• Secondary ID: NCI-2020-0146420
• Status: Withdrawn
• Phase: N/A
• Start date: April 3, 2020
• Est. completion date: April 3, 2020

Study information

• Verified date: November 2020
• Source: Jonsson Comprehensive Cancer Center
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This phase II trial studies how well focal radiation therapy with stereotactic body radiation therapy (SBRT) or high-dose rate (HDR) brachytherapy works in treating patients with low or intermediate-risk prostate cancer. Stereotactic body radiation therapy uses special equipment to position a patient and deliver radiation to tumors with high precision. This method may kill tumor cells with fewer doses over a shorter period and cause less damage to normal tissue. Brachytherapy, also known as internal radiation therapy, uses radioactive material placed directly into or near a tumor to kill tumor cells. HDR brachytherapy uses high doses of radiation to target these tumor cells. Giving focal radiation therapy with SBRT or HDR brachytherapy may target dominant tumor cells while sparing the reminder of the prostate or surrounding normal organs and ultimately reduce side effects while maintaining disease control.

Description:

PRIMARY OBJECTIVES:

I. Evaluate biochemical progression free survival (bPFS) using the Phoenix definition.

II. Changes in quality of life. IIa. Prostate-Quality of Life (PR-QOL). IIb. Expanded Prostate Cancer Index Composite (EPIC).

SECONDARY OBJECTIVES:

I. Prostate-specific antigen (PSA) response at 3, 6, 12, and 24 months. II. Clinical progression free survival. IIa. Including phoenix definition, local progression by Response Evaluation Criteria in Solid Tumors (RECIST), regional progression, distant metastasis, or death.

III. Distant metastasis free survival. IV. Development of castration-resistant disease. V. Overall survival.

OUTLINE: Patients are assigned to 1 of 2 arms.

ARM I: Patients undergo SBRT in 5 fractions over 14 days in the absence of disease progression or unacceptable toxicity.

ARM II: Patients undergo HDR brachytherapy on day 1 and a second fraction within 14 days in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up for 6 weeks, every 3 months for up to 24 months, every 6 months for up to 60 months, and then every 8-12 months until 120 months.

Recruitment information / eligibility

• Status: Withdrawn
• Enrollment: 0
• Est. completion date: April 3, 2020
• Est. primary completion date: April 3, 2020
• Accepts healthy volunteers: No
• Gender: Male
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Histologically confirmed diagnosis of prostate adenocarcinoma within 90 days prior to registration via systematic biopsy and with the following low/intermediate-risk features:

• cT1c - T2b

• PSA =< 15

• < 50% cores positive

• Gleason score (GS) =< 7 (3+4 and 4+3 included)

• Multiparametric magnetic resonance imaging (MRI) (mp-MRI) confirmed lesion(s) with only one lobe involvement of the prostate

• Unilateral disease on systematic biopsy

• No distant or locally advanced disease on standard staging exams as indicated

• Bone scan and abdominopelvic computed tomography (CT)/MRI OR

• Prostate specific membrane antigen (PSMA) positron emission tomography (PET)

• Eastern Cooperative Oncology Group (ECOG)/Zubrod performance status 0/1 within 60 days prior to enrollment

Exclusion Criteria:

• Gleason score >= 8

• Gross extracapsular extension

• Seminal vesicle invasion

• Radiographic nodal or distant metastatic disease

• Androgen deprivation therapy within 90 days of enrollment

• Lesion(s) comprising > 40% of total prostate volume

• Lesion < 0.5 cm from urethra

• Prior radical prostatectomy

• Prior radiotherapy to the pelvis

Related Conditions & MeSH terms

• Prostate Adenocarcinoma
• Prostatic Neoplasms
• Stage I Prostate Cancer American Joint Committee on Cancer (AJCC) v8
• Stage II Prostate Cancer AJCC v8
• Stage IIA Prostate Cancer AJCC v8
• Stage IIB Prostate Cancer AJCC v8
• Stage IIC Prostate Cancer AJCC v8

Intervention

Radiation:
• High-Dose Rate Brachytherapy
Undergo HDR brachytherapy

Other:
• Quality-of-Life Assessment
Ancillary studies
• Questionnaire Administration
Ancillary studies

Radiation:
• Stereotactic Body Radiation Therapy
Undergo SBRT

Locations

Country	Name	City	State
United States	UCLA / Jonsson Comprehensive Cancer Center	Los Angeles	California

Sponsors (1)

Lead Sponsor	Collaborator
Jonsson Comprehensive Cancer Center

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Biochemical progression free survival	Will be assessed using the Phoenix definition and obtained via Kaplan-Meier analysis to provide an overview of efficacy for focal radiation therapy.	At 5 years
Primary	Incidence of adverse events	Will be assessed using National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events version 5.0. Will be defined as the percentage of patients who encounter adverse events and calculated to indicate the toxicity level of focal radiation therapy.	Up to 120 months (10 years)
Primary	Change in quality of life	Will be assessed using Prostate-Quality of Life and Expanded Prostate Cancer Index Composite. The change of the two scores will be assessed via two-sided paired t-test.	Baseline up to 120 months
Secondary	Prostate-specific antigen (PSA) response	PSA response of each patient at 3, 6, 12, and 24 months will be collected and the PSA changes from baseline PSA to each time point will be evaluated via two-sided paired t-test.	At 3, 6, 12, and 24 months
Secondary	Clinical progression free survival		At 5 years
Secondary	Distant metastasis free survival	Will be obtained via Kaplan-Meier analysis to provide an overview of efficacy for focal radiation therapy.	At 5 years
Secondary	Development of castration-resistant disease	Defined as clinical/biochemical progression of prostate cancer with testosterone <40 ng/dl [nanograms (ng) per deciliter (dL)]	Up to 120 months (10 years)
Secondary	Overall survival	Will be obtained via Kaplan-Meier analysis to provide an overview of efficacy for focal radiation therapy.	At 5 years