A Multi-centre Trial on Targeted Microwave Ablation (TMA) for Localized Prostate Cancer

Prostate Cancer Clinical Trial

Official title:

A Multi-centre Trial on Targeted Microwave Ablation (TMA) for Localized Prostate Cancer Using Organ Based Tracking (OBT) Navigation

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT06262633
• Other study ID #: CRE-2023.079
• Status: Recruiting
• Phase: N/A
• Start date: March 15, 2024
• Est. completion date: June 30, 2026

Study information

• Verified date: March 2024
• Source: Chinese University of Hong Kong
• Contact: Peter Ka-Fung CHIU, PhD,MBChB
• Phone: 35052625
• Email: peterchiu[@]surgery.cuhk.edu.hk
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This study is to investigate the efficacy of Targeted Microwave Ablation (TMA) under MRI-Ultrasound fusion and organ-based tracking (OBT) navigation in localized prostate cancer (PCa) in a multi-centre trial.

Description:

This is a prospective multi-centre trial in 5 hospitals in 3 countries to investigate the efficacy and complications of targeted Microwave Ablation as a minimally invasive focal therapy for prostate cancer. Men aged 50-75 with PSA < 20ng/mL and clinically significant prostate cancer with 1-2 MRI lesions ≤15mm and ISUP grade group ≤3 will be recruited. Transperineal targeted Microwave Ablation of the prostate tumor(s) will be done with repeated ablations by a single microwave needle guided by MRI-Ultrasound fusion and organ-based tracking navigation. The primary outcome is any clinically significant prostate cancer detected on biopsy of treated area(s) per patient at 6 months.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 103
• Est. completion date: June 30, 2026
• Est. primary completion date: April 30, 2026
• Accepts healthy volunteers: No
• Gender: Male
• Age group: 45 Years to 75 Years

Eligibility

Inclusion Criteria:

1. Men aged between 45 - 75 years

2. Life expectancy > 10 years upon recruitment

3. Able to understand the trial and can provide informed and written consent, dated and signed before the enrollment and before any exam required by the trial

4. Localized low or intermediate risk prostate cancer diagnosed on MRI-Ultrasound fusion targeted biopsy

5. Organ-confined prostate cancer on MRI

6. PSA < 20 ng/mL

7. 1-2 MRI visible lesion present and size =15mm, with targeted biopsy showing:

• ISUP grade group 2 or 3, or
• ISUP grade group 1 with tumor size =10mm

Exclusion Criteria:

1. Patients not fit for general or spinal anaesthesia

2. Patients unfit for MRI exam or MR gadolinium contrast (e.g. estimated glomerular filtration rate (eGFR) of <50 ml/min)

3. Patients with coagulopathy that cannot be corrected

4. Patients on anticoagulants or antiplatelets that cannot be stopped (Low dose Aspirin, e.g. 80-100mg, is acceptable and no need to stop before or during TMA treatment)

5. Patients with previous treatment of prostate cancer

6. Patients with prior pelvic radiotherapy for prostate cancer or other cancer

7. Patients with maximal length of target lesion >15mm

8. Patients with MRI-visible or invisible lesion within 10mm from rectum or 10mm from sphincter on MRI

9. . Patients with >2 areas (MRI-visible or invisible) of prostate cancer

10. Patients with Gleason score 4+4 or any Gleason pattern 5 cancer

11. Patients with systematic cores showing any Gleason 4 pattern PCa which are not adjacent to the target lesions (1 core of pure Gleason 3 pattern PCa on systematic cores in contralateral lobe is acceptable)

12. Patients with definite cT3 or above disease on imaging (prostate capsular contact without definite extra-capsular extension is acceptable)

13. Patients with bladder pathology including bladder stone and bladder cancer

14. Patients with known urethral stricture

15. Patient with a suspected COVID-19 disease or an active SARS-CoV-2 infection.

Related Conditions & MeSH terms

• Prostate Cancer
• Prostatic Neoplasms

Intervention

Device:
• Targeted Microwave Ablation (TMA) for localized prostate cancer using organ based tracking (OBT) navigation
Targeted microwave ablation (TMA) is a novel treatment developed for focal treatment of prostate cancer, and it is applied with precise navigation guidance under the organ-based tracking (OBT) mechanism.

Locations

Country	Name	City	State
Hong Kong	Peter Ka-Fung CHIU	Sha Tin

Sponsors (1)

Lead Sponsor	Collaborator
Chinese University of Hong Kong

Country where clinical trial is conducted

Hong Kong, 

References & Publications (8)

Barry Delongchamps N, Schull A, Anract J, Abecassis JP, Zerbib M, Sibony M, Jilet L, Abdoul H, Goffin V, Peyromaure M. Feasibility and safety of targeted focal microwave ablation of the index tumor in patients with low to intermediate risk prostate cancer: Results of the FOSTINE trial. PLoS One. 2021 Jul 14;16(7):e0252040. doi: 10.1371/journal.pone.0252040. eCollection 2021. — View Citation

Chiu PK, Chan CH, Yee CH, Lau SY, Teoh JY, Wong HF, Lo KL, Yuen TY, Hung HY, Cho CC, Ng CF. Transperineal Targeted Microwave Ablation (TMA) of localized prostate cancer guided by MRI-Ultrasound fusion and organ-based tracking: a pilot study. Prostate Cancer Prostatic Dis. 2023 Dec;26(4):736-742. doi: 10.1038/s41391-022-00577-8. Epub 2022 Jul 14. — View Citation

Culp MB, Soerjomataram I, Efstathiou JA, Bray F, Jemal A. Recent Global Patterns in Prostate Cancer Incidence and Mortality Rates. Eur Urol. 2020 Jan;77(1):38-52. doi: 10.1016/j.eururo.2019.08.005. Epub 2019 Sep 5. — View Citation

Durand M, Barret E, Galiano M, Rozet F, Sanchez-Salas R, Ahallal Y, Macek P, Gaya JM, Cerruti J, Devilliers H, Loeffler J, Amiel J, Vallancien G, Cathelineau X. Focal cryoablation: a treatment option for unilateral low-risk prostate cancer. BJU Int. 2014 Jan;113(1):56-64. doi: 10.1111/bju.12370. Epub 2013 Oct 31. — View Citation

Rawla P. Epidemiology of Prostate Cancer. World J Oncol. 2019 Apr;10(2):63-89. doi: 10.14740/wjon1191. Epub 2019 Apr 20. — View Citation

Shah TT, Peters M, Eldred-Evans D, Miah S, Yap T, Faure-Walker NA, Hosking-Jervis F, Thomas B, Dudderidge T, Hindley RG, McCracken S, Greene D, Nigam R, Valerio M, Minhas S, Winkler M, Arya M, Ahmed HU. Early-Medium-Term Outcomes of Primary Focal Cryotherapy to Treat Nonmetastatic Clinically Significant Prostate Cancer from a Prospective Multicentre Registry. Eur Urol. 2019 Jul;76(1):98-105. doi: 10.1016/j.eururo.2018.12.030. Epub 2019 Jan 9. — View Citation

Stabile A, Orczyk C, Hosking-Jervis F, Giganti F, Arya M, Hindley RG, Dickinson L, Allen C, Punwani S, Jameson C, Freeman A, McCartan N, Montorsi F, Briganti A, Ahmed HU, Emberton M, Moore CM. Medium-term oncological outcomes in a large cohort of men treated with either focal or hemi-ablation using high-intensity focused ultrasonography for primary localized prostate cancer. BJU Int. 2019 Sep;124(3):431-440. doi: 10.1111/bju.14710. Epub 2019 Mar 18. — View Citation

Turkbey B, Rosenkrantz AB, Haider MA, Padhani AR, Villeirs G, Macura KJ, Tempany CM, Choyke PL, Cornud F, Margolis DJ, Thoeny HC, Verma S, Barentsz J, Weinreb JC. Prostate Imaging Reporting and Data System Version 2.1: 2019 Update of Prostate Imaging Reporting and Data System Version 2. Eur Urol. 2019 Sep;76(3):340-351. doi: 10.1016/j.eururo.2019.02.033. Epub 2019 Mar 18. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	The oncological control of prostate cancer	Any cancer detected on biopsy of each ablated area	At 6 months after treatment
Secondary	Cancer detection on biopsy of each ablated MRI visible lesion	Cancer detection on biopsy of each ablated MRI visible lesion	At 6 months after treatment
Secondary	Cancer detection on biopsy of each ablated MRI invisible lesion	Cancer detection on biopsy of each ablated MRI invisible lesion	At 6 months after treatment
Secondary	Gleason 4 or 5 cancer detected on biopsy of ablated area	The higher the Gleason score, the higher grade the prostate cancer	At 6 months after treatment
Secondary	Out-of-field recurrence: Any cancer outside treated area on systematic biopsy	Out-of-field recurrence: Any cancer outside treated area on systematic biopsy	At 6 months after treatment
Secondary	Common Terminology Criteria for Adverse Events (CTCAE) v5.0	Complications of treatment using Common Terminology Criteria for Adverse Events (CTCAE) v5.0	At 3 Month, 6 Month and 1 year
Secondary	PSA change	PSA change after treatment	At baseline, 3 Month and 6 Month and 12 Month
Secondary	Urinary Symptoms after treatment	Urinary symptoms measured by IPSS score, score ranging from 0-35 (the higher the worse)	At baseline, 3 Month, 6 Month and 12 Month
Secondary	Sexual side effects after treatment	Sexual side effects, up to 1 year, measured by IIEF-5 score (ranging from 1-25), the lower the worse	At baseline, 3 Month, 6 Month and 12 Month
Secondary	Continence side effects after treatment	Continence side effects, up to 1 year, measured by EPIC-26 questionnaire, the higher score the lower score the worse	At baseline, 3 Month, 6 Month and 12 Month
Secondary	Common Terminology Criteria for Adverse Events (CTCAE) rectal toxicity	Rectal toxicity of treatment using Common Terminology Criteria for Adverse Events	At baseline, 3 Month, 6 Month and 12 Month
Secondary	Quality of life measured by ED-5Q-5Lquestionnaire	Quality of life measured by ED-5Q-5L questionnaire, the higher the score the better in quality of life	At baseline, 3 Month, 6 Month and 12 Month
Secondary	Quality of life in patients with prostate cancer measured by EPIC-26	Quality of life in patients with prostate cancer measured by EPIC-26 range 0-100, the higher score the better the quality of life	At baseline, 3 Month, 6 Month and 12 Month
Secondary	Quality of life measured by QLQ-C30,	Quality of life measured by QLQ-C30, score 0-100, the higher the score the better in quality of life	At baseline, 3 Month, 6 Month and 12 Month