Prostate Cancer Clinical Trial
Official title:
Magnetic Nanoparticle Thermoablation-Retention and Maintenance in the Prostate:A Phase 0 Study in Men
Men with early prostate cancer face a number of options which lie at the extremes of care.
On one hand, active surveillance involves monitoring the disease and on the other, immediate
treatment involves surgery or radiotherapy. The difference between these two strategies in
terms of reducing the chance of a man dying from his disease is small. Not only is the
benefit small, surgery or radiotherapy carry significant side-effects. These occur because
of damage to surrounding tissue resulting in incontinence of urine (1 in 5), erectile
dysfunction (1 in 2) and back-passage bleeding, diarrhoea or discomfort (1 in 10).
The investigators have been working on new forms of treatment that use heat, light or cold
to destroy tissue and minimise treatment-related harms. The investigators have not yet found
one that delivers the ideal treatment. The ideal treatment is one that can be done under
local anaesthetic, can effectively destroy areas of cancer, limit damage to surrounding
tissues, is repeatable, and adaptable to future discoveries such as molecular targeting of
cancer cells.
The investigators think magnetic thermoablation may be able to deliver on these ideal
attributes. Magnetic thermoablation involves injecting magnetic iron nanoparticles directly
into the cancer. When a magnetic field is applied close to them, these nanoparticles heat up
to very high temperatures that kill cells. Magnetic thermoablation does not use x-rays or
surgical incisions. The investigators have done a lot of the preclinical work already to
develop this type of treatment. The investigators now need to develop a system that can be
used to treat prostate cancer. However, before the investigators can do this, they need to
test whether the magnetic nanoparticles actually stay where they are injected. The
consequences of them moving to areas that they should not can be serious. First, the
nanoparticles could move away from the cancer which means the cancer will not be heated
effectively. Second, the nanoparticles could move to sensitive structures around the
prostate (back-passage, bladder, sphincter muscle controlling urine flow, nerves controlling
erections). If this happens, damage of those sensitive structures could occur leading to
side-effects.
The investigators propose a study to try and find out what happens to those nanoparticles.
The study will involve approaching men who are having their prostates removed by radical
surgery. If these patients agree to participate, the investigators will inject their
prostate with varying amounts of nanoparticles. The investigators will NOT heat them up. The
investigators will use special scans and, once they have had their surgery, to look at the
pathology specimens to see where the nanoparticles have gone. The actual nanoparticles are
not harmful but the process of injection can carry a small amount of harm. If the
nanoparticles stay where they are injected, the investigators will then be able to run
another study in which we treat men who have prostate cancer with magnetic thermoablation.
PRIMARY
1.1 To conduct a dose escalation safety trial of magnetic nanoparticles injected into the
prostates of men prior to cystoprostatectomy. 1.2 To conduct a dose escalation safety trial
of magnetic nanoparticles injected into the prostates of men prior to prostatectomy. 1.3 To
evaluate ex-vivo prostates with a special marker to determine the retention and distribution
of the magnetic nanoparticles in relation to the intended target area at time of injection
SECONDARY 2.1 To evaluate the anatomical distribution of magnetic nanoparticles compared
with injection site in prostate assessed by both Perls' staining and postoperative imaging
(MRI and CT) of the ex vivo tissue
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