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Safety Study of MRI-guided Transurethral Ultrasound Ablation of Prostate Tissue to Treat Localized Prostate Cancer

Not Applicable
Completed
Conditions
Prostate Cancer
Interventions
Device: MR-Guided Transurethral US Ablation of Prostate Tissue
Registration Number
NCT01686958
Lead Sponsor
Profound Medical Inc.
Brief Summary

This study is to evaluate that the magnetic resonance imaging (MRI)-guided transurethral ultrasound therapy system is safe and feasible to ablate prostate tissue in men with localized prostate cancer.

Detailed Description

Profound Medical Inc. has developed a novel technology called the MRI-guided transurethral ultrasound therapy system. The technology is developed for patients with organ confined prostate cancer. The therapeutic endpoint of this technology is thermal coagulation of prostate tissue.

The treatment is conducted completely within an MRI suite, which enables real-time temperature images of the heated region to be acquired as the ultrasonic treatment is delivered. Using MRI thermometry during treatment, dynamic temperature feedback control over the intensity of the ultrasound beams and rotation of the Ultrasound Applicator can shape the pattern of thermal coagulation accurately and precisely in the prostate gland, thereby reducing the risk of possible damage to important surrounding anatomy such as the rectum, urinary sphincters, neurovascular bundles and pelvic bone. This coagulation method, therefore, has the potential to have lower complication rates than conventional therapies.

Recruitment & Eligibility

Status
COMPLETED
Sex
Male
Target Recruitment
30
Inclusion Criteria
  • Male, age ≥65

  • Patient with low-risk, early-stage organ-confined prostate cancer (Stage T1c or T2a, N0, M0).

  • Gleason score 6 (3+3)

  • Prostate-specific antigen (PSA) ≤ 10 ng/ml

  • Eligible for MR imaging (DOC-10252)

  • Meets the following criteria on pre-treatment transrectal ultrasound imaging:

    1. No cysts or calcifications > 1.0 cm in size
    2. No evidence of extraprostatic extension or seminal vesicle invasion
    3. Overall prostate size less than 5 cm in sagittal length and less than 7 cm in diameter
  • Biopsy confirmed adenocarcinoma of the prostate, performed at least 6 weeks prior to and no more than 6 months prior to the scheduled treatment.

  • Eligible for General Anesthesia, as defined in American Society of Anesthesiologists (ASA)

  • Normal rectal anatomy and rectal mucosa on digital rectal examination

Exclusion Criteria
  • Bleeding disorder
  • Abnormal coagulation and current anticoagulant therapy.
  • Acute or chronic Urinary Tract Infection
  • Interest in future fertility
  • History of allergy relevant medication or other
  • History of any other malignancy other than skin cancer
  • Patients with peripheral arterial disease with intermittent claudication or Leriches Syndrome
  • Prior treatment of the prostate gland
  • Prior treatment with 5 alpha reductase inhibitor allowed (not as prostate cancer treatment or prevention) as long as drug has been stopped for minimum 3 months
  • History of any major rectal or pelvic surgery
  • History of ulcerative colitis or other chronic inflammatory conditions affecting rectum
  • History of documented clinical prostatitis requiring therapy within previous 6 months
  • History of urethral and bladder outlet disorders, including urethral stricture disease, urethral diverticulae, bladder neck contracture, urethral fistulae which had required prior urethrotomy, urethral stenting, urethroplasty or chronic indwelling urethral catheter
  • Patients with artificial urinary sphincter or any penile implant (metallic or non-metallic)
  • Neurologic bladder disorders
  • Untreated bladder stones
  • History of acute urinary retention
  • Confirmed or suspected bladder cancer
  • Urinary sphincter abnormalities
  • Active untreated gross hematuria for any cause
  • Post Void Residual (PVR) bladder volume > 250 mL
  • Obstructing median lobe enlarged out of proportion to the rest of the prostate and protruding significantly into the bladder

Additional exclusion criteria on file....

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
MR-Guided Transurethral US AblationMR-Guided Transurethral US Ablation of Prostate TissueMR-Guided Transurethral US Ablation of Prostate Tissue
Primary Outcome Measures
NameTimeMethod
Safety - Evaluate the Frequency of Treatment Related Adverse Events12 months from the Treatment Date

All reported adverse events were recorded. The frequency was measured as the number of study participants who experienced a treatment/device related adverse event after receiving treatment delivery with PAD-105, the investigational device.

Safety - Evaluate the Severity of Treatment Related Adverse Events12 months from the Treatment Date

Severity of treatment/device related adverse events were evaluated in accordance with the Common Terminology Criteria for Adverse Events (CTCAE) standard (version 4), published by the National Cancer Institute (NCI).

There was no intraoperative complication, no rectal injury or fistula and no severe urinary incontinence. No Grade 4 (G4) or higher adverse events and only one attributable Grade 3 (G3) event; reported below. The common and significant Grade 1 (G1) and Grade 2 (G2) genitourinary events have also been reported.

Secondary Outcome Measures
NameTimeMethod
Feasibility - Evaluate the Effectiveness of the Investigational System to Thermally Coagulate Prostate Tissue Conforming to the Target Volume With a High Degree of Accuracy and PrecisionOn Treatment Date

Conformal thermal coagulation of prostate tissue will be determined quantitatively using measures of targeting accuracy which compare the spatial difference between the target volume and target temperature isotherm determined from MR thermometry images acquired during treatment.

Trial Locations

Locations (3)

William Beaumont Hospital

🇺🇸

Royal Oak, Michigan, United States

London Health Science Centre

🇨🇦

London, Ontario, Canada

German Cancer Research Center (DKFZ)

🇩🇪

Heidelberg, Germany

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