High Intensity Focused Ultrasound in Prostate Cancer

Trial Title: High Intensity Focused Ultrasound in Prostate Cancer

NCT ID: NCT06402357

Condition: Prostate Cancer

Conditions: Official terms:
Prostatic Neoplasms

Conditions: Keywords:
prostate cancer
high intensity focused ultrasound
focal therapy

Study type: Interventional

Study phase: Phase 2

Overall status: Not yet recruiting

Study design:

Allocation: N/A

Intervention model: Single Group Assignment

Primary purpose: Treatment

Masking: None (Open Label)

Intervention:

Intervention type: Device
Intervention name: Focal One high intensity focused ultrasound device
Description: Participants will be treated with one session of high intensity focused ultrasound using the Focal One device.
Arm group label: High Intensity Focused Ultrasound

Summary: This study will investigate the efficacy of focal high intensity focused ultrasound (HIFU) in patients with localized radiorecurrent prostate cancer. This study will also investigate the change in participant quality of life after HIFU therapy as compared to before HIFU therapy.

Detailed description: Focal therapy is increasingly popular due to its minimal side effect profile. Furthermore, HIFU has demonstrated favorable oncologic outcomes in well selected patients, including those with intermediate and high risk disease. In patients with radiorecurrent prostate cancer there remains a paucity of data on the value of focal therapy. Review of focal HIFU rather than whole gland HIFU is based on largely retrospective data and in an era where mpMRI and PSMA PET was not yet widely implemented thus not reflecting the current patient population seeking this care. In fact, and to the investigators' knowledge, only one study has prospectively evaluated focal HIFU therapy in radiorecurrent prostate cancer. Further evaluation into the value of focal HIFU in select men with localized radiorecurrent clinically significant prostate cancer is needed (clinically significant prostate cancer defined as GG2 or above. GG1 prostate cancer will not be considered clinically significant prostate cancer), both in terms of oncologic and functional outcomes as this patient population is increasing.

Criteria for eligibility:
Criteria:
Inclusion Criteria: - Males who are ≥ 18 years of age - Eastern Cooperative Oncology Group Performance Status of 0-3 - A history of prostate cancer treated with radiation therapy or proton beam therapy +/- hormone therapy - MRI or prostate-specific membrane antigen (PSMA) PET region of interest (ROI) - Biopsy proven clinically significant prostate cancer (GG2 or above) recurrence within or ipsilateral to the ROI lesion (within 6 months of the MRI/PET). - Contralateral grade group 1 (GG1) prostate cancer disease to the ROI - PSMA PET negative for metastatic disease (within 3 months of the biopsy) - Subjects must not have more than one active malignancy at the time of enrollment (Subjects with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen [as determined by the treating physician and approved by the PI] may be included). - Written informed consent obtained from the subject and the subject agrees to comply with all the study-related procedures. Exclusion Criteria: - Contraindication to high intensity focused ultrasound (latex allergy, absent rectum, prior rectal fistula or significant rectal surgery making insertion of transrectal probe non-feasible or dangerous.) - Hormone therapy within 6 months of the screening period (Hormone therapy includes oral (relugolix, abiraterone, enzalutamide, apalutamide, darolutamide, casodex) injections (firmagon, Lupron)) - History of Inflammatory Bowel Disease actively treated in last 3 years - Evidence of ≥ cT3 recurrent disease on imaging - Bilateral clinically significant prostate cancer (≥GG2 bilaterally) - GG1 prostate cancer at relapse biopsy (this will not be considered clinically significant prostate cancer) - History of brachytherapy seeds still implanted or other fiduciary marker which is near (same quadrant) as a planned treatment zone - Large Calcification on CT or transrectal ultrasound which, as per the review of the surgeon, limits or hinders a quality high intensity focused ultrasound to the region of interest - History of Urethral strictures - No prior radiation therapy for prostate cancer - Subjects without a ROI on MRI or PET - Metastatic disease or locally advanced disease (defined by pelvic lymph node involvement or T4 disease) on PSMA PET - History of any other disease, metabolic dysfunction, clinical examination finding, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates the use of protocol therapy or that might affect the interpretation of the results of the study or that puts the subject at high risk for treatment complications, in the opinion of the treating physician. - Prisoners or subjects who are involuntarily incarcerated, or subjects who are compulsorily detained for treatment of either a psychiatric or physical illness.

Gender: Male

Minimum age: 18 Years

Maximum age: N/A

Healthy volunteers: No

Locations:

Facility:
Name: University of Florida

Address:
City: Gainesville
Zip: 32608
Country: United States

Contact:
Last name: Casey Walsh

Phone: 352-265-9727
Email: CaseyWalsh@cancer.ufl.edu

Investigator:
Last name: Tarik Benidir, MD
Email: Principal Investigator

Start date: November 2024

Completion date: August 2029

Lead sponsor:
Agency: University of Florida
Agency class: Other

Collaborator:
Agency: EDAP-TMS Focal One
Agency class: Other

Source: University of Florida

Record processing date: ClinicalTrials.gov processed this data on November 12, 2024

Source: ClinicalTrials.gov page: https://clinicaltrials.gov/ct2/show/NCT06402357