Prostate Resection After Microwave Ablation (PRAMA)
Status
RECRUITING
Phase
NA
Age
≥ 18 Years
Enrollments
15Conditions
Prostate CarcinomaSummary
This phase I trial tests the safety of magnetic resonance imaging (MRI)/ ultrasound (US) fusion guided transperineal targeted microwave ablation (TMA) before a radical prostatectomy (RP) and how well it works in treating patients with prostate cancer. Prostate cancer is the second most common cancer in men and most will never become aggressive. Despite this, most men choose to undergo treatment which may include surgery. Removing the prostate gland and sometimes the lymph nodes (radical prostatectomy) is an invasive treatment for prostate cancer that can have a significant negative on quality of life. TMA is a less invasive procedure that uses high temperatures given through the skin between the scrotum and the rectum (transperineal). Using focused high energy and heating tumor cells to several degrees above normal body temperature may kill them without affecting the surrounding tissue. Using multiparametric (mp)MRI/US to create a 3-dimensional picture of the tumor may help in planning and preventing damage to healthy tissue. Giving MRI/US fusion guided transperineal TMA prior to radical prostatectomy may kill tumor cells, and may improve the quality of life in patients with prostate cancer.
Detailed Description
PRIMARY OBJECTIVE:
I. To determine the feasibility of transperineal targeted microwave ablation of an MRI-identified index prostate cancer in patients undergoing radical prostatectomy.
SECONDARY OBJECTIVES:
I. KOELIS Trinity ability to plan and guide treatment needles and ablations in the prostate index lesion.
II. Impact of treatments on functional outcomes and quality of life. III. Predictability of Medwaves Avecure microwave ablation charts. IV. Predictability of post microwave ablation mpMRI.
OUTLINE:
Patients undergo MRI/US fusion guided transperineal targeted TMA and then undergo standard of care RP same day or at 30 days post-TMA on study. Patients undergo planning mpMRI of prostate prior to TMA. Patients also undergo blood sample collection at screening and post RP.
Locations
1 location Found with status Recruiting
Status
- RECRUITING
Contact Person
- Andre Luis Abreu
- 323-865-3000
- [email protected]
Principal Investigator
- Andre Luis Abreu, MD
Eligibility Criteria
Inclusion Criteria:
* Adult men diagnosed with prostate cancer and undergoing prostatectomy as treatment of choice
* Index lesion visible on multiparametric MRI confirmed by targeted biopsies using KOELIS Trinity (registered trademark)
* Patient suitable for intravenous (IV) sedation or general anesthesia and TMA
* Free, informed, and written consent, dated and signed before the enrollment and before any exam required by the trial
Exclusion Criteria:
* Past medical history of prostate surgery
* Past medical history of radiotherapy or pelvic trauma
* Past treatment for prostate cancer (PCa) (radiation, ablation, androgen deprivation therapy [ADT], chemotherapy)
Study Plan
Treatment (TMA, radical prostatectomy)
EXPERIMENTAL
Patients undergo MRI/US fusion guided transperineal targeted TMA and then undergo standard of care RP same day or at 30 days post-TMA on study. Patients may undergo planning mpMRI of prostate prior to TMA. Patients also undergo blood sample collection at screening and post RP.
PROCEDURE:
Biospecimen CollectionDescription:
Undergo blood sample collectionDEVICE:
Microwave AblationDescription:
Undergo transperineal MRI/US fusion guided transperineal targeted microwave ablationDEVICE:
Multiparametric Magnetic Resonance ImagingDescription:
Undergo planning mpMRI of prostateOTHER:
Questionnaire AdministrationDescription:
Ancillary studiesPROCEDURE:
Radical ProstatectomyDescription:
Undergo RP
Outcome Measures
Primary Outcome Measures
The area of the transperineal targeted microwave ablation (TMA) induced tissue death assessed by Triphenyltetrazolium chloride (TTC) staining
Secondary Outcome Measures
Incidence of adverse events
Duration of TMA procedure
Number of microwave ablations needed to ablate one multiparametric magnetic resonance imaging (mpMRI)-visible lesion
The area of the transperineal targeted microwave ablation (TMA) induced tissue death assessed by hematoxylin and eosin (H&E) staining.
Difference between the ablation location in the prostate as seen in the KOELIS 3-dimensional map and the ablation location observed histologically on the prostatectomy specimen
Change in urinary functions assessed by International Prostate Symptoms Score and uroflowmetry
Change in erectile functions assessed by International Index of Erectile Function-5 score
Change in quality of life assessed by Expanded Prostate Cancer Index Composite-26 Short Form
Difference between the treatment effect dimensions measured histologically on the prostatectomy specimen resected after TMA, compared to the predictive ablation charts provided by the manufacturer
Difference between the treatment effect dimensions measured histologically on the prostatectomy specimen resected one month after TMA, compared to post TMA dimensions measured on the pre-RP mpMRI
Timeline
Last Updated
December 7, 2023Start Date
November 13, 2023Today
January 23, 2025Completion Date ( Estimated )
November 10, 2025
Sponsors of this trial
Lead Sponsor
University of Southern CaliforniaCollaborating Sponsors
National Cancer Institute (NCI)
RECRUITING 
21 - 64 Years