SpaceIT Hydrogel System for Perirectal Spacing
Conditions
Prostate CancerSummary
To evaluate the safety and effectiveness of the SpaceIT™ Hydrogel System in patients undergoing External Beam Radiotherapy (EBRT) for the treatment of prostate cancer.
Detailed Description
HYDROSPACE study is a prospective, randomized, multicenter study to evaluate the safety and effectiveness of SpaceIT in patients undergoing External Beam Radiotherapy (EBRT) for the treatment of prostate cancer.
Subjects randomized to the investigational arm will receive SpaceIT Hydrogel System
Subjects randomized to the control arm will receive a commercially marketed Boston Scientific perirectal hydrogel spacer, SpaceOAR System or SpaceOAR Vue Hydrogel
Locations
1 location Found with status Recruiting
Status
- RECRUITING
Contact Person
- Marcio Fagundes, MD
Principal Investigator
- Brian Baumann, MD
Eligibility Criteria
Inclusion Criteria:
Subjects must meet the following criteria to be eligible for participation in the study:
1. Age ≥18 years old
2. Subjects must have had pathologically confirmed (by routine hematoxylin and eosin [H&E] staining) invasive adenocarcinoma of the prostate and planning to undergo EBRT
3. Subjects must meet ALL of the following:
1. Clinical stage T1-T2c (AJCC Ver. 8) tumor AND
2. Gleason Score 7 or less as determined from a biopsy taken within 12 months of the Baseline visit AND
3. Demonstrated blood prostate specific antigen (PSA) levels ≤20 ng/ml as measured within 6 months of the Baseline visit and prior to commencing androgen deprivation therapy (ADT)
4. Subject is able to provide written informed consent, approved by the appropriate Institutional Review Board/Ethics Committee/Research Ethics Board (IRB/EC/REB) of the respective clinical site
Exclusion Criteria:
1. Prostate > 80 cc
2. Subjects who are planning to undergo brachytherapy or focal boost
3. Subjects who have magnetic resonance imaging (MRI) evidence of gross posterior extracapsular extension (ECE) of the prostate cancer Note: MRI must be taken within 6 months prior to the Baseline visit
4. Subjects who have metastatic disease, other ongoing cancers which are being treated during the study or subjects for whom pelvic lymph node radiotherapy is planned
5. Subjects with any prior invasive solid tumor malignancy or hematologic malignancy (except non-melanomatous skin cancer) unless the subject has been disease free and treatment free for a minimum of 3 years
6. History of radical prostatectomy, other ablative anti-prostate cancer therapy (e.g., cryotherapy, high intensity focused ultrasound, irreversible electroporation) or previous pelvic irradiation (including prior prostate brachytherapy) at any time prior to screening
7. History of transurethral prostate surgery (e.g., Transurethral Needle Ablation (TUNA), Transurethral Microwave Therapy (TUMT), Transurethral Resection of the Prostate (TURP)) if performed within 1 year prior to screening
8. History of prior pelvic surgery requiring low anterior or abdominoperineal resections or rectal surgery
9. History of or current perirectal disease that may interfere with interpretation of study outcomes, including anal or perianal diseases such as fistula
10. Bleeding hemorrhoids requiring medical intervention within the prior three months
11. Diagnosed active bleeding disorder or a clinically significant coagulopathy, defined as PTT > 70s or aPTT>35s or INR > 1.4, or platelet count < 100,000 per mm3 Note: Subjects on anticoagulants may be included if the anticoagulant medication can be held for index procedure
12. Active inflammatory or infectious process involving the perineum, GI or urinary tract based on positive diagnosis or suspected diagnosis in the presence of fever >38⁰ C, WBC > 12,000/uL
13. Inability to undergo pelvic MRI or presence of implants causing severe artifact (e.g. bilateral arthroplasty) that interferes with imaging interpretation for this study at Investigator discretion
14. If a subject was enrolled in another investigational drug or device trial that had not completed the primary endpoint or that clinically interfered with this study
15. Unable to comply with the study requirements or follow-up schedule
16. Any condition the Investigator believed would interfere with the intent of the study or would make participation not in the best interest of the patient
17. Known PEG (polyethylene glycol) sensitivity or allergy
18. Known iodine sensitivity or allergy
Study Plan
SpaceIT Hydrogel System
EXPERIMENTAL
Subjects randomized to the investigational arm will undergo a hydrogel procedure with the SpaceIT investigational device.
DEVICE:
SpaceIT Hydrogel SystemDescription:
SpaceIT Hydrogel System is intended to temporarily position the anterior rectal wall away from the prostate during radiotherapy for prostate cancer and in creating this space it is the intent of SpaceIT Hydrogel System to reduce the radiation dose delivered to the anterior rectum. The SpaceIT Hydrogel System is composed of a radiopaque, biodegradable material designed to maintain space for approximately 12 weeks and be absorbed in about 6 months, sufficient time to support the intended use.nnSpaceIT has an iodinated PEG powder making it radiopaque.
Commercially available Boston Scientific Spacer
ACTIVE_COMPARATOR
Subjects randomized to the control arm will undergo a hydrogel procedure with the Boston Scientific commercially available SpaceOAR or SpaceOAR VUE device.
DEVICE:
Commercially available Boston Scientific SpacerDescription:
Boston Scientific's commercially available SpaceOAR Hydrogel System or SpaceOAR Vue Hydrogel System is intended to temporarily position the anterior rectal wall away from the prostate during radiotherapy for prostate cancer and in creating this space it is the intent of SpaceOAR Hydrogel System or SpaceOAR Vue Hydrogel System to reduce the radiation dose delivered to the anterior rectum. SpaceOAR and SpaceOAR Vue are both perirectal spacers. SpaceOAR Vue specifically has an iodinated PEG powder making it radiopaque. SpaceOAR does not contain iodinated PEG powder and is not radiopaque. The SpaceOAR Hydrogel System or SpaceOAR Vue Hydrogel System maintains space during prostate radiotherapy treatment and is completely absorbed by the patient's body over time.
Outcome Measures
Primary Outcome Measures
Primary Safety Endpoint - Acute Grade 3 or greater adverse events related to the hydrogel placement or hydrogel misplacement resulting in a delay or cancellation of radiotherapy
Primary Effectiveness Endpoint - 25% reduction in the volume of the rectum receiving 90% of the prescribed radiation dose
Secondary Outcome Measures
Additional Safety Endpoint - Adverse Device Effects (ADEs) requiring additional procedures and/or medications
Additional Safety Endpoint - Incidence of acute Grade 2 or greater gastrointestinal (GI) and genitourinary (GU) adverse events (AEs)
Additional Safety Endpoint - Incidence of late Grade 2 or greater GI and GU adverse events (AEs)
Additional Effectiveness Endpoint - Visualization of hydrogel
Additional Effectiveness Endpoint - Space Creation
Additional Effectiveness Endpoint - Absorption
Additional Effectiveness Endpoint - Change in radiation dose distributions to the organs at risk
Additional Effectiveness Endpoint - Mean and Maximum Rectal Radiation doses
Additional Effectiveness Endpoint - Quality of Life Questionnaire: EQ-5D-5L
Additional Effectiveness Endpoint - Ease of hydrogel administration
Additional Effectiveness Endpoint - Space Maintenance
Additional Effectiveness Endpoint - Quality of Life Questionnaire: Expanded Prostate Cancer Index Composite (EPIC-26)
Additional Effectiveness Endpoint - Quality of Life Questionnaire, Work Productivity and Activity Impairment Questionnaire: General Health (WPAI:GH)
Timeline
Last Updated
November 5, 2024Start Date
June 11, 2024Today
January 23, 2025Completion Date ( Estimated )
March 31, 2028
Sponsors of this trial
Lead Sponsor
Boston Scientific Corporation