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The aim of this study is to determine the optimal treatment conditions (WST11 dose and light energy dose) to achieve ablation in one lobe of the prostate and to evaluate the safety and quality of life of WST11 medicated Vascular-Targeted Photodynamic therapy (VTP) in men with localized prostate cancer.
This study is designed as a multicenter, phase I/II, prospective, open-labeled, single intravenous (IV) dose, clinical trial in patients with localized prostate cancer.
The study population will be men who have been offered curative therapy (radical prostatectomy; cryotherapy; brachytherapy; External Beam RadioTherapy (EBRT), and refused. Patients must have already had a previous biopsy showing a histologically proven carcinoma of the prostate. The identification and the location of the tumor will be done using both dynamic contrast Magnetic resonance Imaging (MRI) and biopsy.
Only unilateral treatment with WST11-medicated VTP will be performed during the study. Treatment will consist of a single, 10 minute, IV administration of WST11 at doses of 2mg/kg, 4 mg/kg or 6 mg/kg, followed by either light activation delivered through transperineal interstitial optical fibers for 20 minutes using 753 nm laser light at escalating fixed energy doses of 200 J/cm or 300 J/cm by escalating power at each energy to 167 mW/cm or 250 mW/cm respectively. A brachytherapy-like template is used for the placement of the transparent implant catheters which are positioned in the prostate under transrectal ultrasound image guidance. The illumination fiber(s) are then inserted into the implant catheters.
If the safety profile for a given WST11 and light dose is acceptable, additional patients may be treated with multiple fibers at that WST11 treatment dose.
For cases where the Month 6 biopsy is positive, the patient will be offered the opportunity to be retreated with WST11
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| WST11 (TOOKAD® Soluble) | Experimental | WST11-mediated-VTP The WST11-mediated VTP procedure will consist of a single, 10 min, IV administration of WST11 at doses of either 2mg/kg, 4 mg/kg or 6 mg/kg, followed by light activation delivered through one or more transperineal interstitial optical fibers using 753 nm laser light at escalating fixed energy doses |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| WST 11 -mediated -VTP | Drug | The WST11-mediated VTP procedure will consist of a single, 10 min, IV administration of WST11 at doses of either 2mg/kg, 4 mg/kg or 6 mg/kg, followed by light activation delivered through one or more transperineal interstitial optical fibers for 20 minutes using 753 nm laser light at escalating fixed energy doses of 200 J/cm and 300 J/cm, by escalating power at each energy to 167 mW/cm and 250 mW/cm, respectively. A brachytherapy-like template is used for the placement of the optical fiber(s) that are positioned in the prostate areas of interest under trans-rectal ultrasound image guidance. |
| Measure | Description | Time Frame |
|---|---|---|
| Prostate Biopsy | Arm/Group Title: WST 11(TOOKAD® Soluble) Arm/Group Description To define the study drug and light dosage combination to achieve negative biopsy in the treated lobe | Month 6 |
| Prostate Biopsies | Number of patients who had a negative biopsy at Month-6 | Month-6 |
| Measure | Description | Time Frame |
|---|---|---|
| Pharmacokinetic Parameters-Cmax | For each dose group, several pharmacokinetics parameters have been calculated. | T0, 5 min,10 min, 4 h, 8 h, post dose |
| Percentage of Prostatic Necrosis at Day 7 as Observed on the 7-Day MRI |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Samir Taneja, Professor | Department of Urology, New York University Cancer Institute | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| UCLA - Jonsson Comprehensive Cancer Center | Los Angeles | California | 90095 | United States | ||
| Midtown Urology & Midtown Urology Surgical Center |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27291652 | Result | Taneja SS, Bennett J, Coleman J, Grubb R, Andriole G, Reiter RE, Marks L, Azzouzi AR, Emberton M. Final Results of a Phase I/II Multicenter Trial of WST11 Vascular Targeted Photodynamic Therapy for Hemi-Ablation of the Prostate in Men with Unilateral Low Risk Prostate Cancer Performed in the United States. J Urol. 2016 Oct;196(4):1096-104. doi: 10.1016/j.juro.2016.05.113. Epub 2016 Jun 9. | |
| 25712310 |
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The data are available in case report form for each patient
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Thirty patients were included in the study by five different centers in the US. All 30 patients received the entire VTP procedure (first treatment phase).
Two of them discontinued the study prior to Month 12. Eight patients who had positive biopsies at Month 6 entered in the retreatment phase. Only 7 of them actually received retreatment.
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| ID | Title | Description |
|---|---|---|
| FG000 | WST 11(TOOKAD® Soluble) | WST 11-mediated-VTP WST 11 -mediated -VTP: The WST11-mediated VTP procedure will consist of a single, 10 min, IV administration of WST11 at doses of either 2mg/kg, 4 mg/kg or 6 mg/kg, followed by light activation delivered through one or more transperineal interstitial optical fibers for 20 minutes using 753 nm laser light at escalating fixed energy doses of 200 J/cm and 300 J/cm, by escalating power at each energy to 167 mW/cm and 250 mW/cm, respectively. A brachytherapy-like template is used for the placement of the optical fiber(s) that are positioned in the prostate areas of interest under trans-rectal ultrasound image guidance. |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| First Treatment |
|
| |||||||||||||||||||||
| Retreatment |
|
All 30 patients were males suffering from low risk prostate cancer.
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| ID | Title | Description |
|---|---|---|
| BG000 | WST 11(TOOKAD® Soluble) | WST 11-mediated-VTP WST 11 -mediated -VTP: The WST11-mediated VTP procedure will consist of a single, 10 min, IV administration of WST11 at doses of either 2mg/kg, 4 mg/kg or 6 mg/kg, followed by light activation delivered through one or more transperineal interstitial optical fibers for 20 minutes using 753 nm laser light at escalating fixed energy doses of 200 J/cm and 300 J/cm, by escalating power at each energy to 167 mW/cm and 250 mW/cm, respectively. A brachytherapy-like template is used for the placement of the optical fiber(s) that are positioned in the prostate areas of interest under trans-rectal ultrasound image guidance. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Prostate Biopsy | Arm/Group Title: WST 11(TOOKAD® Soluble) Arm/Group Description To define the study drug and light dosage combination to achieve negative biopsy in the treated lobe | Posted | Number | participants | Month 6 |
|
1 year
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | WST 11(TOOKAD® Soluble) | WST 11-mediated-VTP The WST11-mediated VTP procedure will consist of a single, 10 min, IV administration of WST11 at doses of either 2mg/kg, 4 mg/kg or 6 mg/kg, followed by light activation delivered through one or more transperineal interstitial optical fibers using 753 nm laser light at escalating fixed energy doses WST 11 -mediated -VTP: The WST11-mediated VTP procedure will consist of a single, 10 min, IV administration of WST11 at doses of either 2mg/kg, 4 mg/kg or 6 mg/kg, followed by light activation delivered through one or more transperineal interstitial optical fibers for 20 minutes using 753 nm laser light at escalating fixed energy doses of 200 J/cm and 300 J/cm, by escalating power at each energy to 167 mW/cm and 250 mW/cm, respectively. A brachytherapy-like template is used for the placement of the optical fiber(s) that are positioned in the prostate areas of interest under trans-rectal ultrasound image guidance. |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Gastrointestinal disorder | Gastrointestinal disorders | MedDRA (Unspecified) | Non-systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Bertrand Gaillac International Project Leader | STEBA Biotech | + 33 974197905 | b.gaillac@stebabiotech.com |
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| ID | Term |
|---|---|
| D011471 | Prostatic Neoplasms |
| D011469 | Prostatic Diseases |
| D005834 | Genital Neoplasms, Male |
| D014565 | Urogenital Neoplasms |
| D000091662 | Genital Diseases |
| D052801 | Male Urogenital Diseases |
| D009369 | Neoplasms |
| D009371 | Neoplasms by Site |
| D002277 | Carcinoma |
| ID | Term |
|---|---|
| D005832 | Genital Diseases, Male |
| D000091642 | Urogenital Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
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|
|
The adjusted prostate necrosis percentage was defined as follows:
The Day 7 necrosis percentage is the proportion, expressed in %, of Day 7 prostate necrosis volume by planimetry in the treated lobe compared with half the prostate volume by planimetry, considering the average between the baseline volume and Day 7 volume;
| Day 7 |
| International Index of Erectile Functions (IIEF) Results | The International Index of Erectile Functions questionnaire is 15 questions patients auto questionnaire. The results presented are those of the erectile function domain which comprise 6 questions. Possible scores range is 1 to 30 . Best score is 30, worst score is 1. | Month 1-Month 3- Month 6- Month 12 |
| International Prostate Symptom Score (IPSS) Results | The International Prostate Symptom Score (IPSS) is a 7 questions patients auto-questionnaire about urinary symptoms. the possible scores range are 0 to 35 . Best score is 0 worst score is 35 | Month 1, Month 3 , Month 6 , Month 12 |
| Pharmacokinetic Parameters-Tmax | For each dose group, several pharmacokinetics parameters have been calculated. | T0, 5 min,10 min, 4 h, 8 h, post dose |
| Pharmacokinetic Parameters -T1/2 | For each dose group, several pharmacokinetics parameters have been calculated. | T0, 5 min,10 min, 4 h, 8 h, post dose |
| Atlanta |
| Georgia |
| 30308 |
| United States |
| Washington University School of Medicine- Barnes-Jewish Hospital | St Louis | Missouri | 63110 | United States |
| NYU Urology Associates | New York | New York | 10016 | United States |
| Memorial Sloan-Kettering Cancer Center | New York | New York | 10021 | United States |
| Derived |
| Azzouzi AR, Barret E, Bennet J, Moore C, Taneja S, Muir G, Villers A, Coleman J, Allen C, Scherz A, Emberton M. TOOKAD(R) Soluble focal therapy: pooled analysis of three phase II studies assessing the minimally invasive ablation of localized prostate cancer. World J Urol. 2015 Jul;33(7):945-53. doi: 10.1007/s00345-015-1505-8. Epub 2015 Feb 25. |
|
| Participants |
|
| Age, Continuous | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
Number of patients with positives or négatives biopsies at the dose 4mg/Kg-200J/cm
| OG003 | All Doses/Energies | Number of patients with positives or négatives biopsies at all doses/energies |
|
|
| Primary | Prostate Biopsies | Number of patients who had a negative biopsy at Month-6 | Posted | Count of Participants | Participants | Month-6 |
|
|
|
| Secondary | Pharmacokinetic Parameters-Cmax | For each dose group, several pharmacokinetics parameters have been calculated. | Out of 30 patients treated in the study, 29 patients had pharmacokinetic data available. | Posted | Mean | Standard Deviation | ng/mL | T0, 5 min,10 min, 4 h, 8 h, post dose |
|
|
|
| Secondary | Percentage of Prostatic Necrosis at Day 7 as Observed on the 7-Day MRI | The adjusted prostate necrosis percentage was defined as follows: The Day 7 necrosis percentage is the proportion, expressed in %, of Day 7 prostate necrosis volume by planimetry in the treated lobe compared with half the prostate volume by planimetry, considering the average between the baseline volume and Day 7 volume; | Posted | Mean | Standard Deviation | percentage of prostatic necrosis | Day 7 |
|
|
|
| Secondary | International Index of Erectile Functions (IIEF) Results | The International Index of Erectile Functions questionnaire is 15 questions patients auto questionnaire. The results presented are those of the erectile function domain which comprise 6 questions. Possible scores range is 1 to 30 . Best score is 30, worst score is 1. | Posted | Mean | Standard Deviation | units on a scale | Month 1-Month 3- Month 6- Month 12 |
|
|
|
| Secondary | International Prostate Symptom Score (IPSS) Results | The International Prostate Symptom Score (IPSS) is a 7 questions patients auto-questionnaire about urinary symptoms. the possible scores range are 0 to 35 . Best score is 0 worst score is 35 | IPSS results | Posted | Mean | Standard Deviation | units on a scale | Month 1, Month 3 , Month 6 , Month 12 |
|
|
|
| Secondary | Pharmacokinetic Parameters-Tmax | For each dose group, several pharmacokinetics parameters have been calculated. | Out of 30 patients treated in the study, 29 patients had pharmacokinetic data available. | Posted | Mean | Standard Deviation | hours | T0, 5 min,10 min, 4 h, 8 h, post dose |
|
|
|
| Secondary | Pharmacokinetic Parameters -T1/2 | For each dose group, several pharmacokinetics parameters have been calculated. | Out of 30 patients treated in the study, 29 patients had pharmacokinetic data available. | Posted | Mean | Standard Deviation | hours | T0, 5 min,10 min, 4 h, 8 h, post dose |
|
|
|
| 0 |
| 30 |
| 25 |
| 30 |
| General disorders | General disorders | MedDRA (Unspecified) | Non-systematic Assessment |
|
| Injury, poisoning | Injury, poisoning and procedural complications | MedDRA (Unspecified) | Non-systematic Assessment |
|
| Investigations | Investigations | MedDRA (Unspecified) | Non-systematic Assessment |
|
| Musculoskeletal disorders | Musculoskeletal and connective tissue disorders | MedDRA (Unspecified) | Non-systematic Assessment |
|
| Nervous system disorders | Nervous system disorders | MedDRA (Unspecified) | Non-systematic Assessment |
|
| Renal and urinary disorders | Renal and urinary disorders | MedDRA (Unspecified) | Non-systematic Assessment |
|
| Reproductive system and breast disorders | Reproductive system and breast disorders | MedDRA (Unspecified) | Non-systematic Assessment |
|
| Respiratory, thoracic and mediastinal disorders | Respiratory, thoracic and mediastinal disorders | MedDRA (Unspecified) | Non-systematic Assessment |
|
| Skin disorders | Skin and subcutaneous tissue disorders | MedDRA (Unspecified) | Non-systematic Assessment |
|
| Vascular disorders | Vascular disorders | MedDRA (Unspecified) | Non-systematic Assessment |
|
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| D009375 | Neoplasms, Glandular and Epithelial |
| D009370 | Neoplasms by Histologic Type |
| Month 1 |
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| Month 3 |
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| Month 6 |
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| Month 12 |
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| Month 1 |
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| Month 3 |
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| Month 6 |
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| Month 12 |
|