Benign Prostatic Hyperplasia, Prostate Carcinoma
Conditions
Brief summary
This is a Phase II prospective clinical trial in which patients with prostate carcinoma and obstructive lower urinary tract symptoms electing for radiation therapy will undergo Prostatic Artery Embolization (PAE) prior to treatment. PAE will be administered by Interventional Radiology. Patients will be seen for follow-up at 6 weeks and 12 weeks following PAE after which they will start definitive radiotherapy. After completion of radiotherapy the patient will be seen at 12 weeks
Interventions
DEVICEMerit Medical Embospheres
Prostatic Artery Embolization will performed as an outpatient procedure in Interventional Radiology. Bilateral selective pelvic angiograms will be performed to localize the prostatic arteries. Cone-beam or 3D computed tomography (CT) will be performed prior to embolization, if technically feasible and necessary. Embolization will be performed using Merit Medical Embospheres.
RADIATIONRadiation Therapy
Patients will undergo standard of care definitive radiation therapy.
Sponsors
H. Lee Moffitt Cancer Center and Research Institute
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
MALE
Age
50 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Histologically or cytologically confirmed prostate adenocarcinoma in the very low or low or favorable intermediate risk risk stratification groups (i.e. Gleason Grade groups 1 and 2) who are eligible for and who select XRT as their cancer management method. * Ability to receive prostatic artery embolization within 6-12 weeks of definitive radiation therapy. * Ability to understand and the willingness to sign a written informed consent document * Prostate larger than 60 grams but less than 150 grams, as assessed by imaging scans * American Urologic Association (AUA) or International Prostate Symptom Score (IPSS) Score ≥ 15 * Normal organ and marrow function as defined in protocol
Exclusion criteria
* Patients with Gleason Grade Group 1 or 2 PCa who select active surveillance as their cancer management method. * Receiving androgen deprivation therapy (ADT) * Patients with unfavorable intermediate (Gleason Grade Group 3) or high risk localized PCa (Gleason Grade Groups 4 and 5) * Receiving any investigational agents for the explicit purpose of prostatic size reduction * Inability to receive prostatic artery embolization (PAE) within 6-12 weeks of definitive radiation therapy * Active urinary tract infection (UTI) * History of severe allergic reaction to intravenous contrast media (iodinated and gadolinium- based) or any agents used during the PAE; patient cannot be medicated against allergic reaction prior to PAE. * Active cystolithiasis or prostatitis * Inability to have multi-parametric magnetic resonance imaging (mpMRI) * Prior transurethral resection of the prostate (TURP) within 2 years * Prostate size greater than or equal to150 grams * Vulnerable subjects (e.g., inmates and developmentally delayed adults) who are subjects for whom the study may be unsafe or whose rights may be violated with enrollment.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in International Prostate Symptom Score | At screening, Day of PAE, and 6 weeks & 12 weeks after PAE | Participants will take quality of life questionnaires including the International Prostate Symptom Score (IPSS)questionnaire to determine changes in prostate symptoms. Questionnaire will be taken at screening, Day 0- day of prostatic artery embolization (PAE), and at 6 weeks and 12 weeks after PAE. The IPSS asks the patient to rate urinary symptoms on a scale of 0-5, 0 indicating the participant has not had a symptom at all, and 5 indicating the symptom "almost always". |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Prostate Volume Reduction after PAE | At 12 weeks | Prostate volume will be determined by MRI prior to PAE and at 12 weeks post PAE to determine changes in volume. |
| Change in American Urologic Association Score | At 18 weeks | Participants will take quality of life questionnaires including the American Urologic Association (AUA) test to assess genitourinary toxicity after PAE and radiation therapy. The AUA questionnaire asks the patient to rate urinary symptoms on a scale of 0-5, 0 indicating indicating the participant has not had a symptom at all, and 5 indicating the symptom "almost always". |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORNainesh S Parikh, MD, MBA
Moffitt Cancer Center
Outcome results
None listed