MR Guided Focused Ultrasound Surgery of Metastatic Bone Tumors

NCT ID: NCT00350233

Last Updated: 2012-09-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1

Total Enrollment

10 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-05-31

Study Completion Date

2010-02-28

Brief Summary

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The objective of this trial is to evaluate the safety and effectiveness of MRgFUS in the treatment of metastatic bone tumors.

Detailed Description

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Bone is the third most common organ involved by metastasic disease behind lung and liver. In breast cancer, bone is the second most common site of metastatic spread, and 90% of patients dying of breast cancer have bone metastasis. Breast and prostate cancer metastasize to bone most frequently, which reflects the high incidence of both these tumors, as well as their prolonged clinical courses.

Post cancer survival has increased with improvement in early detection and treatments. As a consequence, the number of patients developing metastatic bone disease during their lifetime has also increased. Patients with bone metastasis from breast cancer have an average 2-year survival from the time of presentation with their first bone lesion. In patients who die from breast, prostate, and lung cancer, autopsy studies have shown that up to 85% have evidence of bone metastases at the time of death.

Current treatments for patients with bone metastases are primarily palliative and include localized therapies (radiation and surgery), systemic therapies (chemotherapy, hormonal therapy, radiopharmaceutical, and bisphosphanates), and analgesics (opioids and non-steroidal anti-inflammatory drugs). Recently, radiofrequency ablation has been tested as a treatment option for bone metastases. The main goals of these treatments are improvement of quality of life and functional level. These goals can be further described: 1) Pain relief, 2) Preservation and restoration of function, 3) Local tumor control, 4) Skeletal stabilization.

The study hypothesis is that MRgFUS is a safe and potentially effective non-invasive treatment for metastatic bone tumors with a low incidence of co-morbidity. Based on the result of this study the Sponsor will initiate a larger study in an effort to approve metastatic bone tumors as an indication for its MRgFUS ExAblate device.

Conditions

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Bone Metastases

Keywords

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Bone Tumors Bone Cancer Prostate Cancer lung cancer

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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ExAblate MRgFUS

Group Type EXPERIMENTAL

ExAblate 2000

Intervention Type DEVICE

Interventions

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ExAblate 2000

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1. Men and women age 18 and older
2. Patients who are able and willing to give consent and able to attend all study visits
3. Patients with histologically or cytologically confirmed malignant disease with a bone lesion that appears to be metastatic disease by clinical and or imaging techniques
4. Must have persistent pain from at least one site of bone metastases

* Patient with VAS pain score ≥ 4, when VAS test taken without medication, OR
* Patient taking pain-relieving medication for management of bone metastases.
5. Targeted tumor(s) are ExAblate device accessible
6. Targeted tumor(s) size is smaller than 8 cm in diameter
7. Patient whose lesion is on bone and is ≥ 10-mm from the skin.
8. Tumor(s) clearly visible by non-contrast MRI
9. Able to communicate sensations during the MRgFUS ExAblate treatment
10. At least 2 weeks since chemotherapy
11. At least 1 month since radiation therapy

Exclusion Criteria

1. Diffuse skeletal tumoral spread as evaluated by imaging.
2. Patients who need pre-treatment surgical stabilization of the affected bony structure.
3. Targeted tumor is in weight bearing bones or impending fracture
4. Targeted tumor is in the vertebral column.
5. Patients with unstable cardiac status including:

* Unstable angina pectoris on medication
* Patients with documented myocardial infarction within six months of protocol entry
* Congestive heart failure requiring medication (other than diuretic)
* Patients on anti-arrhythmic drugs
6. Severe hypertension (diastolic BP \> 100 on medication)
7. Patients with standard contraindications for MR imaging such as non-MRI compatible implanted metallic devices including cardiac pacemakers, size limitations (weight \>250 pounds), etc.
8. Known intolerance or allergies to the MRI contrast agent (e.g. Gadolinium or Magnevist)
9. ASA Score\>2 (See "Definitions" below)
10. Extensive scarring in an area in the path of energy planned passage to the treatment area
11. Severe cerebrovascular disease (multiple CVA or CVA within 6 months)
12. Patients on anti-coagulation therapy or those with an underlying bleeding disorder.
13. Individuals who are not able or willing to tolerate the required prolonged stationary position during treatment (approximately 3 hrs.)
14. Patient whose lesion is \< 10-mm from the skin
15. Patients with \< 2-Weeks since chemotherapy
16. Patient with \< 1-Month since radiation therapy
17. Patients with life expectancy \< 6-Months
18. Patients with surgical stabilization of tumor site with metallic hardware
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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InSightec

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Christine Chung, M.D.

Role: PRINCIPAL_INVESTIGATOR

University of California, San Diego

David Gianfelice, M.D.

Role: PRINCIPAL_INVESTIGATOR

Toronto General Hospital

Locations

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University of California at San Diego

La Jolla, California, United States

Site Status

Toronto General Hospital

Toronto, Ontario, Canada

Site Status

Countries

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United States Canada

Related Links

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Other Identifiers

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BM002

Identifier Type: -

Identifier Source: org_study_id