Trial Outcomes & Findings for MRI-Mapped Dose-Escalated Salvage Radiotherapy Post-Prostatectomy: The MAPS Trial (NCT NCT01411345)

NCT ID: NCT01411345

Last Updated: 2025-04-08

Results Overview

Prostate-Specific Antigen (PSA) response rate is defined as the percentage of study patients with PSA less than 0.1 ng/mL at 21 months after completion of study treatment.

Recruitment status

ACTIVE_NOT_RECRUITING

Study phase

NA

Target enrollment

37 participants

Primary outcome timeframe

Up to 23 months

Results posted on

2025-04-08

Participant Flow

Participant milestones

Participant milestones
Measure
Arm I: Standard Salvage Radiation Treatment (SSRT)
Patients will receive a total dose of 68 Gy will be delivered in 34 fractions to the Clinical Target Volume (CTV), 51 Gy in 34 fractions can be given to the pelvic nodes. this arm is closed Standard Salvage Radiation Treatment (SSRT): A total dose of 68 Gy delivered in 34 fractions to the Clinical Target Volume (CTV), 51 Gy in 34 fractions can be given to the pelvic nodes.
Arm II: Mapped Tumor Salvage RT (MTSRT)
Patients will receive the same treatment to the CTV of 68 Gy in 34 fractions and the Gross Tumor Volume (GTV) defined by functional imaging will receive 2.25 Gy per day for a total of 76.5 Gy (biological equivalent to 80 Gy in 2.0 Gy fractions assuming an α/β ratio of 3). this arm was continues as single arm phase 2 Mapped Tumor Salvage RT (MTSRT): Dose escalation to the imaging or Dynamic Contrast Enhanced MRI (DCE-MRI)-defined dominant region(s) by dose painting at 2.25 Gy per fraction, while the rest of the Clinical Target Volume (CTV) receives 2.0 Gy a fraction to 68 Gy. The mapped tumor (MT) boost region will receive an absolute dose of 76.5 Gy. Assuming an α/β ratio of 3.0, this would be equivalent to 80 Gy in 2.0 Gy fractions.
Overall Study
STARTED
15
22
Overall Study
COMPLETED
15
22
Overall Study
NOT COMPLETED
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

MRI-Mapped Dose-Escalated Salvage Radiotherapy Post-Prostatectomy: The MAPS Trial

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Arm I: Standard Salvage Radiation Treatment (SSRT)
n=15 Participants
Patients will receive a total dose of 68 Gy will be delivered in 34 fractions to the Clinical Target Volume (CTV), 51 Gy in 34 fractions can be given to the pelvic nodes. this arm is closed Standard Salvage Radiation Treatment (SSRT): A total dose of 68 Gy delivered in 34 fractions to the Clinical Target Volume (CTV), 51 Gy in 34 fractions can be given to the pelvic nodes.
Arm II: Mapped Tumor Salvage RT (MTSRT)
n=22 Participants
Patients will receive the same treatment to the CTV of 68 Gy in 34 fractions and the Gross Tumor Volume (GTV) defined by functional imaging will receive 2.25 Gy per day for a total of 76.5 Gy (biological equivalent to 80 Gy in 2.0 Gy fractions assuming an α/β ratio of 3). this arm was continues as single arm phase 2 Mapped Tumor Salvage RT (MTSRT): Dose escalation to the imaging or Dynamic Contrast Enhanced MRI (DCE-MRI)-defined dominant region(s) by dose painting at 2.25 Gy per fraction, while the rest of the Clinical Target Volume (CTV) receives 2.0 Gy a fraction to 68 Gy. The mapped tumor (MT) boost region will receive an absolute dose of 76.5 Gy. Assuming an α/β ratio of 3.0, this would be equivalent to 80 Gy in 2.0 Gy fractions.
Total
n=37 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Age, Categorical
Between 18 and 65 years
9 Participants
n=93 Participants
15 Participants
n=4 Participants
24 Participants
n=27 Participants
Age, Categorical
>=65 years
6 Participants
n=93 Participants
7 Participants
n=4 Participants
13 Participants
n=27 Participants
Sex: Female, Male
Female
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Sex: Female, Male
Male
15 Participants
n=93 Participants
22 Participants
n=4 Participants
37 Participants
n=27 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
4 Participants
n=93 Participants
8 Participants
n=4 Participants
12 Participants
n=27 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
11 Participants
n=93 Participants
14 Participants
n=4 Participants
25 Participants
n=27 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Race (NIH/OMB)
Asian
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Race (NIH/OMB)
Black or African American
2 Participants
n=93 Participants
4 Participants
n=4 Participants
6 Participants
n=27 Participants
Race (NIH/OMB)
White
13 Participants
n=93 Participants
18 Participants
n=4 Participants
31 Participants
n=27 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants

PRIMARY outcome

Timeframe: Up to 23 months

Population: Participants that completed a PSA evaluation at 21 months after completion of study treatment.

Prostate-Specific Antigen (PSA) response rate is defined as the percentage of study patients with PSA less than 0.1 ng/mL at 21 months after completion of study treatment.

Outcome measures

Outcome measures
Measure
Arm I: Standard Salvage Radiation Treatment (SSRT)
n=15 Participants
Patients will receive a total dose of 68 Gy will be delivered in 34 fractions to the Clinical Target Volume (CTV), 51 Gy in 34 fractions can be given to the pelvic nodes. this arm is closed Standard Salvage Radiation Treatment (SSRT): A total dose of 68 Gy delivered in 34 fractions to the Clinical Target Volume (CTV), 51 Gy in 34 fractions can be given to the pelvic nodes.
Arm II: Mapped Tumor Salvage RT (MTSRT)
n=20 Participants
Patients will receive the same treatment to the CTV of 68 Gy in 34 fractions and the Gross Tumor Volume (GTV) defined by functional imaging will receive 2.25 Gy per day for a total of 76.5 Gy (biological equivalent to 80 Gy in 2.0 Gy fractions assuming an α/β ratio of 3). this arm was continues as single arm phase 2 Mapped Tumor Salvage RT (MTSRT): Dose escalation to the imaging or Dynamic Contrast Enhanced MRI (DCE-MRI)-defined dominant region(s) by dose painting at 2.25 Gy per fraction, while the rest of the Clinical Target Volume (CTV) receives 2.0 Gy a fraction to 68 Gy. The mapped tumor (MT) boost region will receive an absolute dose of 76.5 Gy. Assuming an α/β ratio of 3.0, this would be equivalent to 80 Gy in 2.0 Gy fractions.
PSA Response Rate
66.6 percentage of participants
85 percentage of participants

SECONDARY outcome

Timeframe: Up to 8 months

Incidence of treatment-emergent toxicity in study participants. Toxicity is defined as adverse events (AEs), serious adverse events (SAEs) and dose-limiting toxicities (DLTs)Acute toxicity is defined as toxicity occurring during treatment and within three months of completing treatment. Late toxicity is toxicity occurring more than three months after treatment completion. Toxicity will be assessed using the NCI Common Terminology Criteria for Adverse Events (CTCAE) version 4.0

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Up to 65 months

Health-related Quality of Life (HRQOL) will be measured using the Expanded Prostate Cancer Index Composite and Medical Outcomes Study SF-12 (EPIC SF-12) to evaluate patient function and satisfaction after prostate cancer treatment. Response options for each item form a Likert scale, and multi-item scale scores are transformed linearly to a 0-100 scale, with higher scores representing better HRQOL.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Up to 65 months

Health-related quality of life (HRQOL) will be measured using the scores on the Modified 18-item Memorial Anxiety Scale for Prostate Cancer (MAX-PC) from pre-treatment to post-treatment. The scale consists of 18 items (e.g. "I thought about prostate cancer even though I didn't mean to.") scored on a scale from 0 ("not at all") to 3 ("often"). Total scores range from 0 to 54, with higher scores indicating higher levels of anxiety.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Up to 65 months

Health-related quality of life (HRQOL) will be measured using the International Prostate Symptom Score (IPSS) to evaluate patient urinary function and quality of life. There are 7 questions related to urinary function. Responses are on a scale from 0 ("not at all") to 5 ("almost always"), with higher scores indicating higher levels of urinary dysfunction. There is 1 quality of life question related to urinary symptoms. Responses are on a scale from 0 ("delighted") to 6 ("terrible").

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Up to 65 months

The cumulative incidence of biochemical or clinical failure allowing for competing risk as needed. Clinical failure is defined as at least a 25% increase in the size of the tumor relative to the smallest volume recorded, or new extension of tumor beyond the capsule, or re-extension of tumor beyond the capsule after initial regression, or urinary obstructive symptoms with carcinoma found at transurethral resection of the prostate (TURP). Biochemical failure is defined as PSA ≥ nadir + 2 ng/mL.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Up to 65 months

Rate of failure-free survival in study participants. Failure-free survival is defined as the elapsed time from start of radiotherapy to first documented evidence of biochemical or clinical failure or death from any cause, whichever occurs first. In the absence of any event defining failure, follow-up time will be censored at the date of last documented failure-free status.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Up to 65 months

Rate of overall survival in study participants. Overall survival is defined as the elapsed time from start of radiotherapy to death from any cause. For surviving patients, follow-up will be censored at the date of last contact.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Up to 65 months

The distribution and degree of expression of tissue biomarkers by ultrasound-directed biopsies for patients who choose to undergo the optional biopsies. Quantification of the amount of the biomarker specific immunohistochemical staining in the area of tumor.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: Up to 65 months

To determine the incidence and relationship of circulating DNA and tumor cells to tissue biomarkers and initial complete biochemical response.

Outcome measures

Outcome data not reported

Adverse Events

Arm I: Standard Salvage Radiation Treatment (SSRT)

Serious events: 0 serious events
Other events: 15 other events
Deaths: 1 deaths

Arm II: Mapped Tumor Salvage RT (MTSRT)

Serious events: 4 serious events
Other events: 21 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Arm I: Standard Salvage Radiation Treatment (SSRT)
n=15 participants at risk
Patients will receive a total dose of 68 Gy will be delivered in 34 fractions to the Clinical Target Volume (CTV), 51 Gy in 34 fractions can be given to the pelvic nodes. this arm is closed Standard Salvage Radiation Treatment (SSRT): A total dose of 68 Gy delivered in 34 fractions to the Clinical Target Volume (CTV), 51 Gy in 34 fractions can be given to the pelvic nodes.
Arm II: Mapped Tumor Salvage RT (MTSRT)
n=22 participants at risk
Patients will receive the same treatment to the CTV of 68 Gy in 34 fractions and the Gross Tumor Volume (GTV) defined by functional imaging will receive 2.25 Gy per day for a total of 76.5 Gy (biological equivalent to 80 Gy in 2.0 Gy fractions assuming an α/β ratio of 3). this arm was continues as single arm phase 2 Mapped Tumor Salvage RT (MTSRT): Dose escalation to the imaging or Dynamic Contrast Enhanced MRI (DCE-MRI)-defined dominant region(s) by dose painting at 2.25 Gy per fraction, while the rest of the Clinical Target Volume (CTV) receives 2.0 Gy a fraction to 68 Gy. The mapped tumor (MT) boost region will receive an absolute dose of 76.5 Gy. Assuming an α/β ratio of 3.0, this would be equivalent to 80 Gy in 2.0 Gy fractions.
Cardiac disorders
Cardiac Disorders, Other
0.00%
0/15 • 12 years
4.5%
1/22 • Number of events 1 • 12 years
Renal and urinary disorders
Hematuria
0.00%
0/15 • 12 years
4.5%
1/22 • Number of events 1 • 12 years
Cardiac disorders
Sick Sinus Syndrome
0.00%
0/15 • 12 years
4.5%
1/22 • Number of events 1 • 12 years
Cardiac disorders
Ventricular tachycardia
0.00%
0/15 • 12 years
4.5%
1/22 • Number of events 1 • 12 years

Other adverse events

Other adverse events
Measure
Arm I: Standard Salvage Radiation Treatment (SSRT)
n=15 participants at risk
Patients will receive a total dose of 68 Gy will be delivered in 34 fractions to the Clinical Target Volume (CTV), 51 Gy in 34 fractions can be given to the pelvic nodes. this arm is closed Standard Salvage Radiation Treatment (SSRT): A total dose of 68 Gy delivered in 34 fractions to the Clinical Target Volume (CTV), 51 Gy in 34 fractions can be given to the pelvic nodes.
Arm II: Mapped Tumor Salvage RT (MTSRT)
n=22 participants at risk
Patients will receive the same treatment to the CTV of 68 Gy in 34 fractions and the Gross Tumor Volume (GTV) defined by functional imaging will receive 2.25 Gy per day for a total of 76.5 Gy (biological equivalent to 80 Gy in 2.0 Gy fractions assuming an α/β ratio of 3). this arm was continues as single arm phase 2 Mapped Tumor Salvage RT (MTSRT): Dose escalation to the imaging or Dynamic Contrast Enhanced MRI (DCE-MRI)-defined dominant region(s) by dose painting at 2.25 Gy per fraction, while the rest of the Clinical Target Volume (CTV) receives 2.0 Gy a fraction to 68 Gy. The mapped tumor (MT) boost region will receive an absolute dose of 76.5 Gy. Assuming an α/β ratio of 3.0, this would be equivalent to 80 Gy in 2.0 Gy fractions.
Gastrointestinal disorders
Abdominal pain
0.00%
0/15 • 12 years
9.1%
2/22 • Number of events 2 • 12 years
Investigations
Alanine aminotransferase increased
0.00%
0/15 • 12 years
9.1%
2/22 • Number of events 4 • 12 years
Investigations
Alkaline phosphatase increased
0.00%
0/15 • 12 years
9.1%
2/22 • Number of events 2 • 12 years
Gastrointestinal disorders
Anal hemorrhage
0.00%
0/15 • 12 years
9.1%
2/22 • Number of events 3 • 12 years
Gastrointestinal disorders
Anal pain
6.7%
1/15 • Number of events 1 • 12 years
0.00%
0/22 • 12 years
Blood and lymphatic system disorders
Anemia
0.00%
0/15 • 12 years
9.1%
2/22 • Number of events 2 • 12 years
Musculoskeletal and connective tissue disorders
Arthralgia
0.00%
0/15 • 12 years
4.5%
1/22 • Number of events 1 • 12 years
Investigations
Aspartate aminotransferase increased
0.00%
0/15 • 12 years
9.1%
2/22 • Number of events 4 • 12 years
Musculoskeletal and connective tissue disorders
Back pain
0.00%
0/15 • 12 years
4.5%
1/22 • Number of events 1 • 12 years
Gastrointestinal disorders
Bloating
0.00%
0/15 • 12 years
4.5%
1/22 • Number of events 1 • 12 years
Musculoskeletal and connective tissue disorders
Bone pain
0.00%
0/15 • 12 years
4.5%
1/22 • Number of events 1 • 12 years
Cardiac disorders
Cardiac disorders - Other
6.7%
1/15 • Number of events 1 • 12 years
0.00%
0/22 • 12 years
General disorders
Chills
0.00%
0/15 • 12 years
4.5%
1/22 • Number of events 1 • 12 years
Gastrointestinal disorders
Constipation
6.7%
1/15 • Number of events 1 • 12 years
9.1%
2/22 • Number of events 2 • 12 years
Investigations
Creatinine increased
0.00%
0/15 • 12 years
4.5%
1/22 • Number of events 1 • 12 years
Renal and urinary disorders
Cystitis noninfective
20.0%
3/15 • Number of events 3 • 12 years
45.5%
10/22 • Number of events 16 • 12 years
Psychiatric disorders
Depression
6.7%
1/15 • Number of events 2 • 12 years
0.00%
0/22 • 12 years
Injury, poisoning and procedural complications
Dermatitis radiation
0.00%
0/15 • 12 years
4.5%
1/22 • Number of events 1 • 12 years
Gastrointestinal disorders
Diarrhea
40.0%
6/15 • Number of events 7 • 12 years
22.7%
5/22 • Number of events 5 • 12 years
Nervous system disorders
Dizziness
6.7%
1/15 • Number of events 1 • 12 years
4.5%
1/22 • Number of events 1 • 12 years
Nervous system disorders
Dysgeusia
0.00%
0/15 • 12 years
4.5%
1/22 • Number of events 1 • 12 years
Reproductive system and breast disorders
Ejaculation disorder
0.00%
0/15 • 12 years
4.5%
1/22 • Number of events 1 • 12 years
Reproductive system and breast disorders
Erectile dysfunction
0.00%
0/15 • 12 years
13.6%
3/22 • Number of events 3 • 12 years
General disorders
Fatigue
86.7%
13/15 • Number of events 16 • 12 years
59.1%
13/22 • Number of events 16 • 12 years
Reproductive system and breast disorders
Gynecomastia
0.00%
0/15 • 12 years
4.5%
1/22 • Number of events 1 • 12 years
Nervous system disorders
Headache
6.7%
1/15 • Number of events 1 • 12 years
9.1%
2/22 • Number of events 3 • 12 years
Renal and urinary disorders
Hematuria
33.3%
5/15 • Number of events 8 • 12 years
45.5%
10/22 • Number of events 20 • 12 years
Gastrointestinal disorders
Hemorrhoids
0.00%
0/15 • 12 years
4.5%
1/22 • Number of events 2 • 12 years
Vascular disorders
Hot flashes
13.3%
2/15 • Number of events 2 • 12 years
31.8%
7/22 • Number of events 7 • 12 years
Vascular disorders
Hypertension
6.7%
1/15 • Number of events 1 • 12 years
0.00%
0/22 • 12 years
Investigations
Investigations - Other
0.00%
0/15 • 12 years
4.5%
1/22 • Number of events 1 • 12 years
Psychiatric disorders
Libido decreased
0.00%
0/15 • 12 years
4.5%
1/22 • Number of events 1 • 12 years
Investigations
Lymphocyte count decreased
0.00%
0/15 • 12 years
4.5%
1/22 • Number of events 2 • 12 years
Musculoskeletal and connective tissue disorders
Myalgia
0.00%
0/15 • 12 years
9.1%
2/22 • Number of events 2 • 12 years
Cardiac disorders
Myocardial infarction
0.00%
0/15 • 12 years
4.5%
1/22 • Number of events 1 • 12 years
Gastrointestinal disorders
Nausea
26.7%
4/15 • Number of events 5 • 12 years
18.2%
4/22 • Number of events 5 • 12 years
Musculoskeletal and connective tissue disorders
Neck pain
0.00%
0/15 • 12 years
4.5%
1/22 • Number of events 1 • 12 years
General disorders
Pain
6.7%
1/15 • Number of events 1 • 12 years
0.00%
0/22 • 12 years
Infections and infestations
Penile infection
0.00%
0/15 • 12 years
4.5%
1/22 • Number of events 2 • 12 years
Reproductive system and breast disorders
Penile pain
13.3%
2/15 • Number of events 2 • 12 years
4.5%
1/22 • Number of events 1 • 12 years
Nervous system disorders
Peripheral sensory neuropathy
0.00%
0/15 • 12 years
4.5%
1/22 • Number of events 1 • 12 years
Investigations
Platelet count decreased
0.00%
0/15 • 12 years
4.5%
1/22 • Number of events 1 • 12 years
Gastrointestinal disorders
Proctitis
6.7%
1/15 • Number of events 1 • 12 years
0.00%
0/22 • 12 years
Gastrointestinal disorders
Rectal hemorrhage
0.00%
0/15 • 12 years
4.5%
1/22 • Number of events 1 • 12 years
Gastrointestinal disorders
Rectal pain
6.7%
1/15 • Number of events 1 • 12 years
0.00%
0/22 • 12 years
Cardiac disorders
Sick sinus syndrome
0.00%
0/15 • 12 years
4.5%
1/22 • Number of events 1 • 12 years
Skin and subcutaneous tissue disorders
Skin and subcutaneous tissue disorders - Other
0.00%
0/15 • 12 years
4.5%
1/22 • Number of events 1 • 12 years
Skin and subcutaneous tissue disorders
Skin hyperpigmentation
0.00%
0/15 • 12 years
4.5%
1/22 • Number of events 1 • 12 years
Infections and infestations
Skin infection
0.00%
0/15 • 12 years
4.5%
1/22 • Number of events 1 • 12 years
Reproductive system and breast disorders
Testicular disorder
20.0%
3/15 • Number of events 3 • 12 years
54.5%
12/22 • Number of events 13 • 12 years
Reproductive system and breast disorders
Testicular pain
6.7%
1/15 • Number of events 1 • 12 years
0.00%
0/22 • 12 years
Nervous system disorders
Transient ischemic attacks
0.00%
0/15 • 12 years
4.5%
1/22 • Number of events 1 • 12 years
Renal and urinary disorders
Urinary frequency
46.7%
7/15 • Number of events 12 • 12 years
31.8%
7/22 • Number of events 11 • 12 years
Renal and urinary disorders
Urinary incontinence
40.0%
6/15 • Number of events 8 • 12 years
36.4%
8/22 • Number of events 12 • 12 years
Renal and urinary disorders
Urinary retention
0.00%
0/15 • 12 years
9.1%
2/22 • Number of events 3 • 12 years
Renal and urinary disorders
Urinary tract infection
0.00%
0/15 • 12 years
4.5%
1/22 • Number of events 1 • 12 years
Renal and urinary disorders
Urinary tract obstruction
6.7%
1/15 • Number of events 2 • 12 years
9.1%
2/22 • Number of events 2 • 12 years
Renal and urinary disorders
Urinary tract pain
20.0%
3/15 • Number of events 4 • 12 years
0.00%
0/22 • 12 years
Cardiac disorders
Ventricular tachycardia
0.00%
0/15 • 12 years
4.5%
1/22 • Number of events 1 • 12 years
Investigations
Weight gain
6.7%
1/15 • Number of events 1 • 12 years
0.00%
0/22 • 12 years
Investigations
White blood cell decreased
0.00%
0/15 • 12 years
13.6%
3/22 • Number of events 6 • 12 years

Additional Information

Matthew Abramowitz MD

University of Miami

Phone: 305-243-4200

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place