A Study to Evaluate Hypofractionated Proton Therapy or IMRT for Recurrent, Oligometastatic Prostate Cancer

NCT ID: NCT04190446

Last Updated: 2025-11-26

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

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE2

Total Enrollment

84 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-01-06

Study Completion Date

2028-11-22

Brief Summary

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This phase II trial studies the side effects of radiation therapy (hypofractionated proton beam therapy or IMRT) for the treatment of prostate cancer that has come back (recurrent) or that has spread to a limited number of sites (oligometastatic) following primary localized treatment. Hypofractionated proton beam radiation therapy delivers smaller doses of radiation therapy over time and may kill more tumor cells and have fewer side effects. IMRT uses high energy x-rays to kill tumor cells and shrink tumors. This trial is being done to find out if a shorter course of radiation therapy is better with fewer side effects for patients with recurrent prostate cancer.

Detailed Description

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PRIMARY OBJECTIVE:

I. To assess late \>= grade 3 gastrointestinal (GI) and/or genitourinary (GU) toxicity of interest with the hypofractionated regimen with proton beam therapy or intensity-modulated radiation therapy (IMRT) (late defined as 3 to 24 months after protocol radiation therapy \[RT\]).

SECONDARY OBJECTIVES:

I. Late grade \>= 2 GI and/or GU toxicities of interest within 24 months after the protocol RT, using the Common Terminology Criteria for Adverse Events (CTCAE) version (v)4.0.

II. Acute grade \>= 3 GI and/or GU toxicities of interest during and within 3 months after the protocol RT, using the CTCAE v4.0.

III. Compare the rates of late \>= grade 3 GI and/or GU toxicity between the 2 treatment schedules.

OUTLINE: Patients are randomized to 1 of 2 arms.

ARM I: Patients undergo proton beam radiation therapy 5 days a week over 3 weeks. Patients undergo positron emission tomography (PET) scan, computed tomography (CT) scan, magnetic resonance imaging (MRI), and blood sample collection throughout the study.

ARM II: Patients undergo IMRT 5 days a week over 5 weeks. Patients undergo PET scan, CT scan, MRI, and blood sample collection throughout the study.

After completion of study, patients are followed up at 3-6, 12, 18, 24, 30, 36, 42, 48, 54, and 60 months.

Conditions

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Metastatic Prostate Adenocarcinoma Oligometastatic Prostate Carcinoma Prostate Adenocarcinoma Recurrent Prostate Carcinoma Stage IV Prostate Cancer AJCC v8

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Arm I (proton beam radiation therapy)

Patients undergo proton beam radiation therapy 5 days a week over 3 weeks. Patients undergo PET scan, CT scan, MRI, and blood sample collection throughout the study.

Group Type EXPERIMENTAL

Proton Beam Radiation Therapy

Intervention Type RADIATION

Undergo proton beam radiation therapy

Quality-of-Life Assessment

Intervention Type OTHER

Ancillary studies

Questionnaire Administration

Intervention Type OTHER

Ancillary studies

Computed Tomography

Intervention Type PROCEDURE

Undergo CT scan

Magnetic Resonance Imaging

Intervention Type PROCEDURE

Undergo MRI

Biospecimen Collection

Intervention Type PROCEDURE

Undergo blood sample collection

Arm II (IMRT)

Patients undergo IMRT 5 days a week over 5 weeks. Patients undergo PET scan, CT scan, MRI, and blood sample collection throughout the study.

Group Type EXPERIMENTAL

Intensity-Modulated Radiation Therapy

Intervention Type RADIATION

Undergo IMRT

Questionnaire Administration

Intervention Type OTHER

Ancillary studies

Computed Tomography

Intervention Type PROCEDURE

Undergo CT scan

Magnetic Resonance Imaging

Intervention Type PROCEDURE

Undergo MRI

Biospecimen Collection

Intervention Type PROCEDURE

Undergo blood sample collection

Interventions

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Intensity-Modulated Radiation Therapy

Undergo IMRT

Intervention Type RADIATION

Proton Beam Radiation Therapy

Undergo proton beam radiation therapy

Intervention Type RADIATION

Quality-of-Life Assessment

Ancillary studies

Intervention Type OTHER

Questionnaire Administration

Ancillary studies

Intervention Type OTHER

Computed Tomography

Undergo CT scan

Intervention Type PROCEDURE

Magnetic Resonance Imaging

Undergo MRI

Intervention Type PROCEDURE

Biospecimen Collection

Undergo blood sample collection

Intervention Type PROCEDURE

Other Intervention Names

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IMRT Intensity Modulated RT Intensity-Modulated Radiotherapy Radiation, Intensity-Modulated Radiotherapy PBRT Proton Proton EBRT Proton External Beam Radiotherapy Proton Radiation Therapy Radiation, Proton Beam External beam radiation therapy protons (procedure) emission tomography (procedure) positron emission tomography scan Positron-Emission Tomography proton magnetic resonance spectroscopic imaging PT Quality of Life Assessment CAT CAT Scan Computed Axial Tomography computerized axial tomography Computerized axial tomography (procedure) Computerized Tomography CT CT SCAN tomography Magnetic Resonance Magnetic resonance imaging (procedure) Magnetic Resonance Imaging Scan Medical Imaging Magnetic Resonance / Nuclear Magnetic Resonance MR MR Imaging MRI MRI Scan NMR Imaging NMRI nuclear magnetic resonance imaging Structural MRI sMRI Biological Sample Collection Biospecimen Collected Specimen Collection

Eligibility Criteria

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Inclusion Criteria

* Male; age \>= 18 years
* Histological confirmation of prostate adenocarcinoma
* Recurrent prostate cancer after prior receipt of primary radiotherapy to the prostate (can also include treatment of splenic vessels \[SVs\] and lymph nodes \[LNs\]) or salvage RT to the prostate fossa (can also include prior pelvic RT)
* Oligometastatic extent of disease

* Recurrent disease involving lymph nodes as diagnosed with choline positron emission tomography (PET)/computed tomography (CT) or other advanced PET imaging (prostate-specific membrane antigen \[PSMA\] or flucyclovine)
* Limited to pelvic and/or retroperitoneal/para-aortic lymph nodes
* Zubrod performance score (PS) =\< 1
* Signed informed consent

Exclusion Criteria

* Bone or visceral metastases present
* Lymph node metastases beyond the pelvis and/or retroperitoneum
* Contraindications to RT (e.g., uncontrolled inflammatory bowel disease)
* Contraindications to androgen suppression
* Concurrent antineoplastic agents (chemotherapy)
* Previous or concurrent malignancy other than non-melanoma skin cancer within 5 years of diagnosis of prostate cancer
* Inability to start the radiation portion of the protocol treatment within 6 months after study enrollment
* Medical or psychiatric conditions that preclude informed decision-making or compliance with the protocol treatment or follow-up
Minimum Eligible Age

18 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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Mayo Clinic

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Brian J. Davis, M.D.

Role: PRINCIPAL_INVESTIGATOR

Mayo Clinic in Rochester

Locations

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Mayo Clinic in Rochester

Rochester, Minnesota, United States

Site Status

Countries

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United States

Related Links

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Other Identifiers

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NCI-2019-07705

Identifier Type: REGISTRY

Identifier Source: secondary_id

MC1851

Identifier Type: OTHER

Identifier Source: secondary_id

19-000708

Identifier Type: OTHER

Identifier Source: secondary_id

MC1851

Identifier Type: -

Identifier Source: org_study_id

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