Pilot Study of an Implantable Microdevice for Evaluating Drug Responses in Situ in Prostate Cancer

NCT ID: NCT04399876

Last Updated: 2023-12-14

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

ENROLLING_BY_INVITATION

Clinical Phase

PHASE1

Total Enrollment

35 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-06-22

Study Completion Date

2026-03-01

Brief Summary

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In this research study, is assessing the feasibility of using an MR-guided implantable microdevice to measure tumor response to chemotherapy and other clinically relevant drugs in participants that have prostate cancer and are scheduled for a radical prostatectomy.

The name of the study intervention involved in this study is:

\- Implantation of a MR-guided microdevice

Detailed Description

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This research study is assessing the feasibility and safety of implanting and retrieving a 'microdevice' that releases up to 20 drugs directly within the prostate cancer lesion as a possible tool to evaluate the effectiveness of several approved cancer drugs against prostate cancer.

Participants will be identified with confirmed prostate cancer whose treatment plan includes surgery as a component of standard-of-care treatment.

The name of the study intervention involved in this study is:

* Implantation of a MR-guided microdevice .
* It is expected that about 35 people will take part in this research study; 5 in the Ex Vivo Cohort and 30 in Surgery Cohort.

* Ex Vivo Cohort will undergo placement of microdevice in the prostate after its surgical removal.
* Surgery Cohort will undergo percutaneous placement of several microdevices in a selected tumor prior to surgery.

This research study is a Pilot Study, which is the first-time investigators are examining this study intervention. The FDA (the U.S. Food and Drug Administration) has not approved the implantation of the microdevice for this specific disease, but usage of this has been approved for other uses.

Conditions

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Prostate Cancer Radical Prostatectomy

Keywords

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Prostate Cancer Radical Prostatectomy

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Surgery Cohort

Participant eligibility for intervention and selection of lesion for device placement

\- Surgery Cohort will undergo percutaneous placement of several microdevices in a selected tumor(s) prior to surgery. The microdevice in the surgery cohort will dwell in the tumor tissue for approximately 48 hours to allow time for tissue effects of the drugs in the microdevice reservoirs.

Placement of at least 1, and up to 6, microdevices depending on the number of lesions, size and accessibility

* Extirpative surgery will proceed according to standard-of-care procedures. The microdevice(s) will be removed surgically along with surrounding tumor tissue.
* Standard of care treatment and follow-up of clinical course

Group Type EXPERIMENTAL

Microdevice

Intervention Type COMBINATION_PRODUCT

Surgery Cohort: Placement of 1-6 microdevices: Drugs chosen have all been FDA approved for the treatment of cancer (so therefore safe) and there are phase 2 or 3 data that the drug has efficacy in prostate cancer. Agents of interest included Abiraterone, Enzalutamide, Pembrolizumab, Ipilimumab, Carboplatin, Docetaxel, and Olaparib as well as combinations

Ex vivo Cohort: Placement of multiple microdevices with miniature drug reservoirs but no drug is loaded into the removed prostate

Ex-Vivo Cohort

Each participant will undergo a screening process to determine their eligibility for microdevice placement, consisting of the following items:

* Routine standard of care for radical prostatectomy.
* Placement of implantable microdevice with multiple miniature drug reservoirs but no drug in prostate that have been removed
* Ex vivo image guided removal using retrieval device
* Standard of Care Treatment and follow-up of clinical course

Group Type EXPERIMENTAL

Microdevice

Intervention Type COMBINATION_PRODUCT

Surgery Cohort: Placement of 1-6 microdevices: Drugs chosen have all been FDA approved for the treatment of cancer (so therefore safe) and there are phase 2 or 3 data that the drug has efficacy in prostate cancer. Agents of interest included Abiraterone, Enzalutamide, Pembrolizumab, Ipilimumab, Carboplatin, Docetaxel, and Olaparib as well as combinations

Ex vivo Cohort: Placement of multiple microdevices with miniature drug reservoirs but no drug is loaded into the removed prostate

Interventions

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Microdevice

Surgery Cohort: Placement of 1-6 microdevices: Drugs chosen have all been FDA approved for the treatment of cancer (so therefore safe) and there are phase 2 or 3 data that the drug has efficacy in prostate cancer. Agents of interest included Abiraterone, Enzalutamide, Pembrolizumab, Ipilimumab, Carboplatin, Docetaxel, and Olaparib as well as combinations

Ex vivo Cohort: Placement of multiple microdevices with miniature drug reservoirs but no drug is loaded into the removed prostate

Intervention Type COMBINATION_PRODUCT

Eligibility Criteria

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Inclusion Criteria

* Participants must have the ability to understand and the willingness to sign a written informed consent document.
* Planned radical prostatectomy for prostate cancer.
* Participants must be 22 years of age or older.

* Participants must have the ability to understand and the willingness to sign a written informed consent document.
* Patients must have the ability to understand and the willingness to sign a written informed consent document at the study site when both the investigator and participant are at the same location, or remotely (e.g., at the participant's home or another convenient venue) where the participant reviews the consent document with the Licensed Physician Investigator over secure Zoom. The electronic consent system, Adobe, ensures the participant electronically signing the informed consent is the subject who will be participating in the research study.
* Participants must present with prostate cancer falling into an intermediate or high risk category to include features: Gleason score 3+4 or higher, greater than 3 biopsy cores positive and ≥50% of 1 core positive for carcinoma, and an MRI-visible lesion concerning for PCa in the region of the positive biopsy.
* Participants must be 22 years of age or older.
* Participants must be evaluated by a urologic oncologist who will determine the clinically appropriate treatment strategy based on clinical history and extent of disease.
* Participants must be deemed medically stable to undergo both percutaneous procedures and standard-of-care surgical procedures by their treating surgeon.
* Participants must have undergone multi-parametric prostate MRI that both assesses the extent of disease and allows the research team to assess for study eligibility. This will have been done as part of the standard-of-care. Abnormal imaging will be correlated with the biopsy findings to maximize the likelihood of the device being put in the lesion. If the images are not adequate, the MRI scan will be repeated at BWH/DFCI, again as part of standard-of-care management.
* The participant's case must be reviewed by representatives of urologic oncology and interventional radiology to assess the following factors:

* Participant is clinically stable to undergo biopsy procedure(s) and surgical procedures.
* Participant has sufficient volume of disease as shown by MRI to allow implantation of the microdevice.
* A lesion can be selected where the microdevice is to be implanted that is a) amenable to percutaneous placement, and b) amenable to removal at the time of primary surgery
* Participants must be willing to undergo research-related genetic sequencing (somatic and germline) and data management, including the deposition of de-identified genetic sequencing data in NIH central data repositories.
* For men: agreement to refrain abstinent (refrain from heterosexual intercourse) or use contraceptive measures, and agreement to refrain from donating sperm during the treatment period and for 28 days after the last dose of ipatasertib.

Exclusion Criteria

Eligibility Criteria: Surgical Cohort


* Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit the safety of a biopsy and/or surgery.
* Uncorrectable bleeding or coagulation disorder known to cause increased risk with surgical or biopsy procedures.
Minimum Eligible Age

22 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

Brigham and Women's Hospital

OTHER

Sponsor Role lead

Responsible Party

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Oliver Jonas

Physician

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Adam S Kibel, MD

Role: PRINCIPAL_INVESTIGATOR

Brigham and Women's Hospital

Locations

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Brigham and Women's Hospital

Boston, Massachusetts, United States

Site Status

Countries

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United States

References

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Stone BV, Dominas CA, Bhagavatula SK, Ahn SW, Tatarova Z, Jakubik J, Matthew D, Mossanen M, Furtado D, Tuncali K, Hirsch MS, Hata N, Tempany C, Jonas O, Kibel AS. Novel Intraprostatic Magnetic Resonance-Guided Implantation of Multidrug-Eluting Microdevice for Testing of Systemic Therapy Agents In Situ: Proof of Concept in Intermediate-Risk and High-Risk Prostate Cancer. J Urol. 2025 Feb;213(2):173-182. doi: 10.1097/JU.0000000000004269. Epub 2024 Sep 30.

Reference Type DERIVED
PMID: 39348711 (View on PubMed)

Other Identifiers

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R01CA232174

Identifier Type: NIH

Identifier Source: secondary_id

View Link

19-599

Identifier Type: -

Identifier Source: org_study_id