REGULUS: MRI-guided Adaptive SABR for Liver Cancers

NCT ID: NCT07223307

Last Updated: 2025-10-31

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

NOT_YET_RECRUITING

Clinical Phase

PHASE2

Total Enrollment

62 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-12-31

Study Completion Date

2030-01-31

Brief Summary

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Single arm unblinded study of simulation-free MRI-guided SABR with adaptive replanning in one session for treatment of patients with liver cancers

Detailed Description

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Conditions

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Liver Cancer Intrahepatic Cholangiocarcinoma Liver Metastases HCC

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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MRI-guided Adaptive Stereotactic Ablative Body Radiotherapy (SABR)

Participants will receive a single fraction of MRI-guided adaptive stereotactic ablative body radiotherapy (SABR) using the MRIdian system. Treatment includes daily adaptive planning based on MRI to optimize dose delivery to the tumor and minimize dose to surrounding normal tissue. Eovist contrast is administered before treatment to enhance visualization. Patients perform an inspiratory breath hold during radiation delivery to minimize motion.

Group Type EXPERIMENTAL

MRI-guided adaptive stereotactic ablative body radiotherapy (SABR)

Intervention Type RADIATION

A single fraction of MRI-guided adaptive stereotactic ablative body radiotherapy (SABR) will be delivered using the MRIdian system. Treatment includes adaptive planning based on daily MRI imaging to update tumor and organ-at-risk contours and optimize the radiation dose. On the day of treatment, Eovist contrast is administered 20 minutes before therapy to enhance tumor visualization. Patients perform an inspiratory breath hold during radiation delivery to minimize motion. The total dose is 30-40 Gy delivered in one fraction using external beam techniques.

Interventions

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MRI-guided adaptive stereotactic ablative body radiotherapy (SABR)

A single fraction of MRI-guided adaptive stereotactic ablative body radiotherapy (SABR) will be delivered using the MRIdian system. Treatment includes adaptive planning based on daily MRI imaging to update tumor and organ-at-risk contours and optimize the radiation dose. On the day of treatment, Eovist contrast is administered 20 minutes before therapy to enhance tumor visualization. Patients perform an inspiratory breath hold during radiation delivery to minimize motion. The total dose is 30-40 Gy delivered in one fraction using external beam techniques.

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

* Histologically confirmed HCC, intrahepatic cholangiocarcinoma, or metastatic cancer. In the case of suspected HCC in patients with known cirrhosis, noninvasive criteria recommended by the European Association for the Study of Liver Diseases (lesion \> 1 cm with arterial phase hyperenhancement and venous phase washout) or LI-RADS score of 5 may be used
* ≥ 18 years old at time of study enrollment
* Child-Pugh A status
* Eastern Cooperative Oncology Group (ECOG) Performance Status of 0, 1, or 2
* Life Expectancy \> 6 months
* For women of childbearing potential or who are not postmenopausal (see Appendix F for Definition of Menopausal Status), a negative urine or serum pregnancy test must be done.
* Ability to understand and the willingness to provide written informed consent.
* Patients treated with prior liver-directed therapies with the exception of radioembolization are eligible for this study if they otherwise meet eligibility criteria

Exclusion Criteria

* Prior treatment with radioembolization
* Cytotoxic chemotherapy or investigational agent within 1 week of SABR
* Prior radiotherapy overlapping with study treatment site
* Female patients who are pregnant
* Contraindication to having an MRI scan or inability to tolerate MRI
* Presence of a pacemaker or other implanted cardiac device
* Direct tumor extension into the stomach, duodenum, small bowel or large bowel
* Patient unable to breath hold \> 15 seconds
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Viewray Inc.

INDUSTRY

Sponsor Role collaborator

Stanford University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Stanford University

Palo Alto, California, United States

Site Status

Countries

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United States

Central Contacts

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Eleanor Brown

Role: CONTACT

Phone: 650-497-8966

Email: [email protected]

Facility Contacts

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Eleanor Brown

Role: primary

Other Identifiers

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IRB-82587

Identifier Type: -

Identifier Source: org_study_id