REDI-CaP(Recovery of Erectile Dysfunction Induced in Prostate Cancer Patients)
NCT ID: NCT07302451
Last Updated: 2025-12-24
Study Results
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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ACTIVE_NOT_RECRUITING
PHASE2
50 participants
INTERVENTIONAL
2025-12-01
2030-12-31
Brief Summary
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* How well and how quickly do patients recover their sexual function and overall quality of life after stopping hormone therapy and receiving radiotherapy?
* How do the details of the radiation treatment (like the dose and how it's delivered) relate to treatment success, side effects, and long-term outcomes such as cancer control, survival, and financial impact? Participants will receive hormonal therapy (Relugolix) following by radiotherapy. They will complete questionnaires on sexual function, quality of life, and financial impact before, during and after treatment, and attend follow-up visits for health assessments. The study will measure how many patients recover erectile function within six months of stopping hormonal therapy, how long recovery takes, how treatment doses relate to outcomes, and assess cancer control, side effects, quality of life, and survival.
Detailed Description
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* Achieving an IIEF5 score ≥ 17: This score indicates mild erectile dysfunction or no erectile dysfunction (as per IIEF5 categories: 22-25 no erectile dysfunction, 17-21 mild dysfunction). AND/OR;
* Significant increase in IIEF5 score compared to baseline: An increase of at least 5 points compared to the baseline (pre-treatment) IIEF5 score, indicating a clinically significant improvement in erectile function.
Recovery will only be evaluated in patients who had erectile dysfunction present (IIEF5 \< 22) at baseline. The study will be considered "successful" if the proportion of patients meeting the individual definition of "erectile function recovery" (as specified above) at 6 months after the completion of hormonal therapy is greater than or equal to 70% of the studied population.
The secondary endpoints of this study aim to provide a comprehensive understanding of both the functional and oncological outcomes following the cessation of hormonal therapy with Relugolix. One key endpoint is the time to sexual function recovery (SFRT), defined as the interval between hormonal therapy cessation and the point at which a patient achieves an IIEF-5 score of 8 or higher, maintained across two consecutive assessments. This threshold was selected to reflect a clinically meaningful level of erectile function recovery, particularly in patients with moderate to severe dysfunction at baseline, and aligns with established literature and the study's primary endpoint criteria. Recovery will be assessed by comparing post-treatment IIEF-5 scores with each patient's baseline value. Additionally, the study will investigate the correlation between erectile function recovery and radiation dose exposure to critical anatomical structures involved in sexual function, including the penile bulb, crura, internal pudendal arteries, periprostatic neurovascular bundles, and testes, aiming to identify dose-dependent effects on functional outcomes. Other secondary endpoints include biochemical progression-free survival (bPFS), measured according to the Phoenix criteria (nadir PSA + 2 ng/mL), as well as local control (time to local recurrence or last follow-up without recurrence) and distant progression-free survival (dPFS), defined as the time to detection of distant metastases. The study will also evaluate acute and late urinary and rectal toxicity, using the RTOG criteria and International Prostate Symptom Score (IPSS) to assess the genitourinary and gastrointestinal side effects of therapy. To gauge broader patient well-being, quality of life (QoL) will be monitored using validated tools including the EORTC QLQ-C30, EORTC PR25, and IIEF-5 questionnaires. Furthermore, the study incorporates a financial toxicity assessment using the PROFFIT questionnaire, which measures the economic burden of treatment from the patient's perspective. Lastly, overall survival (OS) will be tracked, defined as the time from treatment initiation to death from any cause or the date of last follow-up, thereby offering a complete view of treatment impact across survival, function, toxicity, and patient-reported outcomes.
Conditions
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Keywords
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Study Design
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NA
SINGLE_GROUP
TREATMENT
NONE
Study Groups
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Unfavorable Intermediate-Risk Prostate Cancer
This single arm study includes male patients over 18 years of age with histologically confirmed unfavorable intermediate-risk prostate cancer, defined as clinical stage T2b-T2c, PSA ≤ 20 ng/mL, Gleason score 7 (4+3), and ISUP grade 3. Participants must have a prostate volume \< 80 cc, preserved erectile function (IIEF-5 \> 8), ECOG performance status 0-1, and no evidence of capsular invasion or metastatic disease (based on multiparametric MRI, PSMA PET, CT with contrast, and bone scan).
Combined Androgen Deprivation Therapy with Relugolix and Image-Guided Stereotactic Body Radiotherapy (SBRT)
Participants will receive oral androgen deprivation therapy (ADT) with Relugolix (120 mg daily for 12 months) and stereotactic body radiotherapy (SBRT) via CyberKnife®. ADT includes a neoadjuvant phase (months 1-3), concurrent SBRT phase (month 4), and adjuvant phase (months 5-12). About 7-10 days before SBRT, 3-4 intraprostatic fiducial markers will be implanted. SBRT consists of 5 fractions of 7.25 Gy (total 36.25 Gy) delivered over two weeks. Planning involves contrast-enhanced CT, with defined CTV and PTV, and sparing of organs at risk. Treatment uses real-time image guidance and motion tracking. The regimen aims to optimize tumor control while minimizing toxicity. Patients are monitored using RTOG criteria, quality of life questionnaires, PSA/testosterone levels, and financial toxicity assessments over an 18-month follow-up.
Interventions
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Combined Androgen Deprivation Therapy with Relugolix and Image-Guided Stereotactic Body Radiotherapy (SBRT)
Participants will receive oral androgen deprivation therapy (ADT) with Relugolix (120 mg daily for 12 months) and stereotactic body radiotherapy (SBRT) via CyberKnife®. ADT includes a neoadjuvant phase (months 1-3), concurrent SBRT phase (month 4), and adjuvant phase (months 5-12). About 7-10 days before SBRT, 3-4 intraprostatic fiducial markers will be implanted. SBRT consists of 5 fractions of 7.25 Gy (total 36.25 Gy) delivered over two weeks. Planning involves contrast-enhanced CT, with defined CTV and PTV, and sparing of organs at risk. Treatment uses real-time image guidance and motion tracking. The regimen aims to optimize tumor control while minimizing toxicity. Patients are monitored using RTOG criteria, quality of life questionnaires, PSA/testosterone levels, and financial toxicity assessments over an 18-month follow-up.
Eligibility Criteria
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Inclusion Criteria
* Age \> 18 years;
* Diagnosis of prostate cancer via transperineal core biopsy;
* Classified as unfavorable intermediate-risk (T2b-2c, PSA ≤ 20 ng/mL, and Gleason score 7(4+3); ISUP grade 3);
* Signed informed consent for REDI-CaP protocol;
* Signed consent for REDI-CaP data processing;
* Prostate volume \< 80 cc;
* No evidence of prostate capsule invasion (documented by multiparametric MRI of the prostate);
* Performance status: 0-1;
* Negative total-body CT with contrast and bone scan for metastases;
* Negative PSMA PET for secondary lesions;
* IIEF-5 score: \> 8;
* Patient compliance with completing periodic questionnaires and attending regular follow-ups as required by the study.
Exclusion Criteria
* Exhibit erectile dysfunction at baseline (IIEF-5 score: \< 8);
* Show positive PSMA PET results for metastases or pelvic lymph nodes;
* Have capsular involvement documented by multiparametric prostate MRI;
* Have contraindications to radiotherapy and/or hormone therapy;
* Are unable to undergo MRI;
* Cannot adhere to periodic tests and follow-ups;
* Refuse or have contraindications to the implantation of intraprostatic fiducials.
18 Years
MALE
No
Sponsors
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National Cancer Institute, Naples
OTHER
Responsible Party
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Rossella Di Franco
MD
Locations
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Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale - Napoli
Napoli, , Italy
Countries
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Other Identifiers
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EUCT number: 2025-521170-33-00
Identifier Type: OTHER
Identifier Source: secondary_id
INT IRCCS Fondazione Pascale
Identifier Type: -
Identifier Source: org_study_id