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Interstitial Brachytherapy for the Treatment of Unresectable/Unablatable Kidney Cancer

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT04473781
Recruitment Status : Recruiting
First Posted : July 16, 2020
Last Update Posted : July 20, 2022
Sponsor:
Information provided by (Responsible Party):
Jonsson Comprehensive Cancer Center

Tracking Information
First Submitted Date  ICMJE July 13, 2020
First Posted Date  ICMJE July 16, 2020
Last Update Posted Date July 20, 2022
Actual Study Start Date  ICMJE July 16, 2020
Estimated Primary Completion Date June 30, 2023   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: July 13, 2020)
  • Dose limiting toxicity (DLT) [ Time Frame: From the first administration of study therapy up to 60 days ]
    A 3+3 safety lead-in phase will be employed in order to determine the DLT for interstitial renal brachytherapy. Grading of DLTs will follow the guidelines provided in the Common Terminology Criteria for Adverse Events version 5.0 criteria.
  • One year (12-month) linear growth rate [ Time Frame: At 1 year ]
    Adequate local control will be defined as minimal growth kinetics (=< 1 mm/year) on 1 year follow-up.
Original Primary Outcome Measures  ICMJE Same as current
Change History
Current Secondary Outcome Measures  ICMJE Not Provided
Original Secondary Outcome Measures  ICMJE Not Provided
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE Interstitial Brachytherapy for the Treatment of Unresectable/Unablatable Kidney Cancer
Official Title  ICMJE Prospective Study of Interstitial Brachytherapy for Unresectable/Unablatable T1b/T2a Renal Masses
Brief Summary This phase I/II trial investigates the side effects of interstitial brachytherapy and to see how well it works in limiting the growth of large kidney cancer masses in patients with kidney cancer that have refused or are unable to undergo surgery or ablation (unresectable/unablatable). Brachytherapy, also known as internal radiation therapy, temporarily introduces a radiation source into or near the tumor to eradicate the tumor cells. Giving brachytherapy may potentially reduce the size of the kidney cancer mass that would otherwise not be amenable to surgical management and translate into lower risk of spread.
Detailed Description

PRIMARY OBJECTIVES:

I. To determine the safety and feasibility of renal interstitial radiation therapy (interstitial brachytherapy). (Safety Lead-In) II. To evaluate local control of renal interstitial brachytherapy. (Expansion Phase)

SECONDARY OBJECTIVES:

I. To evaluate treatment response of the primary tumor. II. To evaluate 12 month distant progression free survival. III. To evaluate the 12 month volumetric growth of the primary tumor mass. IV. To determine biomarkers predicting response and resistance to radiation treatment.

OUTLINE:

Patients undergo interstitial brachytherapy for 1-2 fractions in the absence of disease progression or unacceptable toxicity. Patients who undergo 2 fractions may receive both fractions in the same day or on 2 separate days over 2 weeks.

After completion of study treatment, patients are followed up every 3 months for at least 3 years.

Study Type  ICMJE Interventional
Study Phase  ICMJE Phase 1
Phase 2
Study Design  ICMJE Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Condition  ICMJE
  • Stage I Renal Cell Cancer
  • Stage II Renal Cell Cancer
Intervention  ICMJE Procedure: Interstitial Radiation Therapy
Undergo interstitial brachytherapy
Other Names:
  • BRACHYTHERAPY, INTERSTITIAL
  • Implant Radiation
Study Arms  ICMJE Experimental: Treatment (interstitial brachytherapy)
Patients undergo interstitial brachytherapy for 1-2 fractions in the absence of disease progression or unacceptable toxicity. Patients who undergo 2 fractions may receive both fractions in the same day or on 2 separate days over 2 weeks.
Intervention: Procedure: Interstitial Radiation Therapy
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Recruiting
Estimated Enrollment  ICMJE
 (submitted: July 13, 2020)
17
Original Estimated Enrollment  ICMJE Same as current
Estimated Study Completion Date  ICMJE June 30, 2024
Estimated Primary Completion Date June 30, 2023   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  • Elected to undergo interstitial brachytherapy as part of conventional treatment for renal cell carcinoma
  • Biopsy proven renal cell carcinoma
  • No definitive evidence of locally advanced (nodal or tumor thrombus) or distant (metastatic) disease
  • Lesion size (maximal dimension) of 4 to 10 cm
  • Patient not a candidate for curative surgery (unwilling or unable to pursue surgery)
  • Lesion cannot be reliably treated with ablative techniques
  • Entire lesion able to be treated adequately by brachytherapy per radiation oncologist
  • Tumor predominantly solid (~ > 80%)
  • Lesion that has been observed for >= 6 months with demonstrable growth rate anticipated to be >= 4 mm/year by same imaging modality
  • Renal tumor that is amenable to percutaneous access for interstitial renal brachytherapy (Institutional Review Board [IRB])
  • Hemoglobin > 9
  • Absolute neutrophil count (ANC) >= 1500/uL (microliter)
  • Platelets >= 100,000/uL
  • Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =< 3.0 upper limit of normal (ULN)
  • Total bilirubin =< ULN
  • A competent immune system
  • Estimated glomerular filtration rate (eGFR) >= 30
  • Good performance status (Eastern Cooperative Oncology Group [ECOG]) < 2
  • Understanding and willingness to provide consent
  • No prior systemic treatment for kidney cancer
  • Women of childbearing potential must have negative pregnancy test at start of therapy

Exclusion Criteria:

  • Presence of an active, untreated, non-renal malignancy
  • Uncontrolled medical illness including infections, hypertension, arrhythmias, heart failure, or myocardial infarction within 6 months
  • History of bleeding diathesis or recent bleeding episode
  • Need for urgent treatment of renal cancer due bleeding, pain, or paraneoplastic syndrome
  • Prior surgery or radiation therapy to the operative site
  • Unwillingness to undergo clinical and laboratory monitoring and/or imaging studies
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 18 Years and older   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE
Listed Location Countries  ICMJE United States
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT04473781
Other Study ID Numbers  ICMJE 19-001258
NCI-2020-04542 ( Registry Identifier: CTRP (Clinical Trial Reporting Program) )
Has Data Monitoring Committee Yes
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: Yes
Product Manufactured in and Exported from the U.S.: Yes
IPD Sharing Statement  ICMJE Not Provided
Current Responsible Party Jonsson Comprehensive Cancer Center
Original Responsible Party Same as current
Current Study Sponsor  ICMJE Jonsson Comprehensive Cancer Center
Original Study Sponsor  ICMJE Same as current
Collaborators  ICMJE Not Provided
Investigators  ICMJE
Principal Investigator: Albert J Chang UCLA / Jonsson Comprehensive Cancer Center
PRS Account Jonsson Comprehensive Cancer Center
Verification Date July 2022

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP