The aims of this study are: * to assess the impact of TOOKAD® Soluble-Vascular Targeted Photodynamic Therapy (VTP) on the rate of absence of definite cancer using patients on active surveillance as a comparison (co-primary objective A) and * to determine the difference in rate of treatment failure associated with observed progression of disease from low risk prostate cancer to moderate or higher risk prostate cancer in men who undergo TOOKAD® Soluble-VTP compared to men on active surveillance (co-primary objective B).
This is a Phase 3, multicentre, open label, randomised controlled study in subjects diagnosed with low risk prostate cancer on TransRectal Ultrasound (TRUS) guided biopsy. Subjects will be randomised to either Active Surveillance or TOOKAD® Soluble VTP. Subjects will remain in the study for approximately 24 months following randomisation. A total of 400 subjects will be entered into the study; 200 will receive Active Surveillance and 200 will receive TOOKAD® Soluble-VTP.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
413
TOOKAD® Soluble-VTP procedure will consist of an IntraVenous (IV) administration to patients using a 753nm laser light at a fixed power of 150mW/cm and a fixed energy at 200J/cm delivered through transperineal interstitial optical fibers. The needles are positioned in the prostate under ultra sound image guidance
Co-primary endpoint 'A': Rate of absence of definite cancer using patients on active surveillance as a comparison.
Histological changes are assessed using biopsies or any other pathology result obtained during the study planned or not.
Time frame: Month 24
Co-primary endpoint 'B': Difference in rate of treatment failure associated with observed progression of disease from low risk prostate cancer to moderate or higher risk prostate cancer.
Moderate or higher risk is defined as the observation of: * More than 3 cores positive for cancer when considering all histological examination available during follow-up of study; * or any Gleason primary or secondary pattern 4 or more; * or at least one cancer core length greater than 5 mm; * or PSA\>10ng/mL ( in 3 consecutive measures); * or any T3 prostate cancer, * or metastasis; * or prostate cancer related death
Time frame: Over 24 months follow-up.
The rate of additional prostate cancer radical therapy
Number of patients undergoing a radical treatment for prostate cancer such as: radical prostatectomy, radiotherapy, brachytherapy divided by the total number of patients.
Time frame: Over 24 months follow-up
Total number of cores positive for cancer
Total number of biopsy sample containing tumor cells at the month 24 biopsy
Time frame: Month 24
The rate of incontinence, erectile dysfunction, urinary symptoms
Number of patients experiencing urinary incontinence, erectile dysfunction or urinary symptoms events divided by the total number of patients.
Time frame: Randomisation visit, Day 7 after VTP , Month 3, Month 6, Month 9, Month 12, Month 24
The rate of adverse events
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Dept. of Urology-University Hospitals Leuven
Leuven, Belgium
Department of Urology-Tampere University Hospital-
Tampere, Finland
Service d'Urologie - Centre Hospitalier Universitaire d'Angers
Angers, France
CHRU Hopital Jean Minjoz
Besançon, France
Site Médipole
Cabestany, France
Polyclinique Sévigné
Cesson-Sévigné, France
Clinique d'Urologie et de Transplantation Rénale CHU Grenoble
Grenoble, France
Hôpital Claude Huriez
Lille, France
Hôpital La Conception
Marseille, France
Clinique Ambroise Paré
Neuilly-sur-Seine, France
...and 40 more locations
Number of patients experiencing adverse events divided by the total number of patients.
Time frame: Screening-Month 24
The rate of severe prostate cancer related events: cancer extension to T3, metastasis and prostate cancer related death
Number of patients experiencing severe prostate cancer related events: cancer extension to T3, metastasis and prostate cancer related death divided by the total number of patients.
Time frame: Screening-Month 24
The overall quality of life will be recorded for potential utility and descriptive studies.
Results of the International Index of Erectile Function (IIEF) and International Prostate Symptoms Score (IPSS) patients questionaires.
Time frame: Randomisation visit; Month 12; Month 24