Intracavernous Bone Marrow Stem-cell Injection for Post Prostatectomy Erectile Dysfunction (INSTIN)
Recruitment status was Recruiting
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Purpose
Erectile dysfunction is a frequent adverse event after radical prostatectomy for prostate cancer.
It is the consequence of penile vascular damage, mainly arterial insufficiency and venous leakage associated with fibrosis of the corpus cavernous. Apoptosis of penile cells, including mesenchymal cells, smooth muscle cells and endothelial is believed to play an important role in the pathophysiology of post prostatectomy erectile dysfunction.
Bone marrow mononucleated cells (BMMNC) contain different cell types that may replace the damaged penile cells after radical prostatectomy. These are mainly: mesenchymal stem cells, endothelial progenitor cells and hematopoietic stem cell. Intracavernous injection of BMMNC may therefore find application in the treatment of post prostatectomy erectile dysfunction.
The aims of this phase I-II study is to test the safety of autologous intracavernous BMMNC injection and to evaluate benefit for the patient concerning recovery of natural erection. Patients with penile vascular abnormality (echo-doppler) and localized prostate cancer (considered as cured by radical prostatectomy) will be included in this study.
Four different doses of BMMNC will be tested.
| Condition | Intervention | Phase |
|---|---|---|
|
Prostate Cancer Erectile Dysfunction |
Biological: injection of bone marrow mononucleated cells |
Phase 1 Phase 2 |
| Study Type: | Interventional |
| Study Design: | Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Intracavernous Bone Marrow Stem-cell Injection for Post Prostatectomy Erectile Dysfunction |
- Absence of serious adverse event (general or local) [ Time Frame: 6 months ] [ Designated as safety issue: Yes ]Side effects envisaged: priapism, local inflammation after cell injection
- Recovery of natural erection, improvement of penile doppler parameters [ Time Frame: 6 month ] [ Designated as safety issue: No ]Evaluation of erectile recovery using validated quesitonnaires (IIEF15, EHS, UCLA-PCI)
| Estimated Enrollment: | 31 |
| Study Start Date: | April 2010 |
| Estimated Study Completion Date: | June 2012 |
| Estimated Primary Completion Date: | May 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: injection of bone marrow cells |
Biological: injection of bone marrow mononucleated cells
Four different concentration of BMMNC will be tested in four groups of 3 patients. In group 5 (n=19): one cell concentration corresponding to the best dose determined by analysis of the previous groups will be tested.
Other Name: cell therapy
|
Detailed Description:
We have shown in a rat model of post prostatectomy erectile dysfunction that BMMNC injection replace apoptotic cavernous cells and restore erectile function.
In the pig, the injection of high dose of BMMNC into the corpus cavernosus does not cause side effect. Moreover, the BMMNC remains at the injection site.
Eligibility| Ages Eligible for Study: | 45 Years to 70 Years |
| Genders Eligible for Study: | Male |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Localized prostate cancer: PSA (Prostate Specific Antigen) prior to radical prostatectomy < 10 ng/ml, histopathologic analysis of the prostate showing a prostate cancer with Gleason score ≤ 7, negative margin, absence of effraction of the prostatic capsule, pT1 or pT2 N0 or NX.
- PSA=0 ng/ml 6 months after radical prostatectomy.
- Normal erectile function prior to radical prostatectomy.
- Penile arterial insufficiency and or venous leakage (doppler) at the time of inclusion: PSV <25 cm/sec, PSV >25 cm/sec, EDV>5cm/sec, RI<0,75.
Exclusion Criteria:
- Non localized prostate cancer.
Contacts and Locations| Contact: René Yiou, MD, PhD | +33149812553 | rene.yiou@hmn.aphp.fr |
| France | |
| CHU Henri Mondor-Albert Chenevier-Centre Intercommunal de Créteil | Recruiting |
| Créteil, France, 94101 | |
| Contact: Philippe Lecorvoisier, MD, PhD +33149813785 lecorvoisphilippe.lecorvoisier@hmn.aphp.fr | |
| Principal Investigator: Hélène Rouard | |
More Information
No publications provided
| Responsible Party: | Institut National de la Santé Et de la Recherche Médicale, France |
| ClinicalTrials.gov Identifier: | NCT01089387 History of Changes |
| Other Study ID Numbers: | BT06-07, 2008-A01248-47 |
| Study First Received: | March 17, 2010 |
| Last Updated: | December 29, 2011 |
| Health Authority: | France: Comité consultatif sur le traitement de l'information en matière de recherche dans le domaine de la santé |
Keywords provided by Institut National de la Santé Et de la Recherche Médicale, France:
|
radical prostatectomy |
Additional relevant MeSH terms:
|
Prostatic Neoplasms Erectile Dysfunction Genital Neoplasms, Male Urogenital Neoplasms Neoplasms by Site Neoplasms |
Genital Diseases, Male Prostatic Diseases Sexual Dysfunction, Physiological Sexual Dysfunctions, Psychological Sexual and Gender Disorders Mental Disorders |
ClinicalTrials.gov processed this record on May 16, 2013