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Feasibility Study of FLASH Radiotherapy for the Treatment of Symptomatic Bone Metastases (FAST-01)

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ClinicalTrials.gov Identifier: NCT04592887
Recruitment Status : Recruiting
First Posted : October 19, 2020
Last Update Posted : August 27, 2021
Sponsor:
Information provided by (Responsible Party):
Varian Medical

Brief Summary:
This purpose of this study is to assess the feasibility of FLASH radiotherapy for the palliative treatment of painful bone metastases. FLASH radiotherapy is radiation treatment delivered at ultra-high dose rates compared to conventional radiation treatment.

Condition or disease Intervention/treatment Phase
Bone Metastasis Radiation: FLASH Radiotherapy Not Applicable

Detailed Description:
This clinical investigation is designed to assess the workflow feasibility of FLASH radiotherapy treatment in a clinical setting, as well as the toxicities, and pain relief when used to treat bone metastasis(-es) in the extremities (excluding feet, hands, wrists). FLASH radiotherapy has been shown in preclinical studies to cause less injury to surrounding normal tissues during radiation treatment, while still having similar tumor cell killing. Patients at least 18 years of age with painful bone metastases located in the limbs will be considered for the study. These patients represent an ideal population for a feasibility study of FLASH radiotherapy as they are known to benefit from the palliative effects of radiotherapy using single dose radiation regimens of 8Gy which is what is being used in this investigation. After treatment, patients will be assessed for pain response as well as any adverse side-effects of radiation. The workflow feasibility of the treatment will also be evaluated.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 10 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Intervention Model Description: Open label, single arm prospective feasibility study
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Feasibility Study of FLASH Radiotherapy for the Treatment of Symptomatic Bone Metastases
Actual Study Start Date : November 3, 2020
Estimated Primary Completion Date : December 2022
Estimated Study Completion Date : December 2022

Arm Intervention/treatment
Experimental: FLASH radiotherapy for painful bone metastasis(-es) Radiation: FLASH Radiotherapy
FLASH radiotherapy is radiation treatment delivered at ultra-high dose rates compared to conventional radiation treatment.




Primary Outcome Measures :
  1. Workflow feasibility [ Time Frame: Will be assessed on day of treatment delivery which occurs within 3 weeks of subject enrollment. ]
    Treatment for an individual subject will be deemed NOT feasible if total treatment time on table is greater than one hour .

  2. Workflow feasibility [ Time Frame: Will be assessed within 4 weeks of subject enrollment. ]
    Treatment for an individual subject will be deemed NOT feasible if delays in study treatment of more than 7 business days from simulation to treatment occurs related to the investigational device (excluding delays due to patient or facility factors not related to study treatment)

  3. Assessment of radiation-related toxicities that are possibly, probably, or definitely related to FLASH radiotherapy. [ Time Frame: Assessed from start of treatment until subject death or lost to follow-up ]
    Toxicities that are possibly, probably, or definitely related to FLASH radiotherapy. Toxicities will be classified per CTCAE version 5.0.


Secondary Outcome Measures :
  1. Pain relief [ Time Frame: Assessed at Day 15, Months 1, 2, 3, long term; flare in bone pain assessed during the first 10 days after treatment ]
    Patient reported pain score overall and specifically for treated sites.

  2. Use of pain medication. [ Time Frame: Assessed at baseline and for the first 10 days after treatment. ]
    Use of pain medication.



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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patient age at least 18 years
  • Up to 3 painful bone metastasis(-es) in the extremities
  • Bone metastases that can be treated using pre-defined treatment field sizes (7.5 cm x 7.5 cm; 7.5 cm x 10 cm; 7.5 cm x 12 cm; 7.5 cm x 14 cm; 7.5 cm x 16 cm; 7.5 cm x 18 cm; 7.5 cm x 20 cm), without overlap of radiation fields
  • Life expectancy of >2 months (in the judgement of the investigator)
  • Patients who are able to comply with the protocol
  • Provision of signed and dated informed consent form

Exclusion Criteria:

  • Prior radiotherapy to the treatment site(s)
  • Lesions of the feet, hands, wrists are not eligible treatment sites for FLASH
  • More than 3 painful bone metastases of the limbs requiring palliative radiotherapy
  • Tumor lysis of >50% of the circumferential bone cortex, or other factors considered to place the subject at significant risk of pathologic fracture
  • Patients with bone fractures and/or metal implants in the treatment field
  • Patients who will receive cytotoxic chemotherapy within 1 week prior to or 1 week following their planned radiation treatment
  • Prior local therapy modality to the treatment site(s) within 2 weeks of study enrollment
  • Patients with pacemakers or other implanted devices at risk of malfunction during radiotherapy
  • Patients with any other medical condition or laboratory value that would, at the discretion of the investigator, preclude the patient from participation in this clinical investigation
  • Patients at known risk of enhanced normal tissue sensitivity to radiotherapy due to inherited predisposition or documented comorbidity that might lead to hypersensitivity to ionizing radiation
  • Patients enrolled in any other clinical studies the investigator believes to be in conflict with this clinical investigation.
  • Patients who are pregnant or nursing

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04592887


Locations
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United States, Ohio
Cincinnati Children's Proton Therapy Center Recruiting
Cincinnati, Ohio, United States, 45044
Contact: Cincinnati Children's Hospital Medical Center-Cancer Line    513-636-2799    cancer@cchmc.org   
Sponsors and Collaborators
Varian Medical
Investigators
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Principal Investigator: John Breneman, MD Professor of Radiation Oncology and Neurosurgery, UCMC
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Responsible Party: Varian Medical
ClinicalTrials.gov Identifier: NCT04592887    
Other Study ID Numbers: VAR-2019-02
First Posted: October 19, 2020    Key Record Dates
Last Update Posted: August 27, 2021
Last Verified: August 2021
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: Yes
Device Product Not Approved or Cleared by U.S. FDA: Yes
Keywords provided by Varian Medical:
FLASH radiotherapy
Radiation treatment
Proton
Bone metastasis
Feasibility study
Pain relief
Toxicities
Extremities
Additional relevant MeSH terms:
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Neoplasm Metastasis
Neoplasms, Second Primary
Bone Neoplasms
Bone Marrow Diseases
Neoplastic Processes
Neoplasms
Pathologic Processes
Neoplasms by Site
Bone Diseases
Musculoskeletal Diseases
Hematologic Diseases