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CompletedNCT03284619FIM MR-LinacUpdated Mar 29, 2018

First-In Man (FIM) Study MR-Linac

An interventional study of Magnetic resonance imager linear accelerator in Bone Metastases, sponsored by Nucletron Operations BV. Completed at 1 site in Netherlands. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2018-03-29.

Sponsored by Nucletron Operations BV · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
5
Allocation
Not applicable
Ages
18 Years and older
Sex
All
01

Study summary

Investigational device is the Magnetic resonance imager linear accelerator. Five (5) patients with bone metastases will be treated with palliative intention in this study. The goal is to confirm the pre-clinically demonstrated technical accuracy and safety of the newly developed MR-Linac in the clinical setting.

Read the detailed description

This is a single center prospective proof of concept study including accuracy and safety aspects according to R-IDEAL stage 1 criteria. Five (5) patients with bone metastases will be treated with palliative intention in this study. Treatment will consist of a single fraction.

The MR linear accelerator (MRL) integrates a radiotherapy accelerator and a diagnostic quality 1.5T MRI, enabling soft-tissue visualization during the actual radiation delivery for improved targeting. This enables on-line treatment optimization for precise radiation delivery. Better visualization of the tumour targets and the surrounding healthy tissues, at the exact moment of treatment, makes it possible to adapt the dose to the actual anatomy while optimally sparing normal tissues.

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Conditions studied

  • Bone Metastases

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Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

In order to be eligible to participate in this study, a patient must meet all of the following criteria:

  • Painful bone metastases in the lumbar spine
  • Radiographic evidence of bone metastases
  • Histologic proof of malignancy (primary carcinoma)
  • Karnofsky Performance Score ≥ 50
  • Age ≥ 18 years
  • Able to provide written informed consent

Exclusion criteria

Exclusion Criteria:

A potential subject who meets any of the following criteria will be excluded from participation in this study:

  • Prior radiation therapy within the region planned to be irradiated
  • Contraindication for MRI according to screening protocol radiology department UMCU (e.g. cardiac pacemakers, and defibrillators, artificial heart valves or cochlear implants, https://richtlijn.mijnumc.nl/Beeld/MRI/Paginas/MRI-Veiligheid-Contra-indicaties.aspx
  • Claustrophobia
  • Standard systemic anti-cancer therapy or radionuclide therapy within 48 hours before or after treatment.
  • Any other type of not standard systemic anti-cancer treatment, except for endocrine treatment.
  • Unstable spine requiring surgical stabilization
  • Neurological deficit due to bone metastasis
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Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
5 participants (actual)

Study arms

  • Experimental
    treatment arm

    Single arm study, 5 patient with bone metastasis will be enrolled for palliative treatment with the Magnetic resonance imager linear accelerator (MR-Linac).

    Device: Magnetic resonance imager linear accelerator

Interventions

  • DeviceMagnetic resonance imager linear accelerator

    The MR linear accelerator (MRL) integrates a radiotherapy accelerator and a diagnostic quality 1.5T MRI, enabling soft-tissue visualization during the actual radiation delivery for improved targeting. This enables on-line treatment optimization for precise radiation delivery. Better visualization of the tumour targets and the surrounding healthy tissues, at the exact moment of treatment, makes it possible to adapt the dose to the actual anatomy while optimally sparing normal tissues.

    Also known as: MR-Linac, Unity

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What researchers measure

Primary outcomes

  1. Safety of the treatment system (a dose distribution accuracy ≤ 5% will be considered acceptable). Incidence of acute toxicity (CTCAE grade 2 are higher) and incidence of Serious (unexpected) Adverse Events will be measured.

    Safety of the system: System behaves in accordance with the workflow and risk mitigation plan, Dosimetric safety: An independent dosimetry check before start irradiation (Oncentra) and an independent dosimetry during irradiation (second chamber) will be used. For the overall process a dose distribution accuracy ≤ 5% will be considered acceptable. Patients safety: by reporting any acute toxicity \> grade 2 (according CTCAE version 4.0 for acute toxicity) and any Serious (Unexpected) Adverse Events (S(U)AE) within 12 weeks after treatment

    Time frame: During treatment (Day 0). For patient safety patients will be contacted at day 1, week 2 and week 12 after treatment.

  2. Geometrical accuracy of targeting by online MR imaging

    Geometrical accuracy: will be checked online by using the MRI in combination with VolumeTool visualization and off-line by comparison of the EPID beam data with the prescribed beam data. A positioning error of ≤ 5 mm will be considered acceptable

    Time frame: During treatment (day 0)

Secondary outcomes

  1. Descriptive analysis of the clinical workflow by keeping a log book for the entire procedure.

    Feasibility of the clinical workflow: by keeping a log book for the entire procedure. The validation of radiation delivery includes assessing the hardware performance and the See-Plan-Treat work flow for on-line MRI guided adaptive radiotherapy.

    Time frame: During treatment (day 0)

  2. Patients comfort

    Patient comfort during the MR-Linac treatment: by patient questionnaire.

    Time frame: immediately after treatment (day 0)

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Study locations

1 site
  • University Medical Centre Utrecht
    Utrecht, 3584 CX, Netherlands
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References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

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Registry details

Key details

Study ID
NCT03284619
Lead sponsor
Nucletron Operations BV
Collaborators
Factory CRO for Medical Devices B.V.
Responsible party
Sponsor
First posted
Sep 15, 2017
Start date
Apr 1, 2017
Primary completion
Jul 11, 2017
Completion
Sep 8, 2017
Last update
Mar 29, 2018

Study contacts

Ina Jürgenliemk-Schulz, MD, PhD
principal investigator · UMCU

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Mar 2018. You cannot join it, but the record below documents what was studied.

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