ClinicalTrials.gg
Not yet recruitingNCT07601672PRISTINEUpdated May 22, 2026

PRISTINE Trial: PRoton Beam Therapy In Seminoma - Toxicity INvestigation and Evaluation of Outcome

An interventional study of protontherapy in Seminoma, sponsored by Istituto Clinico Humanitas. Not yet recruiting. Open to male participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-05-22.

Sponsored by Istituto Clinico Humanitas · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
20
Allocation
Not applicable
Ages
18 Years and older
Sex
Male
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Study summary

Stage II seminoma is a type of cancer that is usually highly curable and most often affects young men.

Radiotherapy is an effective treatment, but it can sometimes cause side effects in the long term and, rarely, increase the risk of developing another cancer later in life.For this reason, more targeted treatments are being explored, such as proton therapy (PBT). This type of radiotherapy uses protons to better focus the treatment on the tumor while reducing exposure to the surrounding healthy tissues.The goal is to treat the cancer effectively while minimizing side effects as much as possible.

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Conditions studied

  • Seminoma

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Keywords

  • seminoma
  • cancer treatment
  • protontherapy
  • radiotherapy
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In context

Seminoma

63 studies on the registry are indexed under Seminoma; 15 are open to participants now.

This study's planned enrollment of 20 is below the median of 50 across 47 interventional studies indexed under Seminoma.

Browse Seminoma studies →

Lead sponsor

Istituto Clinico Humanitas is the lead sponsor of 279 studies on the registry; 70 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

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

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Age ≥ 18 years
  • Male gender
  • Performance status 0 - 1
  • confirmed diagnosis of testicular seminoma
  • Stage IIA - IIB disease with involvement limited to retroperitoneal lymph nodes measuring ≤3 cm in greatest diameter
  • Prior radical orchiectomy
  • Clinical indication for radiotherapy
  • Written provided

Exclusion criteria

Exclusion Criteria:

  • Non-seminomatous germ cell tumor histology
  • Incomplete definitive surgical orchiectomy, including diagnostic alone
  • Prior or concurrent second other than non-melanoma skin cancer, unless disease free for a minimum of five years
  • Prior radiotherapy to the abdominal or pelvic region
  • Known severe, active co-morbidity
  • Inability or refusal to provide
Terms in these criteria, in plain language(6)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

ECOG performance status

A scale of how much an illness limits everyday activity. For people being assessed to join a study, scores run from 0 (fully active) to 4; lower is more active.

0
Fully active, no restrictions.
1
Limited in strenuous activity, but walking and able to do light work, such as housework or office work.
2
Walking and able to look after yourself, but unable to work; up and about more than half of waking hours.
3
Able to look after yourself only in part; in bed or a chair more than half of waking hours.
4
Unable to look after yourself at all; in bed or a chair all day.

Studies most often ask for 0–1 or 0–2. Your doctor gives the score; the WHO scale uses the same steps. The full scale also has 5, which records death.

Histologically or cytologically confirmed

The diagnosis was confirmed by looking at a sample under a microscope: tissue from a biopsy or surgery (histology), or cells from a fluid or needle sample (cytology).

Your pathology report is the document that shows this.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

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Study design

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

Study arms

  • Experimental
    Protontherapy Treatment

    patient will be treated with protontherapy instead of radiotherapy

    Radiation: protontherapy

Interventions

  • Radiationprotontherapy

    patients will be treated with protontherapy instead of radiotherapy with photon as standard of care

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What researchers measure

Primary outcomes

  1. Treatment toxicities

    Incidence of Grade ≥2 late treatment-related toxicity defined according to CTCAE v6.0 criteria

    Time frame: from enrollment to two years follow up

  2. Progression free survival

    Progression free survival within 12 months after radiotherapy defined defined as radiological progression and/or biochemical evidence of relapse, or death from any cause.

    Time frame: from enrollment to 12 months from treatment

  3. Modeled excess absolute risk (EAR) of secondary malignancies

    estimated from individual organ dosimetry using validated dose-response models (exploratory, model-based component)

    Time frame: from treatment to two years follow up

Secondary outcomes

  1. Overall survival

    Overall survival at 3 years post-treatment defined by survival status of patients at each time point

    Time frame: from treatment to three years follow up

  2. Quality of life outcomes

    evaluation of quality of life of patients through the completion of questionnarie QLQ-C30. Question with a scale from 1 to 4 (1 low quality of life - 4 high quality of life)

    Time frame: from treatment to two years follow up

  3. Values of circulating hsa-miR-371a-3p in patient treated with Proton Therapy

    Evaluation of the change in circulating hsa-miR-371a-3p concentration (mg/dL) before and after experimental treatment. This tumor marker is being investigated as a potential biomarker for the early diagnosis of testicular cancer, and the aim is to analyze how it may be influenced by proton therapy by comparing it with standardized reference values.

    Time frame: from treatment to two years follow up

  4. Correlation between miRNA clearance/persistance and outcomes

    analysis of plasma samples to evaluate the concentration of miRNA in plasma and how this could be linked to treatment outcomes

    Time frame: from treatment to two years follow up

  5. Quantification of immune cell populations according to cell type

    Evaluation of of systemic immune modulation through the analysis of concentration in plasma samples of immune cells

    Time frame: from treatment to two years follow up

  6. Quality of life outcomes

    evaluation of quality of life of patients through the completion of questionnarie QLQ-TC26. Question with a scale from 1 to 4 (1 low quality of life - 4 high quality of life).

    Time frame: from treatment to two years follow up

  7. Quality of life outcomes

    evaluation of quality of life of patients through the completion of questionnarie QLQ-AYA. Question with a scale from 1 to 4 (1 low quality of life - 4 high quality of life).

    Time frame: From treatment to two years follow up

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Study locations

No study locations are listed for this record.

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References and documents

Publications

  • Marelli G, Morina N, Puccio S, Iovino M, Pandini M, Portale F, Carvetta M, Mishra D, Diana E, Meregalli G, Paraboschi E, Cibella J, Peano C, Basso G, De Simone G, Camisaschi C, Magrini E, Sartori G, Karimi E, Colombo P, Lazzeri M, Casale P, Morosi L, Martano G, Asselta R, Bonavita E, Matsunami H, Bertoni F, Walsh L, Lugli E, Di Mitri D. Chemosensor receptors are lipid-detecting regulators of macrophage function in cancer. Nat Immunol. 2025 Jul;26(7):1182-1197. doi: 10.1038/s41590-025-02191-x. Epub 2025 Jun 30. PubMed 40588561 ↗
  • Li X, Ding R, Liu Z, Teixeira WMS, Ye J, Tian L, Li H, Guo S, Yao K, Ma Z, Liu Z. A predictive system comprising serum microRNAs and radiomics for residual retroperitoneal masses in metastatic nonseminomatous germ cell tumors. Cell Rep Med. 2024 Dec 17;5(12):101843. doi: 10.1016/j.xcrm.2024.101843. Epub 2024 Dec 12. PubMed 39672156 ↗
  • Alsyouf M, Nappi L, Nichols C, Daneshmand S. Plasma Micro-RNA 371 Expression in Early-Stage Germ Cell Tumors: Are We Ready to Move Toward Biology-Based Decision Making? J Clin Oncol. 2023 May 10;41(14):2478-2482. doi: 10.1200/JCO.22.02002. Epub 2023 Feb 9. No abstract available. PubMed 36758194 ↗
  • Konneh B, Lafin JT, Howard J, Gerald T, Amini A, Savelyeva A, Woldu SL, Lewis CM, Jia L, Margulis V, Coleman N, Scarpini C, Frazier AL, Murray MJ, Amatruda JF, Bagrodia A. Evaluation of miR-371a-3p to predict viable germ cell tumor in patients with pure seminoma receiving retroperitoneal lymph node dissection. Andrology. 2023 May;11(4):634-640. doi: 10.1111/andr.13317. Epub 2022 Nov 2. PubMed 36254623 ↗
  • Nestler T, Schoch J, Belge G, Dieckmann KP. MicroRNA-371a-3p-The Novel Serum Biomarker in Testicular Germ Cell Tumors. Cancers (Basel). 2023 Aug 3;15(15):3944. doi: 10.3390/cancers15153944. PubMed 37568759 ↗
  • Aziz Z, Wagner S, Agyekum A, Pumpalova YS, Prest M, Lim F, Rustgi S, Kastrinos F, Grady WM, Hur C. Cost-Effectiveness of Liquid Biopsy for Colorectal Cancer Screening in Patients Who Are Unscreened. JAMA Netw Open. 2023 Nov 1;6(11):e2343392. doi: 10.1001/jamanetworkopen.2023.43392. PubMed 37971743 ↗
  • Tulik P, Maciak M, Tulik M. A dosimetric comparison of 3D-CRT, IMRT and IMAT treatment techniques - assessment from radiation protection point of view. Rep Pract Oncol Radiother. 2024 Mar 18;29(1):69-76. doi: 10.5603/rpor.99025. eCollection 2024. PubMed 39165590 ↗
  • Pursley J, Remillard K, Depauw N, Lee G, Grassberger C, Paganetti H, Efstathiou JA, Kamran SC. Radiation Therapy for Stage IIA/B Seminoma: Modeling Secondary Cancer Risk for Protons and VMAT versus 3D Photons. Cancers (Basel). 2024 Feb 15;16(4):784. doi: 10.3390/cancers16040784. PubMed 38398175 ↗
  • Maxwell R, Chang Y, Paul C, Vaughn DJ, Christodouleas JP. Cancer Control, Toxicity, and Secondary Malignancy Risks of Proton Radiation Therapy for Stage I-IIB Testicular Seminoma. Adv Radiat Oncol. 2023 May 2;8(5):101259. doi: 10.1016/j.adro.2023.101259. eCollection 2023 Sep-Oct. PubMed 37408671 ↗
  • Ronde HS, Kronborg C, Hoyer M, Hansen J, Bak ME, Agergaard SN, Als AB, Agerbaek M, Lauritsen J, Meidahl Petersen P, Dysager L, Kallehauge JF. Dose comparison of robustly optimized intensity modulated proton therapy (IMPT) vs IMRT and VMAT photon plans for testicular seminoma. Acta Oncol. 2023 Oct;62(10):1222-1229. doi: 10.1080/0284186X.2023.2254925. Epub 2023 Sep 8. PubMed 37683054 ↗
  • Xiang M, Chang DT, Pollom EL. Second cancer risk after primary cancer treatment with three-dimensional conformal, intensity-modulated, or proton beam radiation therapy. Cancer. 2020 Aug 1;126(15):3560-3568. doi: 10.1002/cncr.32938. Epub 2020 May 19. PubMed 32426866 ↗
  • Giannatempo P, Nicolai N. What is the best way to treat patients with stage IIA or IIB seminoma? Lancet Oncol. 2022 Nov;23(11):1349-1350. doi: 10.1016/S1470-2045(22)00625-8. Epub 2022 Oct 10. No abstract available. PubMed 36228645 ↗
  • Classen J, Schmidberger H, Meisner C, Souchon R, Sautter-Bihl ML, Sauer R, Weinknecht S, Kohrmann KU, Bamberg M. Radiotherapy for stages IIA/B testicular seminoma: final report of a prospective multicenter clinical trial. J Clin Oncol. 2003 Mar 15;21(6):1101-6. doi: 10.1200/JCO.2003.06.065. PubMed 12637477 ↗

Individual participant data

Plan to share: Undecided

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on May 22, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT07601672
Collaborators
Associazione Italiana per la Ricerca sul Cancro
Responsible party
Sponsor
First posted
May 22, 2026
Start date
May 1, 2026 (estimated)
Primary completion
May 1, 2031 (estimated)
Completion
May 1, 2031 (estimated)
Last update
May 22, 2026

Study contacts

Ciro Franzese, MD, Radiation Oncologist
Contact
ciro.franzese@hunimed.eu
+39 0282247454
Laura Bonavita, Master Degree
Contact
laura.bonavita@humanitas.it
+39 0282247026

Oversight

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

Not currently enrolling

This study is not yet recruiting, as verified in May 2026. You cannot join it, but the record below documents what was studied.

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