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Interstitial Brachytherapy for the Treatment of Unresectable/Unablatable Kidney Cancer

About

Brief Summary

This phase I/II trial investigates the side effects of interstitial brachytherapy and to see how well it works in limiting the growth of large kidney cancer masses in patients with kidney cancer that have refused or are unable to undergo surgery or ablation (unresectable/unablatable). Brachytherapy, also known as internal radiation therapy, temporarily introduces a radiation source into or near the tumor to eradicate the tumor cells. Giving brachytherapy may potentially reduce the size of the kidney cancer mass that would otherwise not be amenable to surgical management and translate into lower risk of spread.

Primary Purpose
Treatment
Study Type
Interventional
Phase
Phase 1/Phase 2

Eligibility

Gender
All
Healthy Volunteers
No
Minimum Age
18 Years
Maximum Age
N/A

Inclusion Criteria:

  • Elected to undergo interstitial brachytherapy as part of conventional treatment for renal cell carcinoma
  • Biopsy proven renal cell carcinoma
  • No definitive evidence of locally advanced (nodal or tumor thrombus) or distant (metastatic) disease
  • Lesion size (maximal dimension) of 4 to 10 cm
  • Patient not a candidate for curative surgery (unwilling or unable to pursue surgery)
  • Lesion cannot be reliably treated with ablative techniques
  • Entire lesion able to be treated adequately by brachytherapy per radiation oncologist
  • Tumor predominantly solid (~ > 80%)
  • Lesion that has been observed for >= 6 months with demonstrable growth rate anticipated to be >= 4 mm/year by same imaging modality
  • Renal tumor that is amenable to percutaneous access for interstitial renal brachytherapy (Institutional Review Board [IRB])
  • Hemoglobin > 9
  • Absolute neutrophil count (ANC) >= 1500/uL (microliter)
  • Platelets >= 100,000/uL
  • Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =< 3.0 upper limit of normal (ULN)
  • Total bilirubin =< ULN
  • A competent immune system
  • Estimated glomerular filtration rate (eGFR) >= 30
  • Good performance status (Eastern Cooperative Oncology Group [ECOG]) < 2
  • Understanding and willingness to provide consent
  • No prior systemic treatment for kidney cancer
  • Women of childbearing potential must have negative pregnancy test at start of therapy

Exclusion Criteria:

  • Presence of an active, untreated, non-renal malignancy
  • Uncontrolled medical illness including infections, hypertension, arrhythmias, heart failure, or myocardial infarction within 6 months
  • History of bleeding diathesis or recent bleeding episode
  • Need for urgent treatment of renal cancer due bleeding, pain, or paraneoplastic syndrome
  • Prior surgery or radiation therapy to the operative site
  • Unwillingness to undergo clinical and laboratory monitoring and/or imaging studies

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Study Stats
Protocol No.
19-001258
Category
Kidney Cancer
Contact
Albert Chang
Location
  • UCLA Santa Monica
  • UCLA Westwood
For Providers
NCT No.
NCT04473781
For detailed technical eligibility, visit ClinicalTrials.gov.