MR-Guided Radiation Therapy for Cancer

(MRgRT Trial)

Recruiting in Palo Alto (17 mi)

Overseen by Michael Milosevic, MD

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: University Health Network, Toronto

No Placebo Group

Approved in 3 Jurisdictions

Trial Summary

What is the purpose of this trial?

The aim of this study is to evaluate the technical performance of magnetic-resonance guided radiotherapy (MRgRT) facility at the Princess Margaret Cancer Centre and the impact on the workflow of the clinical team in this facility.

Do I need to stop my current medications for this trial?

The trial protocol does not specify whether you need to stop taking your current medications.

What data supports the idea that MR-Guided Radiation Therapy for Cancer is an effective treatment?

The available research shows that MR-Guided Radiation Therapy (MRgRT) is effective for treating certain types of cancer, such as prostate cancer and cancers in the abdomen and chest. For prostate cancer, MRgRT allows for precise targeting of the tumor, which can lead to better outcomes. In the MOMENTUM study, patients with prostate cancer showed positive results after 12 months of treatment with MRgRT. Additionally, MRgRT provides better imaging of tumors compared to traditional methods, which helps in accurately targeting the cancer while sparing healthy tissue. This is particularly beneficial for cancers in the lung, kidney, liver, and stomach. The treatment also shows promise in reducing side effects in pediatric cancer patients. Overall, MRgRT offers improved precision and potentially better outcomes compared to conventional radiation therapy. ^{1 2 3 4 5}

What safety data is available for MR-guided radiation therapy?

Safety data for MR-guided radiation therapy (MRgRT) includes findings from the MOMENTUM study, which reports 12-month outcomes for prostate cancer patients treated with MRgRT. Additionally, a failure modes and effects analysis has been conducted to ensure system safety. Despite improvements in treatment planning and reduced toxicity, genitourinary toxicity remains a concern. Clinical experience with MRgRT systems since 2014 also contributes to the understanding of its safety profile. ^{3 6 7 8 9}

Is Magnetic resonance-guided radiation therapy (MRgRT) a promising treatment for cancer?

Yes, MRgRT is a promising treatment for cancer because it offers better imaging to see tumors and surrounding tissues, allows for precise targeting of radiation, and can adjust treatment plans daily to improve effectiveness. ^{1 2 3 9 10}

Research Team

Michael Milosevic, MD

Principal Investigator

University Health Network, Toronto

Eligibility Criteria

This trial is for adults over 18 who can give informed consent and are scheduled to receive imaging or treatment at the Princess Margaret Cancer Centre's MRgRT facility. There are no specific exclusion criteria mentioned.

Inclusion Criteria

Planned to receive clinical intervention (imaging or treatment) in the MRgRT facility

At least 18 years of age

Ability to provide informed consent

Exclusion Criteria

There are no specific criteria for exclusion or inclusion in this study.

Treatment Details

Interventions

• Magnetic resonance-guided radiation therapy (MRgRT) (Radiation Therapy)

Trial Overview The study focuses on assessing how well magnetic resonance-guided radiation therapy (MRgRT) works in a research setting and its effects on the clinical team's workflow at the cancer center.

Participant Groups

Group I: Magnetic resonance - guided radiation therapy (MRgRT) Experimental Treatment 1 Intervention

Magnetic resonance (MR) - guided radiation therapy

Magnetic resonance-guided radiation therapy (MRgRT) is already approved in Canada for the following indications:

Approved in Canada as MRgRT for:

• Prostate cancer
• Rectal cancer
• Liver cancer
• Pancreatic cancer
• Lung cancer

Find a Clinic Near You

Research Locations Nearby Select from list below to view details:

University Health Network Toronto, Canada

Who Is Running the Clinical Trial?

University Health Network, Toronto

Lead Sponsor

Trials

1555

Recruited

526,000+

Dr. Brad Wouters

University Health Network, Toronto

Chief Medical Officer since 2020

MD from University of Toronto

Dr. Kevin Smith

University Health Network, Toronto

Chief Executive Officer since 2018

Professor at McMaster University and University of Toronto

Findings from Research

In a study of 425 localized prostate cancer patients treated with MR-guided ultrahypofractionated radiation therapy, significant declines in prostate-specific antigen levels were observed, indicating effective treatment outcomes over 12 months.

While the therapy was generally safe, with peak toxicity reported at 3 months, patients not receiving androgen deprivation therapy experienced significant worsening of erectile function by 12 months, highlighting the need for patient education on potential side effects.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Magnetic Resonance-Guided Adaptive Radiation Therapy for Prostate Cancer: The First Results from the MOMENTUM study-An International Registry for the Evidence-Based Introduction of Magnetic Resonance-Guided Adaptive Radiation Therapy. Teunissen, FR., Willigenburg, T., Tree, AC., et al.[2023]

A survey of 12 pediatric radiotherapy institutions indicated that while the expected benefit of magnetic resonance guided radiotherapy (MRgRT) for reducing toxicity and improving outcomes is modest, there is a significant potential for benefit in 55% of primary tumor scenarios and 62% of metastatic tumor scenarios.

The study highlights the need for further investigation into MRgRT's role in pediatric oncology, particularly through prospective studies or registration trials, to better understand its impact on treatment outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The potential role of MR-guided adaptive radiotherapy in pediatric oncology: Results from a SIOPE-COG survey. Seravalli, E., Kroon, PS., Buatti, JM., et al.[2022]

The development of an online Magnetic Resonance guided Radiation Therapy (MRgRT) system aims to enhance safety by providing real-time MRI images before radiation treatment, allowing for better image guidance.

A thorough failure modes and effects analysis identified potential risks during the design and operation of the MRgRT system, leading to design improvements and safety measures before installation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Poster - Thur Eve - 05: Safety systems and failure modes and effects analysis for a magnetic resonance image guided radiation therapy system. Lamey, M., Carlone, M., Alasti, H., et al.[2019]

The implementation of the MR-linac system for magnetic resonance-guided radiation therapy (MRgRT) at a single institution in Turkey has shown feasibility for routine clinical use, successfully treating 72 patients across 84 tumor sites with real-time imaging and adaptive radiation planning.

The system allowed for on-table adaptive radiation therapy (oART) in 93.2% of patients and utilized automated beam gating to manage breathing-related motion, demonstrating its potential to improve treatment precision and patient safety during radiation therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

First 500 Fractions Delivered with a Magnetic Resonance-guided Radiotherapy System: Initial Experience. Sahin, B., Zoto Mustafayev, T., Gungor, G., et al.[2020]

References

1. United States pubmed.ncbi.nlm.nih.gov

A New Era of Image Guidance with Magnetic Resonance-guided Radiation Therapy for Abdominal and Thoracic Malignancies. [2022]

2. Netherlands pubmed.ncbi.nlm.nih.gov

Clinical implementation of magnetic resonance imaging guided adaptive radiotherapy for localized prostate cancer. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Magnetic Resonance-Guided Adaptive Radiation Therapy for Prostate Cancer: The First Results from the MOMENTUM study-An International Registry for the Evidence-Based Introduction of Magnetic Resonance-Guided Adaptive Radiation Therapy. [2023]

4. Ireland pubmed.ncbi.nlm.nih.gov

The potential role of MR-guided adaptive radiotherapy in pediatric oncology: Results from a SIOPE-COG survey. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

MRI-guided Radiotherapy (MRgRT) for Treatment of Oligometastases: Review of Clinical Applications and Challenges. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Poster - Thur Eve - 05: Safety systems and failure modes and effects analysis for a magnetic resonance image guided radiation therapy system. [2019]

7. United States pubmed.ncbi.nlm.nih.gov

Dosimetric predictors for genitourinary toxicity in MR-guided stereotactic body radiation therapy (SBRT): Substructure with fraction-wise analysis. [2023]

8. United States pubmed.ncbi.nlm.nih.gov

Two-and-a-half-year clinical experience with the world's first magnetic resonance image guided radiation therapy system. [2022]

9. United States pubmed.ncbi.nlm.nih.gov

A facility for magnetic resonance-guided radiation therapy. [2022]

10. United States pubmed.ncbi.nlm.nih.gov

First 500 Fractions Delivered with a Magnetic Resonance-guided Radiotherapy System: Initial Experience. [2020]