Targeted Microwave Ablation for Prostate Cancer Under Magnetic Resonance Imaging-Ultrasound Fusion and Organ-based Tracking: Final Results from the First Phase 2 Trial (TMA-HK).
Peter Ka-Fung Chiu, Alex Qinyang Liu, Chi-Hang Yee, Ho-Fai Wong, Chun-Hong Chan, Angel Kong, Sui-Yan Lau, Jeremy Yuen-Chun Teoh, Ka-Lun Lo, Tsz-Yau Yuen, Kin-Hoi Wong, Cheuk-Man Chu, Hiu-Yee Hung, Carmen Chi-Min Cho, Chi-Fai Ng
{"title":"Targeted Microwave Ablation for Prostate Cancer Under Magnetic Resonance Imaging-Ultrasound Fusion and Organ-based Tracking: Final Results from the First Phase 2 Trial (TMA-HK).","authors":"Peter Ka-Fung Chiu, Alex Qinyang Liu, Chi-Hang Yee, Ho-Fai Wong, Chun-Hong Chan, Angel Kong, Sui-Yan Lau, Jeremy Yuen-Chun Teoh, Ka-Lun Lo, Tsz-Yau Yuen, Kin-Hoi Wong, Cheuk-Man Chu, Hiu-Yee Hung, Carmen Chi-Min Cho, Chi-Fai Ng","doi":"10.1016/j.euo.2024.11.013","DOIUrl":null,"url":null,"abstract":"<p><p>Targeted microwave ablation (TMA) is a novel focal therapy modality for prostate cancer (PC). TMA-HK is the first phase 2 trial investigating the efficacy and functional outcomes of transperineal TMA (NCT04113811) in 30 men with low- or intermediate-risk PC. TMA was performed transperineally with magnetic resonance imaging (MRI)-ultrasound fusion guidance and organ-based tracking. All participants underwent prostate MRI at 6 mo after TMA, followed by targeted and 18-core systematic prostate biopsy. The primary outcome was cancer detection on biopsy in each ablated area at 6 mo. Secondary outcomes included per-patient analysis of positive biopsy results, complications, and functional outcomes at 12 mo. A total of 42 areas were treated in 30 patients (seven low-risk and 23 intermediate-risk PC), with no cancer detected in 90.5% (38/42) of the treated areas. Per-patient analysis revealed in-field recurrence in 10.0% (three of 30) of patients, of whom two had grade group 1 and one had grade group 2 disease. At 12 mo, out-of-field biopsies were positive in 40.0% (12/30) of the patients (ten grade group 1, two grade group 2 disease). Only self-limiting grade 1 and 2 complications were reported. Three patients (10.0%) reported de novo failure to achieve penetrative sexual intercourse. The results demonstrate that TMA for PC resulted in effective ablation, with good cancer control up to 12 mo. PATIENT SUMMARY: We performed the first efficacy trial of targeted microwave treatment for prostate cancer in 30 patients with low- or intermediate-risk disease. Our results show that this treatment achieved excellent local control of the cancer up to 12 months, with a low rate of complications. More research in larger patient groups and over longer follow-up is needed to confirm these findings.</p>","PeriodicalId":12256,"journal":{"name":"European urology oncology","volume":" ","pages":""},"PeriodicalIF":8.3000,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European urology oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.euo.2024.11.013","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Targeted microwave ablation (TMA) is a novel focal therapy modality for prostate cancer (PC). TMA-HK is the first phase 2 trial investigating the efficacy and functional outcomes of transperineal TMA (NCT04113811) in 30 men with low- or intermediate-risk PC. TMA was performed transperineally with magnetic resonance imaging (MRI)-ultrasound fusion guidance and organ-based tracking. All participants underwent prostate MRI at 6 mo after TMA, followed by targeted and 18-core systematic prostate biopsy. The primary outcome was cancer detection on biopsy in each ablated area at 6 mo. Secondary outcomes included per-patient analysis of positive biopsy results, complications, and functional outcomes at 12 mo. A total of 42 areas were treated in 30 patients (seven low-risk and 23 intermediate-risk PC), with no cancer detected in 90.5% (38/42) of the treated areas. Per-patient analysis revealed in-field recurrence in 10.0% (three of 30) of patients, of whom two had grade group 1 and one had grade group 2 disease. At 12 mo, out-of-field biopsies were positive in 40.0% (12/30) of the patients (ten grade group 1, two grade group 2 disease). Only self-limiting grade 1 and 2 complications were reported. Three patients (10.0%) reported de novo failure to achieve penetrative sexual intercourse. The results demonstrate that TMA for PC resulted in effective ablation, with good cancer control up to 12 mo. PATIENT SUMMARY: We performed the first efficacy trial of targeted microwave treatment for prostate cancer in 30 patients with low- or intermediate-risk disease. Our results show that this treatment achieved excellent local control of the cancer up to 12 months, with a low rate of complications. More research in larger patient groups and over longer follow-up is needed to confirm these findings.
期刊介绍:
Journal Name: European Urology Oncology
Affiliation: Official Journal of the European Association of Urology
Focus:
First official publication of the EAU fully devoted to the study of genitourinary malignancies
Aims to deliver high-quality research
Content:
Includes original articles, opinion piece editorials, and invited reviews
Covers clinical, basic, and translational research
Publication Frequency: Six times a year in electronic format