60 Participants Needed

Fiducial Markers + Mp-MRI for Bladder Cancer

(FMBRT Trial)

Recruiting at 3 trial locations
JP
LS
Overseen ByLaura Sarmiento, CCRP
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new method to help doctors better target bladder cancer during radiation treatment. It uses tiny gold markers, known as fiducial markers, to pinpoint the tumor's original location, along with a special MRI scan called multiparametric MRI (mpMRI) that may detect cancer sooner and more accurately. The trial seeks participants with bladder cancer who plan to undergo chemoradiation and have not recently received certain treatments. As an unphased trial, this study provides a unique opportunity to contribute to innovative research that could enhance cancer detection and treatment precision.

Will I have to stop taking my current medications?

The trial protocol does not specify if you need to stop taking your current medications. However, if you are receiving intravesical chemo- or biologic therapy, you must not have had it within 6 weeks of the first treatment.

What prior data suggests that fiducial marker placement and mp-MRI are safe for bladder cancer treatment?

Research has shown that fiducial markers used in bladder cancer treatment are generally safe and stable. These tiny markers help doctors aim radiation therapy more precisely at the tumor. Studies have found that using these markers can enhance treatment accuracy without causing significant side effects.

The mpMRI, or multiparametric MRI, is a common imaging technique that helps doctors see bladder cancer more clearly. This method is known to be safe and effective for detecting and assessing bladder cancer.

Overall, both fiducial markers and mpMRI have been well-tolerated in previous studies, with no major safety concerns reported.12345

Why are researchers excited about this trial?

Researchers are excited about using fiducial markers with multiparametric MRI (mpMRI) for bladder cancer because this innovative approach could enhance the precision of chemo-radiotherapy. Unlike traditional treatment methods that rely on less detailed imaging, mpMRI offers detailed visualization of the bladder and surrounding tissues, allowing for more accurate targeting during radiation therapy. This improved targeting could potentially lead to better outcomes by minimizing damage to healthy tissues and enhancing the effectiveness of the treatment. Additionally, the use of fiducial markers helps in real-time tracking of tumor movement, further refining the precision of radiation delivery. Overall, this method represents a significant step forward in personalizing cancer treatment and improving patient care.

What evidence suggests that fiducial markers and mp-MRI are effective for bladder cancer?

Studies have shown that fiducial markers enhance the accuracy of radiation treatment for bladder cancer by clearly marking the tumor's location. This precision allows doctors to target the cancer more effectively, potentially increasing treatment efficacy and reducing side effects. Research indicates that these markers remain safe and stable in patients.

Research shows that multiparametric MRI (mpMRI) excels at detecting bladder cancer and assessing its spread. This advanced imaging aids in early cancer detection and effective treatment planning. In this trial, participants will receive both fiducial marker placement and mpMRI within a single treatment arm, aiming to improve bladder cancer detection and treatment.12467

Who Is on the Research Team?

MG

Maurice Garcia, MD

Principal Investigator

Cedars-Sinai Medical Center

Are You a Good Fit for This Trial?

This trial is for adults with bladder cancer (urothelial carcinoma) that's not spread beyond the pelvis. They should be set to receive chemo and radiation but haven't had major bladder surgery or recent intravesical therapy. Good kidney function is needed, and they must use birth control if applicable.

Inclusion Criteria

My bladder cancer is at a stage where it's not spread far and I'm choosing to get chemoradiation.
Ability to understand and willingness to sign a written informed consent
I agree to use birth control during and for 3 months after the study.
See 4 more

Exclusion Criteria

I am scheduled for immune system treatment before surgery, but BCG vaccine is okay.
My cancer has spread to distant parts of my body like the lungs or liver.
I do not have any infections or uncontrolled conditions that would stop me from joining the study.
See 8 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Fiducial Marker Placement

24-K gold fiducial markers are endoscopically implanted around the tumor resection area to mark the location of the tumor site

1 day
1 visit (in-person)

Radiotherapy Planning

Radiation planning CT scan and mpMRI are conducted to guide radiotherapy targeting

1-2 weeks

Chemo-radiation Treatment

Participants undergo chemo-radiation treatment with fiducial markers to minimize collateral radiation

2 weeks
Daily visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment with mpMRI and/or surveillance cystoscopy at 3, 6, and 9 months post-treatment

9 months
3 visits (in-person)

What Are the Treatments Tested in This Trial?

Interventions

  • Fiducial marker placement
  • Multiparametric MRI (mpMRI)
Trial Overview The study tests placing tiny gold markers near the tumor before radiation so doctors can target it better. It also checks if a new type of MRI scan can more accurately detect bladder cancer when scopes don't see it.
How Is the Trial Designed?
1Treatment groups
Experimental Treatment
Group I: Single Arm - Bladder Chemo-RadiotherapyExperimental Treatment2 Interventions

Find a Clinic Near You

Who Is Running the Clinical Trial?

Cedars-Sinai Medical Center

Lead Sponsor

Trials
523
Recruited
165,000+

National Cancer Institute (NCI)

Collaborator

Trials
14,080
Recruited
41,180,000+

Published Research Related to This Trial

The study demonstrated that cystoscopy-guided placement of hydrogel markers in 32 patients with muscle-invasive bladder cancer is safe, with no procedure-related adverse events reported.
While 76.6% of the markers were sufficient for tumor delineation at the start, only 46.7% remained visible and adequate for routine verification by the end of treatment, indicating a need for improvement in marker performance during radiation therapy.
The Feasibility and Utility of Cystoscopy-Guided Hydrogel Marker Placement in Patients With Muscle-Invasive Bladder Cancer.Wortel, K., Hovius, MC., van Andel, G., et al.[2020]
Multiparametric MRI (mpMRI) demonstrated high sensitivity (92% and 88%) and specificity (74% and 84%) for detecting muscle invasive bladder cancer in a study of 45 patients, indicating its effectiveness in local staging after tumor resection.
While mpMRI was specific for detecting peri-vesical invasion and regional nodal disease, it showed lower sensitivity (72% and 67% for peri-vesical invasion, and 45% for nodal disease), suggesting it may be more reliable for certain aspects of bladder cancer staging.
Bladder cancer local staging: multiparametric MRI performance following transurethral resection.van der Pol, CB., Shinagare, AB., Tirumani, SH., et al.[2022]
The Vesical Imaging-Reporting and Data System (VI-RADS) is a promising non-invasive tool for accurately staging bladder cancer, helping to differentiate between non-muscle-invasive (NMIBC) and muscle-invasive bladder cancer (MIBC).
This review analyzed 18 articles and included MRI images from patients diagnosed with bladder cancer between 2019 and 2021, highlighting the potential of VI-RADS in improving diagnostic pathways, although further prospective studies are needed to confirm its clinical effectiveness.
VESICAL IMAGING-REPORTING AND DATA SYSTEM - A NEW APPROACH TO BLADDER CANCER STAGING.Jakimów, K., Sznajder, K.[2022]

Citations

Intravesical Fiducial Marker Placement to Facilitate Image- ...RESULTS: All 10 patients had successful implantation of Visicoil fiducial markers without procedure-related acute complications. No patient developed acute ...
Endoscopic Gold Fiducial Marker Placement into the ...Bladder fiducial markers improve targeting accuracy, and may increase treatment efficacy and reduce morbidity from collateral radiation.
Gold Fiducial Marker Tracking to Optimize Radiation ...The use of gold fiducial markers (GFMs) for improved targeting of the tumor bed during radiation therapy was investigated.
Intravesical fiducial marker placement to facilitate image- ...RESULTS: All 10 patients had successful implantation of Visicoil fiducial markers without procedure-related acute complications. No patient ...
investigation-of-fiducial-marker-migration-during-the- ...Studies have shown that fiducial markers are safe, stable, and can provide superior tumor tracking and targeting capability during both ...
Exploratory models comparing ethiodized oil-glue and gold ...Image-guidance with fiducials has been shown to improve pelvic radiotherapy outcome. However, bladder fiducials using ethiodized oil (EO) alone can disperse ...
Investigation of Fiducial Marker Migration during the ...Studies have shown that fiducial markers are safe, stable, and can provide superior tumor tracking and targeting capability during both ...
Unbiased ResultsWe believe in providing patients with all the options.
Your Data Stays Your DataWe only share your information with the clinical trials you're trying to access.
Verified Trials OnlyAll of our trials are run by licensed doctors, researchers, and healthcare companies.
Terms of Service·Privacy Policy·Cookies·Security