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MR Guided Focused Ultrasound Surgery of Metastatic Bone Tumors

Phase 1
18 Years
Not Enrolling
Bone Metastases

Thank you

Trial Information

MR Guided Focused Ultrasound Surgery of Metastatic Bone Tumors

Bone is the third most common organ involved by metastasic disease behind lung and liver. In
breast cancer, bone is the second most common site of metastatic spread, and 90% of patients
dying of breast cancer have bone metastasis. Breast and prostate cancer metastasize to bone
most frequently, which reflects the high incidence of both these tumors, as well as their
prolonged clinical courses.

Post cancer survival has increased with improvement in early detection and treatments. As
a consequence, the number of patients developing metastatic bone disease during their
lifetime has also increased. Patients with bone metastasis from breast cancer have an
average 2-year survival from the time of presentation with their first bone lesion. In
patients who die from breast, prostate, and lung cancer, autopsy studies have shown that up
to 85% have evidence of bone metastases at the time of death.

Current treatments for patients with bone metastases are primarily palliative and include
localized therapies (radiation and surgery), systemic therapies (chemotherapy, hormonal
therapy, radiopharmaceutical, and bisphosphanates), and analgesics (opioids and
non-steroidal anti-inflammatory drugs). Recently, radiofrequency ablation has been tested
as a treatment option for bone metastases. The main goals of these treatments are
improvement of quality of life and functional level. These goals can be further described:
1) Pain relief, 2) Preservation and restoration of function, 3) Local tumor control, 4)
Skeletal stabilization.

The study hypothesis is that MRgFUS is a safe and potentially effective non-invasive
treatment for metastatic bone tumors with a low incidence of co-morbidity. Based on the
result of this study the Sponsor will initiate a larger study in an effort to approve
metastatic bone tumors as an indication for its MRgFUS ExAblate device.

Inclusion Criteria:

1. Men and women age 18 and older

2. Patients who are able and willing to give consent and able to attend all study visits

3. Patients with histologically or cytologically confirmed malignant disease with a bone
lesion that appears to be metastatic disease by clinical and or imaging techniques

4. Must have persistent pain from at least one site of bone metastases

- Patient with VAS pain score ≥ 4, when VAS test taken without medication, OR

- Patient taking pain-relieving medication for management of bone metastases.

5. Targeted tumor(s) are ExAblate device accessible

6. Targeted tumor(s) size is smaller than 8 cm in diameter

7. Patient whose lesion is on bone and is ≥ 10-mm from the skin.

8. Tumor(s) clearly visible by non-contrast MRI

9. Able to communicate sensations during the MRgFUS ExAblate treatment

10. At least 2 weeks since chemotherapy

11. At least 1 month since radiation therapy

Exclusion Criteria:

1. Diffuse skeletal tumoral spread as evaluated by imaging.

2. Patients who need pre-treatment surgical stabilization of the affected bony

3. Targeted tumor is in weight bearing bones or impending fracture

4. Targeted tumor is in the vertebral column.

5. Patients with unstable cardiac status including:

- Unstable angina pectoris on medication

- Patients with documented myocardial infarction within six months of protocol

- Congestive heart failure requiring medication (other than diuretic)

- Patients on anti-arrhythmic drugs

6. Severe hypertension (diastolic BP > 100 on medication)

7. Patients with standard contraindications for MR imaging such as non-MRI compatible
implanted metallic devices including cardiac pacemakers, size limitations (weight
>250 pounds), etc.

8. Known intolerance or allergies to the MRI contrast agent (e.g. Gadolinium or

9. ASA Score>2 (See "Definitions" below)

10. Extensive scarring in an area in the path of energy planned passage to the treatment

11. Severe cerebrovascular disease (multiple CVA or CVA within 6 months)

12. Patients on anti-coagulation therapy or those with an underlying bleeding disorder.

13. Individuals who are not able or willing to tolerate the required prolonged stationary
position during treatment (approximately 3 hrs.)

14. Patient whose lesion is < 10-mm from the skin

15. Patients with < 2-Weeks since chemotherapy

16. Patient with < 1-Month since radiation therapy

17. Patients with life expectancy < 6-Months

18. Patients with surgical stabilization of tumor site with metallic hardware

Type of Study:


Study Design:

Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Determine safety of MRgFUS of Bone Metastases

Outcome Time Frame:

Within 1 month of Treatment

Safety Issue:


Principal Investigator

Christine Chung, M.D.

Investigator Role:

Principal Investigator

Investigator Affiliation:

University of California, San Diego


United States: Food and Drug Administration

Study ID:




Start Date:

May 2006

Completion Date:

February 2010

Related Keywords:

  • Bone Metastases
  • Bone Tumors
  • Bone Cancer
  • Prostate Cancer
  • lung cancer
  • Bone Neoplasms
  • Neoplasm Metastasis
  • Bone Marrow Diseases



University of California at San Diego La Jolla, California  92093