A trial looking at a device called Nanoknife to treat small areas of prostate cancer (NEAT)

Cancer type:

Prostate cancer

Status:

Results

Phase:

Other

This trial looked at treating prostate cancer with a device called a Nanoknife. It uses electrical current to destroy areas of cancer.

More about this trial

Treatment for prostate cancer that has not spread outside the prostate gland includes surgery or radiotherapy. But these are treatments to the whole prostate gland and often cause side effects such as problems getting an erection, urinary problems, diarrhoea and pain or bleeding from the back passage.

For some men, radiotherapy or surgery to remove the prostate gland is not a suitable treatment, or they don’t want to have the side effects of these treatments. For these men, monitoring the cancer until it starts to grow may be an option. This called active surveillance.

One other option may be to only treat the area of the prostate that contains cancer. This is called focal therapy. Nanoknife is a type of focal therapy. It has already been used to treat some other types of cancer. Researchers wanted to find out how well it works for prostate cancer.

If there is only a small area of cancer, doctors can treat all of it with focal therapy. But if there is more than one area, they may use focal therapy to treat only the biggest area of cancer. This is because they think only larger areas of prostate cancer are likely to get worse or spread. Doctors describe these areas as being clinically significant.

In this trial, doctors only treated clinically significant areas of cancer in the front part of the prostate gland. But they regularly checked the other areas to make sure they weren’t getting worse.

The aims of this trial were to see:

how safe Nanoknife is
how well it works as a treatment for prostate cancer in the short term

Summary of results

This trial showed that Nanoknife treatment didn’t cause serious side effects. But didn’t work as well as the research team would have liked.

This trial recruited 19 men with prostate cancer that was contained within the prostate gland and had not spread. They all had Nanoknife treatment. The treatment took between 55 minutes and 1 hour 20 minutes. 16 of the 19 men completed all the trial visits, up to a year after treatment.

None of the men taking part had any serious side effects. Some men had side effects which were not classed as serious. These included things such as pain or difficulty passing urine, or a urine infection. But none of the men had any problems with leaking urine (incontinence) either before treatment, or afterwards.

4 out of 16 men (25%) had difficulty maintaining an erection (impotence) at the start of the trial. This increased to 5 out of 16 men (31%) a year after treatment.

The men taking part completed quality of life questionnaires as part of the trial. These ask a number of questions about how the men are feeling and about any problems they may be having. The results showed that their quality of life had not gone down as a result of having Nanoknife treatment. In some areas, it had improved.

The research team also looked at how well the treatment had worked. 18 of the 19 men who had treatment had another biopsy done of the area that was treated. The researchers found that:

11 out of 18 men (61%) had no cancer left
7 out of 18 men (39%) had some cancer left

These results were not as good as the research team had hoped they would be. This could have been because of the position of the cancer within the prostate gland. Or perhaps because they didn’t treat a large enough area of the prostate around the cancer.

The trial team concluded that Nanoknife treatment didn’t cause many side effects and was safe to use. But that more work needs to be done to find out the best way to do it, and which men it works best for.

We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item ) and published in a medical journal. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.