Trial examines whether targeted steam can destroy prostate cancer
Key takeaways:
- The steam-based treatment offers a less invasive option to patients with intermediate-risk prostate cancer.
- A national, multisite clinical trial is evaluating the approach’s safety and efficacy.
Researchers at Keck Medicine of USC are part of a national, multisite clinical trial to evaluate a minimally invasive water vapor system that uses steam to treat prostate cancer.
Vanquish Water Vapor Ablation System (Francis Medical) uses small, targeted amounts of steam to kill cancer cells. The trial will evaluate the safety and efficacy of the system in patients with intermediate-risk prostate cancer.
Patients with low-risk and indolent prostate cancer may not require treatment. When treatment is needed, however, the traditional approaches include surgery or radiation. Although these traditional strategies usually are effective, they may lead to adverse events.
The water vapor system is a minimally invasive treatment currently being studied for prostate cancer treatment.
Prior to the procedure, physicians locate the cancer cells in the prostate using MRI and 3D mapping prostate biopsies. The VAPOR procedure involves using ultrasonography and prostate mapping to place a needle into the area of the prostate where the tumor is located. The physician then releases a targeted burst of steam to destroy the tumor. The outpatient procedure is designed to be effective after one application.
The clinical trial is being conducted at up to 30 U.S. hospitals and health centers, with post-treatment outcomes to be followed for 5 years. To date, more than 180 procedures have been completed, according to the release.
“If this trial is successful, this would greatly impact patients with localized prostate cancer,” Andre Abreu, MD, a urologist at Keck Medicine and lead investigator of the Keck clinical trial site, told Healio. “For carefully selected patients, this intervention has the potential to control the disease and achieve similar outcomes as the radical treatments, yet keeping the patients’ quality of life, [including] continence, potence and bowel function.”
Healio spoke with Abreu about the need for less invasive approaches for treating prostate cancer and how he hopes this approach will affect routine clinical practice.
Healio: What are the drawbacks to current prostate cancer treatment approaches?
Abreu: The current paradigm for prostate cancer treatment is all-or-nothing. Some types of prostate cancer are low-risk or nonaggressive. We usually don’t treat these patients because they don’t benefit from treatment. In cases of high-risk disease, the treatment is usually prostatectomy or radiation therapy that treats the whole prostate. However, there are patients in between who are considered intermediate risk. Overall, these patients aren’t ideal candidates for surveillance. However, if you treat them with traditional methods, they will be exposed to side effects that could otherwise be avoided. These side effects include incontinence, impotency and bowel dysfunction. For select patients who fall into the intermediate-risk category, we need to find a solution that can control or cure the cancer while decreasing or minimizing side effects.
Healio: What motivated you to evaluate the water vapor system?
Abreu: The concept of treating only part of the prostate while avoiding radical treatments parallels organ-preserving approaches used in other cancers, such as lumpectomy for breast cancer or partial nephrectomy for kidney cancer. In the past, women with breast cancer often underwent radical mastectomy, a procedure that significantly impacted their quality of life. Similarly, patients with kidney cancer used to undergo radical nephrectomy that could compromise the renal function. Currently, many eligible patients can opt for lumpectomy, which removes the affected portion of the breast while preserving its overall appearance while maintaining cancer control. Similar to a lumpectomy in breast cancer or a partial nephrectomy, where only the affected portion of the kidney is removed and therefore the renal function is preserved, we aimed to explore partial prostate gland ablation—also known as focal therapy—for prostate cancer treatment in men.
Healio: How is the steam ablation procedure performed, and how was the technology developed?
Abreu: The steam ablation device was originally developed to treat benign prostatic hyperplasia (BPH), where precision is less critical. However, for prostate cancer treatment, the technology has been refined to precisely target the cancerous area. The prostate cancer treatment requires focusing on the malignant region with appropriate margins while preserving surrounding structures, such as the nerves responsible for sexual function and the external sphincter essential for urinary continence. This advanced device allows for real-time intraoperative cancer localization, enabling precise needle placement within the tumor and its margins. Once the needle is positioned, multiple bursts of water vapor are delivered to ablate the cancerous tissue while minimizing damage to adjacent healthy structures.
Healio: What are some of the other benefits of this approach?
Abreu: Patients undergoing prostate removal surgery typically require hospitalization and may experience complications, such as bleeding requiring a blood transfusion. Radiation therapy usually involves multiple treatment sessions and carries a risk of complications. In contrast, the water vapor procedure is a single outpatient treatment lasting about two hours. The complication rate for the water vapor procedure is expected to be very low.
Healio: What is the current status of the clinical trial?
Abreu: The trial has accrued and enrolled all its patients. It is my understanding that by the end of February, all the patients will be treated, and we will follow those patients according to the protocol. We will perform follow-up assessments to monitor for complications and ensure patient safety. In addition, we will administer multiple questionnaires to evaluate quality of life, along with PSA blood tests, MRIs, and prostate biopsies to assess the success of the treatment.
Healio: What are the potential implications of this research?
Abreu: If successful, this trial would be the first FDA-approved treatment for prostate cancer utilizing partial gland ablation. It has the potential to retain quality of life, enhance patient satisfaction, and maintain cancer control or cure, as well as overall survival. Given the high prevalence of prostate cancer, this innovation can have a significant impact on both the field and patient care.
Reference:
- Keck Medicine of USC. Can you steam away prostate cancer (press release)? Available at: https://news.keckmedicine.org/can-you-steam-away-prostate-cancer/. Published Jan. 7, 2025. Accessed Feb. 17, 2025.
For more information:
Andre Abreu, MD, can be reached at andre.abreu@med.usc.edu.
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