Trial of Prostate Cancer Patients Undergoing Active Surveillance With or Without MRI-Guided Management

NCT ID: NCT01838265

Last Updated: 2014-12-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

WITHDRAWN

Study Classification

OBSERVATIONAL

Study Start Date

2012-08-31

Brief Summary

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1. Using multiparametric MRI Ultrasound-guided or MRI-guided biopsies will allow more accurate sampling of the tumors and therefore will increase the rate of "progression" on early (first and second) surveillance biopsies and decrease the rate of "progression" on late (third and further) surveillance biopsies compared to Transrectal Ultrasound-guided biopsies.
2. Quality of life (QoL) will be similar in patients undergoing MRI Ultrasound or MRI-guided and Transrectal Ultrasound-guided biopsies.
3. Biomarker expression levels will correlate with biopsy progression.

Detailed Description

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Favorable risk patients will be randomized to one of two active surveillance arms. Stratification will be based on Prostate-specific antigen density (PSAD) (=\< 0.15 vs \> 0.15 ng/mL per mL), and number of positive cores in the diagnostic biopsy (1 vs 2):

* Arm I: Active Surveillance Alone (AS). TRUS guided biopsies at start (within 6 months of enrollment) and at yearly intervals thereafter up to 36 months after the initial biopsy (maximum four biopsies).
* Arm II: MRI-Managed Active Surveillance (MRI-AS). MRIus or MRI-guided biopsies at start (within 6 months of enrollment) and at yearly intervals thereafter up to 36 months after the initial biopsy (maximum four biopsies).

Patients will also complete Quality of Life (QoL) assessments to provide unique data on the effects of MRI monitoring for patients undergoing active surveillance on QOL. The investigators have selected a group of measures that have been used extensively in prostate cancer populations.

Conditions

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Prostate Cancer Prostate Adenocarcinoma

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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AS: Active Surveillance Alone

Active Surveillance Alone (AS). Transrectal Ultrasound-guided biopsies within 6 months of enrollment and at 1 year intervals thereafter (maximum four biopsies).

Transrectal Ultrasound-Guided Biopsy

Intervention Type PROCEDURE

Active Surveillance Alone (AS). Transrectal Ultrasound-guided biopsies within 6 months of enrollment and at 1 year intervals thereafter (maximum four biopsies).

Expanded Prostate Cancer index Composite Questionnaire

Intervention Type BEHAVIORAL

Quality of life questionnaire obtained at Baseline, and at 12, 24 and 36 months after initial biopsy

Short-Form 12 of Health Related Quality of Life Questionnaire

Intervention Type BEHAVIORAL

Quality of life questionnaire obtained at Baseline, and at 12, 24 and 36 months after initial biopsy

Memorial Anxiety Scale for Prostate Cancer

Intervention Type BEHAVIORAL

Quality of life questionnaire obtained at Baseline, and at 12, 24 and 36 months after initial biopsy

Plasma/Serum Sample for biomarkers

Intervention Type PROCEDURE

Plasma/Serum Sample for biomarkers obtained at Baseline, and at 12, 24 and 36 months after initial biopsy for correlative studies (CTC, fcDNA, SNPs)

Urine Sample for Biomarkers

Intervention Type PROCEDURE

Urine Sample for biomarkers obtained at Baseline, and at 12, 24, and 36 months for correlative studies (hypermethylated DNA)

Blood Tests for Blood Urea Nitrogen and Creatinine

Intervention Type PROCEDURE

Blood Tests for Blood Urea Nitrogen (BUN) and Creatinine obtained at 0 - 6 months, and at 12, 24, and 36 months from initial biopsy. This is optional, subject may refuse

Blood Test for Serum PSA

Intervention Type PROCEDURE

Blood test for Serum PSA obtained at Baseline, at every 6 months up to 36 months from initial biopsy.

MRI-AS: MRI+ Active Surveillance

MRI-Managed Active Surveillance (MRI-AS). MRI Ultrasound or MRI-guided biopsies within 6 months of enrollment and at 1 year intervals thereafter (maximum four biopsies)

MRI Ultrasound Biopsy

Intervention Type PROCEDURE

MRI-Managed Active Surveillance (MRI-AS). MRI Ultrasound or MRI-guided biopsies within 6 months of enrollment and at 1 year intervals thereafter (maximum four biopsies)

Expanded Prostate Cancer index Composite Questionnaire

Intervention Type BEHAVIORAL

Quality of life questionnaire obtained at Baseline, and at 12, 24 and 36 months after initial biopsy

Short-Form 12 of Health Related Quality of Life Questionnaire

Intervention Type BEHAVIORAL

Quality of life questionnaire obtained at Baseline, and at 12, 24 and 36 months after initial biopsy

Memorial Anxiety Scale for Prostate Cancer

Intervention Type BEHAVIORAL

Quality of life questionnaire obtained at Baseline, and at 12, 24 and 36 months after initial biopsy

Plasma/Serum Sample for biomarkers

Intervention Type PROCEDURE

Plasma/Serum Sample for biomarkers obtained at Baseline, and at 12, 24 and 36 months after initial biopsy for correlative studies (CTC, fcDNA, SNPs)

Urine Sample for Biomarkers

Intervention Type PROCEDURE

Urine Sample for biomarkers obtained at Baseline, and at 12, 24, and 36 months for correlative studies (hypermethylated DNA)

Blood Tests for Blood Urea Nitrogen and Creatinine

Intervention Type PROCEDURE

Blood Tests for Blood Urea Nitrogen (BUN) and Creatinine obtained at 0 - 6 months, and at 12, 24, and 36 months from initial biopsy. This is optional, subject may refuse

Blood Test for Serum PSA

Intervention Type PROCEDURE

Blood test for Serum PSA obtained at Baseline, at every 6 months up to 36 months from initial biopsy.

Interventions

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Transrectal Ultrasound-Guided Biopsy

Active Surveillance Alone (AS). Transrectal Ultrasound-guided biopsies within 6 months of enrollment and at 1 year intervals thereafter (maximum four biopsies).

Intervention Type PROCEDURE

MRI Ultrasound Biopsy

MRI-Managed Active Surveillance (MRI-AS). MRI Ultrasound or MRI-guided biopsies within 6 months of enrollment and at 1 year intervals thereafter (maximum four biopsies)

Intervention Type PROCEDURE

Expanded Prostate Cancer index Composite Questionnaire

Quality of life questionnaire obtained at Baseline, and at 12, 24 and 36 months after initial biopsy

Intervention Type BEHAVIORAL

Short-Form 12 of Health Related Quality of Life Questionnaire

Quality of life questionnaire obtained at Baseline, and at 12, 24 and 36 months after initial biopsy

Intervention Type BEHAVIORAL

Memorial Anxiety Scale for Prostate Cancer

Quality of life questionnaire obtained at Baseline, and at 12, 24 and 36 months after initial biopsy

Intervention Type BEHAVIORAL

Plasma/Serum Sample for biomarkers

Plasma/Serum Sample for biomarkers obtained at Baseline, and at 12, 24 and 36 months after initial biopsy for correlative studies (CTC, fcDNA, SNPs)

Intervention Type PROCEDURE

Urine Sample for Biomarkers

Urine Sample for biomarkers obtained at Baseline, and at 12, 24, and 36 months for correlative studies (hypermethylated DNA)

Intervention Type PROCEDURE

Blood Tests for Blood Urea Nitrogen and Creatinine

Blood Tests for Blood Urea Nitrogen (BUN) and Creatinine obtained at 0 - 6 months, and at 12, 24, and 36 months from initial biopsy. This is optional, subject may refuse

Intervention Type PROCEDURE

Blood Test for Serum PSA

Blood test for Serum PSA obtained at Baseline, at every 6 months up to 36 months from initial biopsy.

Intervention Type PROCEDURE

Other Intervention Names

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TRUS EPIC SF-12 SF-12 HRQOL MAX-PC PSA test

Eligibility Criteria

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Inclusion Criteria

* Biopsy confirmed adenocarcinoma of the prostate.
* Biopsy must consist of at least 8 cores.
* Enrollment is =\< 1 year from diagnosis.
* One or two biopsy cores with less than 50% tumor present in each core and Gleason score =\< 6 (3+3).
* Candidate for multiparametric MRI.
* T1-T2a disease based on digital rectal exam.
* No concurrent, active malignancy, other than nonmetastatic skin cancer or early stage chronic lymphocytic leukemia (well-differentiated small cell lymphocytic lymphoma). If a prior malignancy is in remission for \>= 5 years then the patient is eligible.
* Ability to understand and willingness to sign a written informed consent document
* Zubrod performance status \< 2.
* Patients must agree to fill out the psychosocial questionnaires.
* Age \>= 35 and =\< 75 years

Exclusion Criteria

* Not biopsy confirmed adenocarcinoma of the prostate.
* Biopsy consists of less than 8 cores.
* Three or more biopsy cores are positive.
* Gleason score \>= 3+4=7.
* A single core has \>= 50% involvement with Gleason score =6 (3+3) or less.
* DCE-MRI study before enrollment.
* Inability to undergo MRI exam.
* Greater than T2a disease based on digital rectal exam.
* Concurrent, active malignancy, other than nonmetastatic skin cancer or early stage chronic lymphocytic leukemia (well-differentiated small cell lymphocytic lymphoma). If a prior malignancy is in remission for \< 5 years then the patient is ineligible
* Inability to understand or unwilling to sign a written informed consent document.
* Zubrod performance status \>= 2.
* Patient unwilling to fill out the psychosocial questionnaires.
* Age \< 35 or \> 75.
Minimum Eligible Age

35 Years

Maximum Eligible Age

75 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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University of Miami

OTHER

Sponsor Role lead

Responsible Party

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Sanoj Punnen

Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Dipen Parekh, MD

Role: PRINCIPAL_INVESTIGATOR

University of Miami

Alan Pollack, MD

Role: PRINCIPAL_INVESTIGATOR

University of Miami

Sanoj Punnen, MD

Role: PRINCIPAL_INVESTIGATOR

University of Miami

Locations

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University of Miami

Miami, Florida, United States

Site Status

Countries

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United States

Other Identifiers

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20120698

Identifier Type: -

Identifier Source: org_study_id