Comparison of a Novel Transperineal Targeted Fusion Biopsy System to Conventional Transrectal Targeted Fusion Biopsy

NCT ID: NCT03936127

Last Updated: 2022-10-25

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

360 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-10-11

Study Completion Date

2024-12-31

Brief Summary

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This study is designed as a randomized control trial which intends to determine if transperineal (TP) targeted biopsy is not inferior to transrectal (TR) targeted biopsy for diagnosis of clinically significant prostate cancer while comparing post-procedural infection rates between the two techniques. The study will also look to compare patient reported pain scores related to the procedure, rates of other minor complications (e.g. bleeding, urinary retention) and procedure time.

The expected sample size at The Ottawa Hospital is 360 men.

Detailed Description

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Patients undergo mp-MRI, at the discretion of the treating Urologist, when they are referred to the Cancer Assessment Clinic for their initial visit with a risk factor for prostate cancer (e.g. abnormal digital rectal exam \[DRE\] or elevated prostate serum antigen \[PSA\] level). Performing an mp-MRI in a man with risk factors for prostate cancer prior to an initial biopsy has become the standard of care for diagnosis of prostate cancer based on two large multi-center randomized control trials.

At the second visit, which is standard of care, the Urologist (or delegate \[Resident, Fellow\]) will discuss targeted biopsy and will introduce the trial design obtaining informed consent to participate. If consent is obtained, the patient will be randomly assigned to receive either the standard transrectal (TR) ultrasound guided targeted fusion biopsy or the novel transperineal (TP) targeted fusion biopsy system which has also been preliminarily validated as being accurate for detection of significant prostate cancers at targeted biopsy.

Patients will be notified regarding which method of targeted biopsy will be employed at time of scheduling.

Both the TR and TP biopsies will be conducted in existing biopsy rooms in The Ottawa Hospital (TOH) and will employ a brief 30-minute post-procedural observation period at which point the patient is required to urinate prior to discharge. Level of pain will be recorded by the ultrasound technologists during the 30 minutes observation period as well.

This study aims to compare ultrasound guided transrectal and transperineal targeted fusion biopsy for diagnosis of prostate cancer in abnormalities detected on MRI for the purpose of reducing or completely eliminating the risk of serious infection associated with the transrectal approach.

Conditions

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Prostate Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Transperineal (TP) Ultrasound (US) Targeted Fusion Biopsy

Transperineal (TP) ultrasound (US) targeted fusion biopsy (which is performed using a validated Health Canada approved elastic software fusion platform).

Group Type EXPERIMENTAL

Ultrasound (US) Targeted Fusion Biopsy

Intervention Type PROCEDURE

Ultrasound (US) Targeted Fusion Biopsy

Transrectal (TR) Ultrasound (US) Targeted Fusion Biopsies

Transrectal (TR) ultrasound (US) targeted fusion biopsy (which is performed using a validated Health Canada approved elastic software fusion platform).

Group Type ACTIVE_COMPARATOR

Ultrasound (US) Targeted Fusion Biopsy

Intervention Type PROCEDURE

Ultrasound (US) Targeted Fusion Biopsy

Interventions

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Ultrasound (US) Targeted Fusion Biopsy

Ultrasound (US) Targeted Fusion Biopsy

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* MRI positive - abnormal area detected
* Patient re-evaluated in the TOH Prostate CAC (Cancer Assessment Centre) for planning of targeted biopsy
* Signed Consent

Exclusion Criteria

* MRI negative - no abnormal area detected
* Patient with a prior diagnosis of prostate cancer enrolled in active surveillance
Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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The Ottawa Hospital Academic Medical Association

OTHER

Sponsor Role collaborator

Dr. Nicola Schieda

OTHER

Sponsor Role lead

Responsible Party

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Dr. Nicola Schieda

Director of Abdominal and Pelvic MRI, The Ottawa Hospital

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Nicola Schieda, MD

Role: PRINCIPAL_INVESTIGATOR

The Ottawa Hospital

Locations

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The Ottawa Hospital

Ottawa, Ontario, Canada

Site Status RECRUITING

Countries

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Canada

Central Contacts

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Nicola Schieda, MD

Role: CONTACT

613-759-0958

Betty Anne Schwarz, PhD

Role: CONTACT

613-798-5555 ext. 17522

Facility Contacts

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Nicola Schieda, MD

Role: primary

613-759-0958

Betty Anne Schwarz, PhD

Role: backup

613-798-5555 ext. 17522

References

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Ahmed HU, El-Shater Bosaily A, Brown LC, Gabe R, Kaplan R, Parmar MK, Collaco-Moraes Y, Ward K, Hindley RG, Freeman A, Kirkham AP, Oldroyd R, Parker C, Emberton M; PROMIS study group. Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study. Lancet. 2017 Feb 25;389(10071):815-822. doi: 10.1016/S0140-6736(16)32401-1. Epub 2017 Jan 20.

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Reference Type BACKGROUND
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Costa DN, Kay FU, Pedrosa I, Kolski L, Lotan Y, Roehrborn CG, Hornberger B, Xi Y, Francis F, Rofsky NM. An initial negative round of targeted biopsies in men with highly suspicious multiparametric magnetic resonance findings does not exclude clinically significant prostate cancer-Preliminary experience. Urol Oncol. 2017 Apr;35(4):149.e15-149.e21. doi: 10.1016/j.urolonc.2016.11.006. Epub 2016 Dec 9.

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Oderda M, Faletti R, Battisti G, Dalmasso E, Falcone M, Marra G, Palazzetti A, Zitella A, Bergamasco L, Gandini G, Gontero P. Prostate Cancer Detection Rate with Koelis Fusion Biopsies versus Cognitive Biopsies: A Comparative Study. Urol Int. 2016;97(2):230-7. doi: 10.1159/000445524. Epub 2016 Jun 4.

Reference Type BACKGROUND
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Weinreb JC, Barentsz JO, Choyke PL, Cornud F, Haider MA, Macura KJ, Margolis D, Schnall MD, Shtern F, Tempany CM, Thoeny HC, Verma S. PI-RADS Prostate Imaging - Reporting and Data System: 2015, Version 2. Eur Urol. 2016 Jan;69(1):16-40. doi: 10.1016/j.eururo.2015.08.052. Epub 2015 Oct 1.

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Related Links

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http://www.cancer.ca/en/cancer-information/cancer-type/prostate/statistics/?region=on

Canadian Cancer Society (2018) Canadian Cancer Statistics

Other Identifiers

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20190262-01H

Identifier Type: -

Identifier Source: org_study_id

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