Prospective REgistry of Targeted RadionucLide TherapY in Patients With mCRPC (REALITY Study)

NCT ID: NCT04833517

Last Updated: 2022-12-08

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

RECRUITING

Total Enrollment

500 participants

Study Classification

OBSERVATIONAL

Study Start Date

2016-01-01

Study Completion Date

2025-12-31

Brief Summary

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This prospective registry aims to assess outcome and toxicity of targeted radionuclide therapies in patients with advanced prostate cancer in clinical routine. While the major investigated treatment modality is prostate-specific membrane antigen (PSMA)-targeted radioligand therapy, also other radionuclide therapies such as Ra223 and liver-directed radioembolization are included. The investigators believe that prospectively assessed long-term outcome data on implementation of radionuclide therapy, especially in the palliative setting of advanced mCRPC, help to better define the real benefits and risks of the respective treatment modalities for patients regarding survival and quality-of-life.

Detailed Description

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Targeted radionuclide therapy is comprised of different modalities that may be applied in advanced prostate cancer, either targeting bone metastases (mainly using Radium-223), any site of metastases with PSMA-expression (ß- / alpha-emitter labelled radioligands) or loco-regionally applying internal radiation (Yttrium-90 microspheres) to metastatic liver disease. While in Germany, each form of treatment is used in clinical routine, data is sparse regarding the real benefits and risks of respective modalities, also when used in a sequential order. As an example, patients receiving Ra223 treatment may later undergo PSMA targeted radioligand therapy, with little data available on dependent response relationships or cumulative risks. Prospective assessment of outcomes and toxicities in a radionuclide therapy registry is apparently superior over retrospective analyses of selected patient populations.

The goal of the REALITY study is to gain a better understanding of the real-life clinical application of radionuclide therapies, with a focus on PSMA-targeted radioligand therapy in a high-volume treatment centre, and the impact of each treatment for patient outcome.

Based on primary and secondary outcome measures the potential prediction of treatment benefit by baseline patient and tumor characteristics, and early changes of biomarkers will be of interest.

Conditions

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Prostate Cancer Metastatic Castration Resistant Prostatic Cancer Advanced Prostate Carcinoma

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Lu177 PSMA RLT

Lutetium-177 prostate-specific membrane antigen (Lu177 PSMA) radioligand therapy (RLT) according to standard local protocol

No interventions assigned to this group

Ac225 PSMA RLT

Actinium-225 prostate-specific membrane antigen (Ac225 PSMA) radioligand therapy (RLT) according to standard local protocol

No interventions assigned to this group

Tandem Lu177 / Ac225 PSMA RLT

Combined Lu177 / Ac225 PSMA radioligand therapy according to standard local protocol

No interventions assigned to this group

Ra223 chloride

Bone-targeted Radium-223 (Ra223) radionuclide therapy in standard application

No interventions assigned to this group

Sm153 EDTMP

Bone-targeted Samarium-153 (Sm153) EDTMP radionuclide therapy in standard application

No interventions assigned to this group

Y90 microspheres

Radioembolization with yttrium-90 (Y90) microspheres, standard methodology

No interventions assigned to this group

Tb161 PSMA RLT

Terbium-161 prostate-specific membrane antigen (Tb161 PSMA) radioligand therapy (RLT) according to standard local protocol

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Signed informed consent form (Registry Study Inclusion Form)


* sufficient tumoral PSMA expression defined as tracer uptake markedly higher than (physiologic) uptake in healthy liver tissue.
* sufficient bone marrow reserve: leukocytes ≥ 2 G/L, platelets \> 75 × 109/L
* sufficient overall patient condition: Eastern Oncology Cooperative Group (ECOG) performance status ≤ 3

Exclusion Criteria

* Inability or unwillingness to provide informed consent
Minimum Eligible Age

18 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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Universität des Saarlandes

OTHER

Sponsor Role lead

Responsible Party

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Samer Ezziddin, MD

Director, Dept. of Nuclear Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Samer Ezziddin, MSc, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Universität des Saarlandes

Locations

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Dept. of Nuclear Medicine, Saarland University

Homburg, Saarland, Germany

Site Status RECRUITING

Countries

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Germany

Central Contacts

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Samer Ezziddin, MSc, MD, PhD

Role: CONTACT

+49 6841 16 22201

Katja Threm

Role: CONTACT

+49 6841 16 24667

References

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Bastian MB, Speicher T, Blickle A, Burgard C, Bastian JLD, Bartholoma M, Schaefer-Schuler A, Maus S, Ezziddin S, Rosar F. Tolerability of PSMA radioligand therapy in metastatic prostate cancer patients with baseline mild to moderate leukopenia. EJNMMI Res. 2025 Jul 6;15(1):82. doi: 10.1186/s13550-025-01280-0.

Reference Type DERIVED
PMID: 40619537 (View on PubMed)

Rosar F, Schuler J, Burgard C, Blickle A, Bartholoma M, Maus S, Petto S, Khreish F, Schaefer A, Ezziddin S. Efficacy and safety of rechallenge [177Lu]Lu-PSMA-617 RLT after initial partial remission in patients with mCRPC: evaluation of a prospective registry (REALITY study). Eur J Nucl Med Mol Imaging. 2024 Nov;51(13):4151-4162. doi: 10.1007/s00259-024-06825-4. Epub 2024 Jul 15.

Reference Type DERIVED
PMID: 39008067 (View on PubMed)

Rosar F, Burgard C, Rohloff LV, Blickle A, Bartholoma M, Maus S, Petto S, Schaefer-Schuler A, Ezziddin S. 225 Ac-PSMA-617 Augmentation in High-Risk mCRPC Undergoing 177 Lu-PSMA-617 Radioligand Therapy : Pilot Experience From a Prospective Registry. Clin Nucl Med. 2024 Jul 1;49(7):621-629. doi: 10.1097/RLU.0000000000005253. Epub 2024 May 21.

Reference Type DERIVED
PMID: 38769643 (View on PubMed)

Burgard C, Hein C, Blickle A, Bartholoma M, Maus S, Petto S, Schaefer-Schuler A, Ezziddin S, Rosar F. Change in total lesion PSMA (TLP) during [177Lu]Lu-PSMA-617 radioligand therapy predicts overall survival in patients with mCRPC: monocentric evaluation of a prospective registry. Eur J Nucl Med Mol Imaging. 2024 Feb;51(3):885-895. doi: 10.1007/s00259-023-06476-x. Epub 2023 Oct 27.

Reference Type DERIVED
PMID: 37889298 (View on PubMed)

Other Identifiers

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RNT-Prostate

Identifier Type: -

Identifier Source: org_study_id

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