PSMA Response in Metastasized Hormone Sensitive Prostate Cancer

NCT ID: NCT05161728

Last Updated: 2024-01-09

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

Clinical Phase

NA

Total Enrollment

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-10-19

Study Completion Date

2025-10-19

Brief Summary

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PSMA-PET/CT response measurements after LHRH agonist and upfront therapy in men diagnosed with de novo metastasized hormonal sensitive prostate cancer.

Detailed Description

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Rationale: Men, newly diagnosed with metastasized prostate cancer on PSMA PET/CT, who start on standard hormonal therapy, are additionally treated with either upfront chemotherapy or upfront extra androgen-receptor targeted agents ('ARTA'), as per guidelines' recommendations. The benefit in overall survival of these two options is similar, but important differences exist in patient-specific efficacy, costs, side-effects, and impact on quality of life. No predictive factors are available to individualize treatment choice. Currently, a one-size-fits-all strategy with hormonal therapy plus chemotherapy is usually followed.

Objective: To assess the predictive value of early response measurements on PSMA-PET/CT for therapy success, defined as time to development of castration-resistant prostate cancer (CRPC), in order to personalize treatment choice.

Study design: Prospective, single arm, open label, non-interventional, non-therapeutic observational cohort study.

Study population: Patients \>18 years with newly diagnosed, histologically proven prostate cancer with \>3 skeletal or visceral metastatic lesions on the PSMA-PET/CT, who are considered eligible for upfront therapy (apalutamide or abiraterone) in addition to standard hormonal therapy.

Main study parameters/endpoints:

Primary parameter: Predictive value of early response on PSMA-PET/CT to upfront therapy, according to PERCIST criteria. Primary endpoint: Time to development of CRPC. Secondary parameters: Predictive value of early response on PSMA-PET/CT to hormonal therapy; predictive value of baseline PSMA-PET/CT, analysis of response in different subgroups of patients: e.g. high versus low tumour load, high versus low PSA, high versus low Gleason score. Secondary endpoint: Time to initiation of second line therapy after castration-resistant disease has been found.

Nature and extent of the burden and risks associated with participation, benefit, and group relatedness:

Patients will be treated according to standard of care, including baseline PSMA-PET/CT. The timing of follow-up PSMA-PET/CT imaging will be standardized. Instead of imaging at biochemical or clinical signs of disease progression, one PSMA-PET/CT will be performed after two months of hormonal therapy, one PSMA-PET/CT will be performed after two months of upfront therapy. Each PSMA-PET/CT scan will require an extra visit (2-3 hours) and a limited radiation burden after intravenous injection of PSMA. The additional information from the standardized follow-up PSMA-PET/CT scans will not be used for clinical decision-making.

Conditions

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Prostate Cancer

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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PSMA response evaluation arm

PSMA-PET/CT response evaluation, 2 months after starting hormonal therapy, 2 months after starting upfront therapy

Group Type EXPERIMENTAL

PSMA-PET/CT

Intervention Type DIAGNOSTIC_TEST

PSMA-PET/CT

Interventions

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PSMA-PET/CT

PSMA-PET/CT

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Men \>18 years of age.
* Mentally competent and understanding of benefits and potential burden of the study.
* Written and signed informed consent.
* Histological confirmed diagnosis of adenocarcinoma of the prostate.
* Indicated to start on hormonal therapy (any LHRH agonist or antagonist).
* Indicated to start on upfront therapy (apalutamide or abiraterone).
* Any initial PSA.
* Any Gleason score.
* Any T-stage.
* Any N-stage.
* Stage M1, with multiple / high volume metastasis: More than three (\>3) metastatic lesions (any combination of either lymph node metastasis outside of pelvis, bone metastasis, or visceral metastasis), as seen on PSMA-PET/CT-imaging. As these patients are treated with palliative intent.

Exclusion Criteria

* Concomitant malignancy (except from BCC of the skin).
* History of prior diagnosed or treated PCa.
* Any unrelated illness (e.g. active infection, inflammation or laboratory abnormalities) that in the judgment of the investigator will significantly affect patient's clinical status and/or outcome of the study.
* Any known allergy for the upfront therapy.
* Any known allergy for LHRH agonist or antagonist.
Minimum Eligible Age

18 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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Roderick van den Bergh

OTHER

Sponsor Role lead

Responsible Party

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Roderick van den Bergh

Dr. Roderick CN van den Bergh

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Marnix Lam, MD PhD

Role: STUDY_CHAIR

UMC Utrecht

Locations

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Meander MC

Amersfoort, , Netherlands

Site Status RECRUITING

Canisius-Wilhelmina Ziekenhuis

Nijmegen, , Netherlands

Site Status RECRUITING

St Antonius Ziekenhuis

Utrecht, , Netherlands

Site Status RECRUITING

UMC Utrecht

Utrecht, , Netherlands

Site Status RECRUITING

Countries

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Netherlands

Central Contacts

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Roderick van den Bergh, MD PhD

Role: CONTACT

+31623456800

Facility Contacts

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Tom Arends

Role: primary

Jean-Paul van Basten, MD PhD

Role: primary

Roderick van den Bergh

Role: primary

+31623456800

Peter-Paul Willemse

Role: primary

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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NL77093.041.21

Identifier Type: -

Identifier Source: org_study_id

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