Evaluation of an Active Surveillance Protocol for Prostate Cancer in the Brazilian Population

NCT ID: NCT05343936

Last Updated: 2024-01-18

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

490 participants

Study Classification

OBSERVATIONAL

Study Start Date

2022-08-19

Study Completion Date

2026-12-31

Brief Summary

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In this study, the investigators aim to form a Brazilian national prospective active surveillance cohort of patients with low-risk prostate cancer in the public health system. The investigators aim to demonstrate data on the pathological reclassification rate, treatment-free survival, among others. This cohort aim to evaluate and validate the active surveillance strategy in Brazil.

Detailed Description

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Prostate cancer is the most common malignancy in men in Brazil. It is estimated that about 80% of patients diagnosed with prostate cancer have localized disease, and many of these cases have low-risk cancer.

Active surveillance(AS) is a treatment strategy mainly for low risk prostate cancer to avoid radical treatment through periodic assessments (PSA, digital rectal exam and Prostatic Biopsies). During this follow-up, the patient will be treated only when necessary and with curative intent. Several series of institutional cohorts with long-term follow-up have demonstrated that the AS strategy in selected patients is a safe alternative to immediate treatment, with comparable survival.

The active surveillance strategy has never been evaluated in the Brazilian population. The main outcomes from AS derive from international cohorts. The Brazilian population is extremely diverse, so validation in this cohort is relevant. The current study aim to form a national multicentric prospective cohort of patients with low-risk prostate cancer following an AS protocol in the the public health system to evaluate and validate this strategy in Brazil.

Conditions

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Prostate Cancer

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Active surveillance

This is a multicentric active surveillance prospective cohort study. The eligibility criteria defined are: low-risk prostate adenocarcinoma (clinical stage of cT1-T2a / Group Grade 1 (Gleason score less or equal to 6) / PSA less or equal to 10 ng/ml), transrectal prostate biopsy with at least 12 cores, estimated life expectancy over 10 years, clinical conditions for definitive treatment, multiparametric prostate MRI performed or planned.

Active surveillance

Intervention Type OTHER

The active surveillance protocol involves a TRUS prostate biopsy at eligibility, at 12 months and then every two years. MRI with or without biopsy at eligibility and then every two years. Clinical evaluation with digital rectal examination and PSA every 6 months. Every year a quality of life and anxiety evaluation are planned.

A new prostate biopsy is indicated if biochemical progression by PSA or changes in multiparametric MRI. Triggers for definitive intervention are biopsy pathological reclassification with Gleason score greater than 6, clinical progression or patient's request.

Interventions

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Active surveillance

The active surveillance protocol involves a TRUS prostate biopsy at eligibility, at 12 months and then every two years. MRI with or without biopsy at eligibility and then every two years. Clinical evaluation with digital rectal examination and PSA every 6 months. Every year a quality of life and anxiety evaluation are planned.

A new prostate biopsy is indicated if biochemical progression by PSA or changes in multiparametric MRI. Triggers for definitive intervention are biopsy pathological reclassification with Gleason score greater than 6, clinical progression or patient's request.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Pathological diagnosis of prostate adenocarcinoma;
* Prostate biopsy with at least 12 cores;
* PSA less than or equal to 10 ng/ml and clinical stage cT1/cT2a;
* Gleason score below or equal to 6 (3+3);
* Prostate multi parametric MRI performed or planned
* Availability of pathological samples

Exclusion Criteria

* Clinical contraindication to prostatectomy and/or radiotherapy procedures;
* Life expectancy below 10 years, according to the Charlson Comorbidity Index (ICC);
* Previous treatment with hormone blockade or radical therapies.
* Intraductal or cribriform histology on biopsy
Minimum Eligible Age

18 Years

Maximum Eligible Age

78 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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Hospital Moinhos de Vento

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Pedro Henrique Isaacsson Velho, M.D.

Role: PRINCIPAL_INVESTIGATOR

Head of Clinical Research

Locations

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Oncocentro Ceará

Fortaleza, Ceará, Brazil

Site Status RECRUITING

Hospital Universitário Cassiano Antônio Moraes

Vitória, Espírito Santo, Brazil

Site Status RECRUITING

Hospital Obras de Caridade Irma Dulce

Salvador, Estado de Bahia, Brazil

Site Status RECRUITING

Hospital Santa Izabel

Salvador, Estado de Bahia, Brazil

Site Status RECRUITING

Hospital Universitario de Brasilia

Brasília, Federal District, Brazil

Site Status RECRUITING

Hospital Mario Penna

Belo Horizonte, Minas Gerais, Brazil

Site Status RECRUITING

Hospital Erasto Gaertner

Curitiba, Paraná, Brazil

Site Status RECRUITING

Hospital Universitario Joao de Barros Barreto

Belém, Pará, Brazil

Site Status RECRUITING

Hospital Escola - UFPEL

Pelotas, Rio Grande do Sul, Brazil

Site Status RECRUITING

Hospital Moinhos de Vento

Porto Alegre, Rio Grande do Sul, Brazil

Site Status RECRUITING

Hospital de Clinicas de Porto Alegre

Porto Alegre, Rio Grande do Sul, Brazil

Site Status RECRUITING

Hospital Nossa Senhora da Conceição

Porto Alegre, Rio Grande do Sul, Brazil

Site Status RECRUITING

Hospital Universidade Dr. Miguel Riet Corrêa Jr.

Rio Grande, Rio Grande do Sul, Brazil

Site Status RECRUITING

Hospital de Amor

Barretos, São Paulo, Brazil

Site Status RECRUITING

IAMSPE

São Paulo, São Paulo, Brazil

Site Status RECRUITING

Countries

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Brazil

Central Contacts

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Pedro Henrique Isaacsson Velho, M.D.

Role: CONTACT

+55-51-3314-2965

Jeziel Basso, M.D.

Role: CONTACT

Facility Contacts

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Karine Martins da Trindade, MD

Role: primary

(85)3034.8693

Vitor Fiorin, MD

Role: primary

Nilo Jorge Leão, MD

Role: primary

Tercia Reis, MD

Role: primary

(71) 2203-8620

Role: backup

(71) 2203-8476

Eduardo Ribeiro, MD

Role: primary

+55 (61) 2028- 5021

Renato Corradi, MD

Role: primary

(31) 3299-9543

Murilo Luz, MD

Role: primary

Williams Barra, MD

Role: primary

(91) 3201-6705

Alessandra Notari

Role: primary

(53) 32844900 ext. 5219

Pedro Henrique Isaacsson Velho, M.D.

Role: primary

+55-51-3314-2965

Brasil Silva Neto, MD

Role: primary

Daniel Melecchi de Oliveira Freitas, MD

Role: primary

(51) 3357-2000

Hsu Yuan Ting, MD

Role: primary

(53) 3233-8851

Joao Paulo Fantin, MD

Role: primary

(17)3321-6600 ext. 7157

Renato Panhoca, MD

Role: primary

References

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Basso J, de Lima JB, Bessel M, Tobar Leitao SA, Machado Baptista T, Roithmann S, Franco Carvalhal E, da Silva Schmitt C, Morzoletto Pedrollo I, Schuch A, Atalibio Hartmann A, Neubarth Estivallet CL, Behrend Silva Ribeiro G, Zordan RA, Isaacsson Velho P. The Brazilian national prospective active surveillance (AS) cohort of patients with low-risk prostate cancer in the public health system: vigiaSUS study protocol. BMC Urol. 2023 Dec 11;23(1):208. doi: 10.1186/s12894-023-01380-w.

Reference Type DERIVED
PMID: 38082337 (View on PubMed)

Other Identifiers

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56352622.8.1001.5330

Identifier Type: -

Identifier Source: org_study_id

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