Accuracy of 18F-rhPSMA-7.3 PET/ MRI for Prediction of Lymph Node Metastasis in Localized High-Risk Prostate Cancer

NCT ID: NCT06389786

Last Updated: 2025-10-24

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

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-06-11

Study Completion Date

2026-05-31

Brief Summary

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This clinical trial evaluates the use of an imaging scan (18F-rhPSMA-7.3 positron emission tomography \[PET\]/magnetic resonance imaging \[MRI\]) for identifying patients who are at risk of having their disease spread to the lymph nodes in those undergoing radical prostatectomy for prostate cancer that has not spread to other parts of the body (localized). Prostate specific membrane antigen (PSMA) PET/computed tomography (CT) has emerged as an option to stage newly diagnosed high risk prostate cancer patients. PSMA PET/CT has demonstrated improved diagnostic accuracy for identifying metastasis. PET is procedure in which a small amount of radioactive glucose (sugar) is injected into a vein, and a scanner is used to make detailed, computerized pictures of areas inside the body where the glucose is used. Because cancer cells often use more glucose than normal cells, the pictures can be used to find cancer cells in the body. MRI is procedure in which radio waves and a powerful magnet linked to a computer are used to create detailed pictures of areas inside the body. These pictures can show the difference between normal and diseased tissue. This study may help researchers learn whether 18F-rhPSMA-7.3 PET/ MRI may improve predicting which patients are at risk of lymph node metastases and who are suitable candidates for pelvic lymph node dissection in patients with localized high-risk prostate cancer undergoing radical prostatectomy.

Detailed Description

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PRIMARY OBJECTIVE:

I. To investigate the diagnostic ability of flotufolastat F-18 gallium (18F-rhPSMA-7.3) PSMA PET/MRI prior to radical prostatectomy in newly diagnosed, high-risk prostate cancer patients.

SECONDARY OBJECTIVES:

I. Calculating the specificity, positive-predictive value, and negative-predictive value for the detection of lymph node positivity.

II. Investigating the rates of biochemical recurrence (BCR) as measured by post-operative prostate specific antigen (PSA) (PSA \> 0.20) at pre-defined timepoints in patients.

OUTLINE:

Patients receive 18F-rhPSMA-7.3 intravenously (IV) and undergo PET/MRI up to 30 days prior to standard of care (SOC) robotic radical prostatectomy with bilateral pelvic lymph node dissection. Patients also undergo CT/MRI or bone scan/PET, as well as tissue collection during screening.

Upon completion of study treatment, patients are followed up at 6 weeks, 3 months, 9 months, and 12 months post-surgery.

Conditions

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Localized Prostate Carcinoma Oligometastatic Prostate Carcinoma Stage I Prostate Cancer AJCC v8 Stage II Prostate Cancer AJCC v8 Stage III Prostate Cancer AJCC v8 Stage IVA Prostate Cancer AJCC v8

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

SCREENING

Blinding Strategy

NONE

Study Groups

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Screening (18F-rhPSMA-7.3 PET/MRI)

Patients receive 18F-rhPSMA-7.3 IV and undergo PET/MRI up to 30 days prior to SOC robotic radical prostatectomy with bilateral pelvic lymph node dissection. Patients also undergo CT/MRI or bone scan/PT, as well as tissue collection during screening.

Group Type EXPERIMENTAL

Bilateral Pelvic Lymph Node Dissection

Intervention Type PROCEDURE

Undergo bilateral pelvic lymph node dissection

Biospecimen Collection

Intervention Type PROCEDURE

Undergo tissue sample collection

Bone Scan

Intervention Type PROCEDURE

Undergo bone scan

Computed Tomography

Intervention Type PROCEDURE

Undergo CT

Electronic Health Record Review

Intervention Type OTHER

Ancillary studies

Flotufolastat F-18 Gallium

Intervention Type OTHER

Given IV

Laparoscopic Radical Prostatectomy with Robotics

Intervention Type PROCEDURE

Undergo robotic radical prostatectomy

Magnetic Resonance Imaging

Intervention Type PROCEDURE

Undergo MRI or PET/MRI

Positron Emission Tomography

Intervention Type PROCEDURE

Undergo PET/MRI

Interventions

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Bilateral Pelvic Lymph Node Dissection

Undergo bilateral pelvic lymph node dissection

Intervention Type PROCEDURE

Biospecimen Collection

Undergo tissue sample collection

Intervention Type PROCEDURE

Bone Scan

Undergo bone scan

Intervention Type PROCEDURE

Computed Tomography

Undergo CT

Intervention Type PROCEDURE

Electronic Health Record Review

Ancillary studies

Intervention Type OTHER

Flotufolastat F-18 Gallium

Given IV

Intervention Type OTHER

Laparoscopic Radical Prostatectomy with Robotics

Undergo robotic radical prostatectomy

Intervention Type PROCEDURE

Magnetic Resonance Imaging

Undergo MRI or PET/MRI

Intervention Type PROCEDURE

Positron Emission Tomography

Undergo PET/MRI

Intervention Type PROCEDURE

Other Intervention Names

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Biological Sample Collection Biospecimen Collected Specimen Collection Bone Scintigraphy CAT CAT Scan Computed Axial Tomography Computerized Axial Tomography Computerized axial tomography (procedure) Computerized Tomography Computerized Tomography (CT) scan CT CT Scan tomography (18F)-rhPSMA-7.3 18F-rhPSMA-7.3 18FrhPSMA-7.3 F-18-rhPSMA-7.3 Fluorine F 18 Radiohybrid PSMA-7.3 Fluorine F 18 rhPSMA-7.3 Fluorine-18 rhPSMA-7.3 Posluma rhPSMA-7.3 (18F) RARP Robot-assisted Radical Prostatectomy Magnetic Resonance Magnetic Resonance Imaging (MRI) Magnetic resonance imaging (procedure) Magnetic Resonance Imaging Scan Medical Imaging, Magnetic Resonance / Nuclear Magnetic Resonance MR MR Imaging MRI MRI Scan MRIs NMR Imaging NMRI Nuclear Magnetic Resonance Imaging sMRI Structural MRI Medical Imaging, Positron Emission Tomography PET PET Scan Positron emission tomography (procedure) Positron Emission Tomography Scan Positron-Emission Tomography PT

Eligibility Criteria

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Inclusion Criteria

* Male subjects ≥ 30 and ≤ 85 years old
* Primary diagnosis of prostate cancer selected for surgical intervention (radical prostatectomy with extended lymph node dissection)
* Primary diagnosis of untreated American Urological Association (AUA) guidelines high-risk localized prostate cancer, hormone-naïve prostate cancer via contrast enhanced prostate MRI + tissue sampling
* Planned elective radical prostatectomy with extended pelvic lymph node dissection
* Clinical oligometastatic disease with ≤ 3 nodes positive on preoperative standard of care imaging of prostate region within 6 months of surgery
* Patient agrees to comply with the investigator instructions
* Patient agrees to comply with the follow-up surveillance schedule
* Have ability to provide full written consent

Exclusion Criteria

* High-risk cancer planned for neoadjuvant therapy
* Patients with a history of more than two weeks treatment with immunosuppressants (including systemic corticosteroids), cytotoxic chemotherapy within one month prior to initial screening, or who receive such medications during the screening period, or who are anticipated to require such medications during the course of the study
* Patients that have had prior hormonal therapy such as Lupron or oral antiandrogens ≤ 12 weeks prior to registration
* Clinical oligometastatic disease with \> 3 nodes positive preoperative standard of care imaging of prostate region
* Previous history of pelvic radiation
* Patients with obesity defined as body mass index (BMI) \> 40 kg/m\^2
* History of prior laparoscopic inguinal hernia repair with mesh
* Scheduled at the time of screening to undergo chemotherapy, radiation, hormone therapy, or open surgery during the study period
* Inability to lie still for 75 minutes during 18F-rhPSMA-7.3 PSMA PET-MRI imaging
* Any neurologic disorder or psychiatric disorder that might confound postsurgical assessments
* Has any condition(s), which seriously compromises the subject's ability to participate in this study, sign consent, or has a known history of poor adherence with medical treatment
* Received administration of an investigational drug within 30 days prior to study registration, and/or has planned administration of another investigational product or procedure during participation in this study
Minimum Eligible Age

30 Years

Maximum Eligible Age

85 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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Mayo Clinic

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Ram A. Pathak, MD

Role: PRINCIPAL_INVESTIGATOR

Mayo Clinic

Locations

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Mayo Clinic in Florida

Jacksonville, Florida, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Clinical Trials Referral Office

Role: CONTACT

855-776-0015

Facility Contacts

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Clinical Trials Referral Office

Role: primary

855-776-0015

Related Links

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Other Identifiers

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NCI-2024-03306

Identifier Type: REGISTRY

Identifier Source: secondary_id

23-009377

Identifier Type: OTHER

Identifier Source: secondary_id

MC230504

Identifier Type: OTHER

Identifier Source: secondary_id

MC230504

Identifier Type: -

Identifier Source: org_study_id

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