The Radium-select Study

NCT ID: NCT06659926

Last Updated: 2025-07-08

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

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-02-24

Study Completion Date

2029-07-01

Brief Summary

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Radium-223 is an established radionuclide therapy for patients with metastatic castration resistant prostate cancer (mCRPC) and symptomatic bone metastasis. Patients are eligible for this treatment when they have mCRPC and bone metastases; limited extraskeletal lesions (local prostate, lymph nodes \<3 cm) on conventional contrast enhanced CT (ceCT) were allowed in the registration trial(1). Previous research revealed that extraskeletal disease on ceCT and bone scans correlates with a poor response. Meanwhile, 68Ga-PSMA-PET/CT emerged as more sensitive imaging strategy that increases the detection of extraskeletal prostate cancer metastases. It is unclear whether these extraskeletal lesions harbour any predictive value in the treatment of mCRPC patients with Radium-223.

Detailed Description

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Study design:

The investigators will conduct a prospective clinical study in which patients with mCRPC and bone-only disease according to ceCT and bone scan will receive standard-of-care treatment with Radium-223. In addition to standard-of-care systemic treatment, each patient will undergo an additional 68Ga-PSMA-PET/CT scan at baseline and will be followed throughout the treatment with patient reported outcome measure (PROM) questionnaires (Kaiku application) and blood sampling for circulating tumor DNA (ctDNA) analysis. The treating physicians will be blinded to the result of the baseline 68Ga-PSMA-PET/CT scan. Each patient will receive a maximum number of 6 cycles of Radium-223 therapy according to current clinical guidelines and will undergo response evaluation by ceCT and bone scans upon clinical progression. At clinical progression, each patient will undergo a second 68Ga-PSMA-PET/CT to determine the location of disease progression and assess the value of 68Ga-PSMA-PET/CT imaging as a response measure. The clinical response of Radium-223 therapy in the patients with bone-only disease according to 68Ga-PSMA-PET/CT scanning, will be compared to the treatment outcomes collected in our previously reported ROTOR registry. Secondary aims are to determine the value of ctDNA as predictive biomarker and the value of 68Ga-PSMA-PET/CT imaging in the response assessment.

Conditions

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mCRPC Male Urogenital Diseases

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

The investigators will conduct a prospective clinical study in which patients with mCRPC and bone-only disease according to ceCT and bone scan will receive standard-of-care treatment with Radium-223. In addition to standard-of-care systemic treatment, each patient will undergo an additional 68Ga-PSMA-PET/CT scan at baseline and will be followed throughout the treatment with online patient reported outcome measure (PROM) questionnaires (Kaiku application) and blood sampling for circulating tumor DNA (ctDNA) analysis.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

The treating physicians will be blinded to the result of the baseline 68Ga-PSMA-PET/CT scan

Study Groups

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mCRPC patients with bone-only disease according to 68Ga-PSMA-PET/CT

a prospective clinical study in which patients with mCRPC and bone-only disease according to ceCT and bone scan will receive standard-of-care treatment with Radium-223. In addition to standard-of-care systemic treatment, each patient will undergo an additional 68Ga-PSMA-PET/CT scan at baseline and will be followed throughout the treatment with online patient reported outcome measure (PROM) questionnaires (Kaiku application) and blood sampling for circulating tumor DNA (ctDNA) analysis.

Group Type OTHER

68Ga-PSMA-PET/CT scan

Intervention Type OTHER

68Ga-PSMA-PET/CT scan at baseline and will be followed throughout the treatment with online patient reported outcome measure (PROM) questionnaires (Kaiku application) and blood sampling for circulating tumor DNA (ctDNA) analysis. At clinical progression, each patient will undergo a second 68Ga-PSMA-PET/CT to determine the location of disease progression and assess the value of 68Ga-PSMA-PET/CT imaging as a response measure

Interventions

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68Ga-PSMA-PET/CT scan

68Ga-PSMA-PET/CT scan at baseline and will be followed throughout the treatment with online patient reported outcome measure (PROM) questionnaires (Kaiku application) and blood sampling for circulating tumor DNA (ctDNA) analysis. At clinical progression, each patient will undergo a second 68Ga-PSMA-PET/CT to determine the location of disease progression and assess the value of 68Ga-PSMA-PET/CT imaging as a response measure

Intervention Type OTHER

Other Intervention Names

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Online patient reported outcome measure (PROM) questionnaires Blood sampling

Eligibility Criteria

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Inclusion Criteria

* Histologically confirmed adenocarcinoma of the prostate.
* Progressive disease after previous treatment defined as a rise in serum (Prostate Specific Antigen) PSA (PCWG3 criteria(22), see appendix 1) and/or progression on conventional imaging (PCWG3).
* A positive bone scan (osteoblastic bone metastases), with at least two metastases.
* Hemoglobin concentration \>10 g/dl (6.2 mmol/l) and thrombocytes \>100 109/I at baseline.
* Each patient will need to (continue to) receive adequate bone protective agents (e.g. bisphosphonates) and androgen deprivation therapy (ADT) according to current clinical guidelines.

Exclusion Criteria

* Eastern Cooperative Oncology Group (ECOG) performance score \>2
* Life expectancy \< 6 months.
* Detected extra-skeletal metastases or lymph node metastases (\>3 cm short axis) as identified by conventional imaging (ceCT thorax/abdomen)
Minimum Eligible Age

18 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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Bayer

INDUSTRY

Sponsor Role collaborator

The Netherlands Cancer Institute

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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J.C. van der Mijn

Role: PRINCIPAL_INVESTIGATOR

NKI-AvL

Locations

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NKI-AVL

Amsterdam, North Holland, Netherlands

Site Status RECRUITING

Meander Medisch Centrum

Amersfoort, Utrecht, Netherlands

Site Status RECRUITING

Sint Antonius ziekenhuis

Nieuwegein, Utrecht, Netherlands

Site Status RECRUITING

Diakonessenhuis

Utrecht, , Netherlands

Site Status NOT_YET_RECRUITING

UMC

Utrecht, , Netherlands

Site Status RECRUITING

Countries

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Netherlands

Central Contacts

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J.C. van der Mijn, Dr.

Role: CONTACT

+31205129111

Facility Contacts

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J.C. van der Mijn, MD, PhD

Role: primary

+31205129111

Joyce Dodewaard, MD, PhD

Role: primary

+31 (0)33-8501189

Jules Lavalaye, MD, PhD

Role: primary

+31 883207500

Tanja Oostergo, MD, MSc

Role: primary

+31 88 250 9810

Marnix Lam, MD, PhD

Role: primary

+31887555555

Other Identifiers

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NL86928.041.24

Identifier Type: REGISTRY

Identifier Source: secondary_id

M24PSM

Identifier Type: -

Identifier Source: org_study_id

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