Biological Markers and Advanced Imaging for Prostate Cancer Progression in Active Surveillance

NCT ID: NCT06866041

Last Updated: 2025-05-16

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

74 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-05-07

Study Completion Date

2030-03-31

Brief Summary

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This study aims to identify patients with low-risk prostate cancer (ISUP Grade Group 1) eligible for active surveillance who are at higher risk of upgrading to ISUP Grade Group 2 or higher at confirmatory biopsy one year after diagnosis. Patients with low-risk ISUP GG1 tumors will be selected and undergo:

* PSMA PET with calculation of SUVmax and PRIMARY-Likert score
* Whole Exome Sequencing (WES) analysis on diagnostic prostate biopsies
* Immunohistochemistry on diagnostic prostate biopsies
* Confirmatory biopsy one year after diagnosis, as recommended by international guidelines This prospective, monocentric, single-arm interventional study will assess the predictive accuracy of a multivariable model integrating next-generation imaging and molecular biomarkers to improve risk stratification in active surveillance patients.

Detailed Description

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Conditions

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Low-Risk 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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single arm

All patients with low-risk prostate cancer (ISUP Grade Group 1) eligible for active surveillance will undergo:

* PSMA-PET/MRI → Evaluation of intraprostatic PSMA expression (SUVmax, PRIMARY-likert score).
* Whole Exome Sequencing (WES) → Genomic analysis of diagnostic biopsies. Multiplex Immunohistochemistry (IHC) → Study of biomarkers on diagnostic biopsies.

Confirmation biopsy one year after diagnosis, according to international guidelines.

Group Type EXPERIMENTAL

mpMRI-targeted confirmatory biopsy

Intervention Type PROCEDURE

mpMRI-targeted confirmatory biopsy after one year from the diagnosis, according to the international guidelines

Interventions

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mpMRI-targeted confirmatory biopsy

mpMRI-targeted confirmatory biopsy after one year from the diagnosis, according to the international guidelines

Intervention Type PROCEDURE

Other Intervention Names

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18F-PSMA PET/MRI WES and spatial transcriptomics on the diagnostic biopsy specimens Multiplex immunohistochemistry on the diagnostic biopsy specimens

Eligibility Criteria

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Inclusion Criteria

* Histologically proven low-risk PCa (PSA ≤10 ng/ml; clinical stage ≤T2a, and biopsy ISUP GG 1)
* Non-metastatic status at study inclusion (patient enrollment).
* No prior or concomitant androgen deprivation therapy
* Ability to understand a written informed consent and willingness to sign it.

Exclusion Criteria

* Unable to tolerate a PSMA-PET scan
* Unwillingness to be managed with AS
* Receipt of neoadjuvant or curative-intent therapies
* Pacemaker
* Inability to obtain the FFPE prostate biopsy specimens from the initial biopsy
Minimum Eligible Age

45 Years

Maximum Eligible Age

80 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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Università Vita-Salute San Raffaele

OTHER

Sponsor Role lead

Responsible Party

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Giorgio Gandaglia

Medical Doctor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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IRCCS Ospedale San Raffaele

Milan, Italy, Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Giorgio Gandaglia

Role: CONTACT

+39 0226438068

Lucia Dambrosio

Role: CONTACT

Facility Contacts

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Giorgio Gandaglia

Role: primary

+39 0226438068

Lucia Dambrosio

Role: backup

Other Identifiers

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PSMA-AS

Identifier Type: -

Identifier Source: org_study_id

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