Study of PSMA PET/CT Imaging to Help Select Men With Low-Risk Prostate Cancer for Active Surveillance

NCT ID: NCT07168616

Last Updated: 2025-09-15

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

201 participants

Study Classification

OBSERVATIONAL

Study Start Date

2025-09-01

Study Completion Date

2028-06-01

Brief Summary

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This is a multicenter, prospective diagnostic accuracy study evaluating the Istanbul PSMA PET/CT Criteria (IPPC) for selecting patients with biopsy-confirmed low-risk prostate cancer (ISUP Grade 1) for active surveillance (AS). The study integrates delayed Ga-68 PSMA PET/CT imaging into the diagnostic pathway to refine patient stratification, minimize overtreatment and potentially reduce unnecessary biopsies and MRI, or exposing high-risk individuals to the danger of cancer progression if left untreated scans.

Detailed Description

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Prostate cancer is the most common malignancy in men and demonstrates heterogeneous clinical behavior. While many low-risk patients have indolent disease, a subset harbors clinically significant prostate cancer (csPCa) requiring early intervention. Active Surveillance (AS) is widely used to avoid overtreatment; however, current selection criteria-PSA, DRE, biopsy Gleason score, number of positive cores, PSA density, and mpMRI-lack sufficient predictive accuracy. Studies indicate that up to 30% of patients classified as low-risk by biopsy are found to have higher-grade disease at radical prostatectomy. The Istanbul PSMA PET/CT Criteria (IPPC) were developed by a multidisciplinary expert panel in Turkey to classify intraprostatic lesions on delayed (120-minute) Ga-68 PSMA PET/CT imaging into three risk categories:

* IPPC 1 No or homogeneous low uptake - safe for monitoring.
* IPPC 2: Indeterminate uptake - AS with close follow-up.
* IPPC 3: Focal, lentiform, high SUVmax ≥12 uptake in peripheral zone - definitive treatment recommended.

This study will evaluate the diagnostic performance of IPPC compared to standard mpMRI and biopsy findings, using radical prostatectomy pathology or long-term clinical follow-up as the reference standard.

Conditions

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Low Risk Prostate Cancer Clinically Significant Prostate Cancer

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Interventions

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Ga-68 PSMA11 PET/CT

delayed (120-minute) Ga-68 PSMA PET/CT and will be evaluated by using Istanbul PSMA PET/CT Criteria (IPPC)

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* mpMRI performed within 3 months prior to enrollment
* Systematic or MRI-targeted prostate biopsy performed
* Biopsy-confirmed ISUP Grade 1 low-risk PCa
* Prostate biopsy report specifying tumor localization and number of positive cores
* Meets AS criteria: ISUP 1, PSA ≤10 ng/mL, PSAd \>0.15 ng/mL², clinical stage cT1c-T2a, ≤3 positive cores
* Life expectancy ≥10 years
* No prior PSMA PET imaging
* No evidence of extra-prostatic disease on mpMRI
* Signed informed consent for study procedures

Exclusion Criteria

* High-risk or unfavorable intermediate-risk PCa, or adverse histologies (neuroendocrine, ductal adenocarcinoma, basal cell carcinoma, TP53 or BRCA1/2 mutations if available)
* Prior prostate cancer treatment or prostate surgery
* MRI evidence of extracapsular extension, seminal vesicle invasion, or nodal metastasis
* History of pelvic radiotherapy
* Life expectancy \<10 years
* Severe renal impairment
* Inability to comply with follow-up schedule
Minimum Eligible Age

18 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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Yeditepe University

OTHER

Sponsor Role collaborator

Yedikule Training and Research Hospital

OTHER

Sponsor Role collaborator

Acibadem University

OTHER

Sponsor Role collaborator

Ankara Yildirim Beyazıt University

OTHER

Sponsor Role collaborator

University of Gaziantep

OTHER

Sponsor Role collaborator

Istanbul Training and Research Hospital

OTHER_GOV

Sponsor Role collaborator

Saglik Bilimleri Universitesi Gazi Yasargil Training and Research Hospital

OTHER

Sponsor Role collaborator

Sisli Hamidiye Etfal Training and Research Hospital

OTHER

Sponsor Role collaborator

Haseki Training and Research Hospital

OTHER

Sponsor Role collaborator

Istanbul University - Cerrahpasa

OTHER

Sponsor Role lead

Responsible Party

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Levent Kabasakal

Professor of Nuclear Medicine, Medical Doctor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Levent Kabasakal, Prof. MD

Role: PRINCIPAL_INVESTIGATOR

Istanbul University - Cerrahpasa

Locations

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Yeditepe University

Istanbul, Turkey, Turkey (Türkiye)

Site Status RECRUITING

Bilkent Şehir Hastanesi

Ankara, , Turkey (Türkiye)

Site Status RECRUITING

Gazi Yaşargil Egitim ve Arastirma Hastanesi

Diyarbakır, , Turkey (Türkiye)

Site Status RECRUITING

Gaziantep Üniversitesi Şahinbey Araştırma ve Uygulama hastanesi

Gaziantep, , Turkey (Türkiye)

Site Status RECRUITING

Acibadem University Altunizade Hospital

Istanbul, , Turkey (Türkiye)

Site Status RECRUITING

Acibadem University Maslak Hospital

Istanbul, , Turkey (Türkiye)

Site Status RECRUITING

Haseki Eğitim ve Araştırma Hastanesi

Istanbul, , Turkey (Türkiye)

Site Status RECRUITING

Istanbul University-Cerrahpaşa

Istanbul, , Turkey (Türkiye)

Site Status RECRUITING

SBÜ Başakşehir Çam Sakura Şehir hastanesi

Istanbul, , Turkey (Türkiye)

Site Status RECRUITING

Sisli Hamidiye Etfal Eğitim ve Arastırma Hastanesi

Istanbul, , Turkey (Türkiye)

Site Status RECRUITING

Countries

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Turkey (Türkiye)

Central Contacts

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Levent Kabasakal, Prof. MD

Role: CONTACT

00905323667908

Nalan Alan, Prof. MD.

Role: CONTACT

00905322940667

Facility Contacts

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Nalan Alan, Prof. MD.

Role: primary

00905322940667

Kaan Akcay, Resident, MD

Role: backup

00905079195680

Elif Cingi Ozdemir, Prof. MD.

Role: primary

00905326841880

Halil Komek, Prof. MD.

Role: primary

00905064767778

Umut Elboga, Prof. MD.

Role: primary

00905355164132

Mehmet Ozturk, Asc. Prof. MD.

Role: backup

00905393328554

Levent Turkeri, Prof. MD.

Role: primary

00905333572898

Ali Rıza Kural, Prof. MD.

Role: primary

00905323139626

Mustafa Bilal Tuna, Asc. Prof. MD.

Role: backup

00905052532047

Rüştü Turkay, Prof. MD.

Role: primary

00905322008672

Ezgi Gursoy, Radiologist MD

Role: backup

00905054669151

Levent Kabasakal, Prof. MD.

Role: primary

00905323667908

Onur Erdem Sahin, Asc. Prof. MD.

Role: backup

00905557041806

Burcu Esen Akkaş, Prof. MD.

Role: primary

00905327450364

Halil Lütfi Canat, Prof. MD.

Role: backup

00905056884234

Nurettin Cem Sonmez, Prof. MD.

Role: primary

00905324259128

References

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Seravalli J, Kumar M, Ragsdale SW. Rapid kinetic studies of acetyl-CoA synthesis: evidence supporting the catalytic intermediacy of a paramagnetic NiFeC species in the autotrophic Wood-Ljungdahl pathway. Biochemistry. 2002 Feb 12;41(6):1807-19. doi: 10.1021/bi011687i.

Reference Type BACKGROUND
PMID: 11827525 (View on PubMed)

Drachenberg CB, Abruzzo LV, Klassen DK, Bartlett ST, Johnson LB, Kuo PC, Kumar D, Papadimitriou JC. Epstein-Barr virus-related posttransplantation lymphoproliferative disorder involving pancreas allografts: histological differential diagnosis from acute allograft rejection. Hum Pathol. 1998 Jun;29(6):569-77. doi: 10.1016/s0046-8177(98)80005-1.

Reference Type BACKGROUND
PMID: 9635676 (View on PubMed)

Akcay K, Kibar A, Sahin OE, Demirbilek M, Beydagi G, Asa S, Aghazada F, Toklu T, Selcuk NA, Onal B, Kabasakal L. Prediction of clinically significant prostate cancer by [68 Ga]Ga-PSMA-11 PET/CT: a potential tool for selecting patients for active surveillance. Eur J Nucl Med Mol Imaging. 2024 Apr;51(5):1467-1475. doi: 10.1007/s00259-023-06556-y. Epub 2023 Dec 19.

Reference Type BACKGROUND
PMID: 38112777 (View on PubMed)

Cornford P, van den Bergh RCN, Briers E, Van den Broeck T, Brunckhorst O, Darraugh J, Eberli D, De Meerleer G, De Santis M, Farolfi A, Gandaglia G, Gillessen S, Grivas N, Henry AM, Lardas M, van Leenders GJLH, Liew M, Linares Espinos E, Oldenburg J, van Oort IM, Oprea-Lager DE, Ploussard G, Roberts MJ, Rouviere O, Schoots IG, Schouten N, Smith EJ, Stranne J, Wiegel T, Willemse PM, Tilki D. EAU-EANM-ESTRO-ESUR-ISUP-SIOG Guidelines on Prostate Cancer-2024 Update. Part I: Screening, Diagnosis, and Local Treatment with Curative Intent. Eur Urol. 2024 Aug;86(2):148-163. doi: 10.1016/j.eururo.2024.03.027. Epub 2024 Apr 13.

Reference Type BACKGROUND
PMID: 38614820 (View on PubMed)

Other Identifiers

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2024-KAEK-21/1153

Identifier Type: -

Identifier Source: org_study_id

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