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Prostate Specific Membrane Antigen (PMSA)-Based PET Imaging of High Risk Prostate Cancer

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT03976843
Recruitment Status : Recruiting
First Posted : June 6, 2019
Last Update Posted : April 2, 2024
Sponsor:
Information provided by (Responsible Party):
National Institutes of Health Clinical Center (CC) ( National Cancer Institute (NCI) )

Brief Summary:

Background:

People with prostate cancer usually have their cancer imaged with a CT scan and bone scan. They then have their prostate gland removed. Researchers want to test a scan that might predict if prostate cancer will return after this surgery.

Objective:

To test if a PET/CT scan before the prostate gland is removed can predict if prostate cancer will return. Also, to test if this approach is better or worse than the usual approach for prostate cancer.

Eligibility:

Men ages 18 and older with prostate cancer that appears to be contained within the prostate but is at risk of having spread

Design:

Participants will be screened with:

  • Medical history
  • Blood tests
  • CT and MRI scans: Participants will lie in a machine. The machine will take pictures of the body.
  • Bone scan

Participants will have a radiotracer injected into a vein. They will have a PET/CT scan of their whole body 60 90 minutes later. During the scan, they will lie on their back and stay still.

Within 60 days after the scan, participants will have surgery. This will remove the prostate gland and lymph nodes around it. Some tissue will be used for genetic testing.

If the PET/CT scan suggests the cancer has spread, participants may need to have another biopsy within 60 days after the scan.

After surgery, participants will have follow-up visits for 5 years. They will have 5 visits the first year and 2 the second. Then they will have visits once a year.

If participants cancer returns, they will have repeat PET/CT scans.


Condition or disease Intervention/treatment Phase
Prostate Cancer Drug: 18F-DCFPyL Phase 2

Show Show detailed description

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 201 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Diagnostic
Official Title: A Phase II Multi-Institutional Trial to Evaluate Prostate Specific Membrane Antigen (PMSA)-Based PET Imaging of High Risk Prostate Cancer
Actual Study Start Date : December 4, 2019
Estimated Primary Completion Date : August 31, 2025
Estimated Study Completion Date : August 31, 2025

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Prostate Cancer

Arm Intervention/treatment
Experimental: 1/18F-DCFPyL PET/CT + radical prostatectomy
18F-DCFPyL PET/CT with radical prostatectomy and lymphadenectomy
Drug: 18F-DCFPyL
18F-labeled agent that is a high affinity small molecule inhibitor of PSMA to detect prostate cancer via PET imaging




Primary Outcome Measures :
  1. progression free survival [ Time Frame: 6 weeks, 3,6,9,12, and 18 months, 2,3, and 4 years ]
    progression-free survival which is improved over that of historical data from a general population


Secondary Outcome Measures :
  1. progression free survival [ Time Frame: 6 weeks, 3,6,9,12, and 18 months, 2,3, and 4 years ]
    progression-free survival of patients with an 18F-DCFPyL PET/CT that is positive for metastases



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   Male
Accepts Healthy Volunteers:   No
Criteria
  • INCLUSION CRITERIA:
  • Patients must have histologically proven prostate adenocarcinoma confirmed by a CLIA certified laboratory.
  • Must have prostate cancer with high risk features defined as:

    • Gleason 8 and higher OR
    • PSA > 20 ng/mL OR
    • Clinical stage T3a (i.e. likely extraprostatic extension on MRI) or T3b
  • Patients must be eligible for and must be planning to undergo radical prostatectomy and lymphadenectomy regardless of findings on 18F-DCFPyL PET/CT
  • Men age greater than or equal to 18 years.
  • ECOG performance status <2
  • Patients must have adequate organ and marrow function as defined below:

    • Hemoglobin greater than or equal to 9 g/dL
    • leukocytes greater than or equal to 3,000/mcL
    • platelets greater than or equal to 100,000/mcL
    • total bilirubin <2 X normal institutional limits
  • AST(SGOT)/ALT(SGPT) less than or equal to 3 X normal institutional limits
  • creatinine <2 X normal institutional limits

OR

eGFR greater than or equal to 50 mL/min/1.73 m2 for patients with creatinine levels above institutional normal.

  • Ability of subject to understand and the willingness to sign a written informed consent document.
  • Willingness and ability to undergo biopsy of radiotracer-avid lesion if feasible.
  • Willingness and ability to undergo multiparametric prostate MRI and 18F-DCFPyL PET/CT

EXCLUSION CRITERIA:

  • Any investigational agents in the past 28 days prior to enrollment.
  • Clinical stage T4 (tumor invades adjacent structures except seminal vesicles).
  • Distant metastatic disease on conventional imaging studies (computed tomography (CT)) of the abdomen and pelvis and bone scan. NaF PET/CT scan cannot substitute for a bone scan. Given lack of specificity of CT for lymph node metastases at lower thresholds, pelvic lymph nodes below 2 cm in the short axis are allowed.
  • Any prior hormone therapy used to treat prostate cancer, except limited androgen receptor antagonist therapy, defined as less than or equal to 3 days of treatment. The medication must be discontinued within 5 half-lives of the compound prior to study entry.
  • Any prior therapy for prostate cancer with surgery, radiation, and/or chemotherapy.
  • Contraindication to MRI or PET:

    • Patients weighing more than weight limit for the scanner tables or unable to fit within the imaging gantry
    • Prior reaction to 18F-DCFPyL
    • Patients with pacemakers, cerebral aneurysm clips, shrapnel injury or implantable electronic device that are not MRI compatible at 3 T
    • Severe claustrophobia unresponsive to oral anxiolytics
  • Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements.
  • Other medical conditions deemed by the principal investigator (or associates) to make the subject unsafe/ineligible for the protocol procedures or for radical prostatectomy.
  • A malignancy within the past 3 years for which prostatectomy is a contraindication.
  • Radiotracer administered within 5 half-lives prior to the date of 18F-DCFPyL PET/CT imaging.
  • PSMA-targeted imaging within 6 months with 18F-DCFPyL tracer prior to the date of 18F-DCFPyL PET/CT imaging. Participants can have PSMA targeted imaging with Gallium.
  • Unable to refrain from fathering a child or donating sperm for 10 days after each 18FDCFPyL injection.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03976843


Contacts
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Contact: Michele L Reed, R.N. (240) 760-6121 michele.reed@nih.gov
Contact: Fatima H Karzai, M.D. (301) 480-7174 fatima.karzai@nih.gov

Locations
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United States, California
University of California, San Francisco Recruiting
San Francisco, California, United States, 94143
Contact: Imelda Tenggara    415-353-7348    imelda.tenggara@ucsf.edu   
United States, Louisiana
Tulane University Recruiting
New Orleans, Louisiana, United States, 70112-2699
Contact: Charlotte Manogue    504-988-3908    cmanogue@tulane.edu   
United States, Maryland
Johns Hopkins University Recruiting
Baltimore, Maryland, United States, 21205
Contact: Rana Harb    410-502-5500    r-harb1@jhmi.edu   
National Institutes of Health Clinical Center Recruiting
Bethesda, Maryland, United States, 20892
Contact: For more information at the NIH Clinical Center contact National Cancer Institute Referral Office    888-624-1937      
United States, Massachusetts
Brigham and Women s Hospital Recruiting
Boston, Massachusetts, United States, 02115
Contact: Isabella Izidoro    617-525-8710    Isabella_Izodoro@DFCI.HARVARD.EDU   
United States, New York
Memorial Sloan Kettering Cancer Center Recruiting
New York, New York, United States, 10021
Contact: Emma Zulch    646-888-1331    zulche@mskcc.org   
United States, Pennsylvania
Thomas Jefferson University Recruiting
Philadelphia, Pennsylvania, United States, 19107-6541
Contact: Christine Hubert    215-955-9954    christine.hubert@jefferson.edu   
Sponsors and Collaborators
National Cancer Institute (NCI)
Investigators
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Principal Investigator: Fatima H Karzai, M.D. National Cancer Institute (NCI)
Additional Information:
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Responsible Party: National Cancer Institute (NCI)
ClinicalTrials.gov Identifier: NCT03976843    
Other Study ID Numbers: 190104
19-C-0104
First Posted: June 6, 2019    Key Record Dates
Last Update Posted: April 2, 2024
Last Verified: March 29, 2024
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes
Plan Description: .All IPD recorded in the medical record will be shared with intramural investigators upon request. @@@@@@In addition, all large scale genomic sequencing data will be shared with subscribers to dbGaP
Supporting Materials: Study Protocol
Statistical Analysis Plan (SAP)
Informed Consent Form (ICF)
Time Frame: Clinical data available during the study and indefinitely.@@@@@@Genomic data are available once genomic data are uploaded per protocol GDS plan for as long as database is active.
Access Criteria: Clinical data will be made available via subscription to BTRIS and with the permission of the study PI.@@@@@@Genomic data are made available via dbGaP through requests to the data custodians.@@@@@@Requests for all collected IPD data from clinical trials, conducted under a binding collaborative agreement between NCI/DCTD and a pharmaceutical/biotechnology company, that are not under DSMB monitoring must be in compliance with the terms of the binding collaborative agreement and must be approved by NCI/DCTD and the Pharmaceutical Collaborator (i.e., the NCI ETCTN Director in conjunction with the NCI/DCTD Regulatory Affairs Branch).

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by National Institutes of Health Clinical Center (CC) ( National Cancer Institute (NCI) ):
PSMA
PET agent
Prostatectomy
Progression Free Survival
Additional relevant MeSH terms:
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Prostatic Neoplasms
Genital Neoplasms, Male
Urogenital Neoplasms
Neoplasms by Site
Neoplasms
Genital Diseases, Male
Genital Diseases
Urogenital Diseases
Prostatic Diseases
Male Urogenital Diseases