Imaging and Genomic Biomarkers to Predict Response in Prostate Cancer

Clinicaltrials.gov ID: NCT05477823
db-list-check Status RECRUITING
b-loader Phase EARLY_PHASE1
b-people Age ≥ 18 Years
b-bullseye-arrow Enrollments 30

Conditions

Prostate Cancer

Drugs

Androgen deprivation therapy

Summary

The purpose of this study is to evaluate the imaging and gene expression biomarkers in prostate cancer. Participants have high-risk prostate cancer and have indicated they will undergo external beam radiation therapy, brachytherapy, and androgen deprivation therapy (EBRT+BTX+ADT). Participants can expect to be in this study for up to 5 years.

Detailed Description

This is a pilot study to prospectively investigate potential predictive imaging and genomic biomarkers for patients with high-risk prostate cancer treated with standard of care EBRT + BTX + ADT. The primary imaging modalities that will be evaluated will be PSMA positron emission tomography (PET) and multi-parametric magnetic resonance imaging (MRI). Pre-treatment PET/MRI scans will also be obtained as part of standard of care prior to study enrollment. Response will be assessed on a mid-treatment PET/MRI scan obtained for research purposes after completion of EBRT but prior to brachytherapy boost. PET/CT (computerized tomography) may be used instead if PET/MRI is not technically possible. Imaging response will be compared to pathology from image-directed prostate biopsies taken at the time of the brachytherapy boost. The primary genomic marker that will be evaluated is a clinically available gene-expression array, Decipher, that will be obtained as part of standard of care prior to study enrollment.

Locations

1 location Found with status Recruiting

Status

  • RECRUITING

Contact Person

Principal Investigator

  • John Floberg, MD, PhD

Eligibility Criteria

Inclusion Criteria:

* Age ≥ 18
* Histologically confirmed adenocarcinoma of the prostate
* Cancer classified as high-risk or very high-risk by National Comprehensive Cancer Network (NCCN) criteria: Grade group ≥4, PSA >20, or primary tumor stage ≥T3a
* ECOG performance status 0-1
* Agreed to undergo EBRT, high dose rate (HDR) brachytherapy boost, and 6-36 months of ADT as part of standard of care therapy prior to study enrollment
* Able to undergo a HDR brachytherapy implant: Pre-radiation IPSS score ≤20 with or without medical management; prostate ≤60 cc as measured by MRI or ultrasound; no prior trans-urethral resection of prostate (TURP); and, median lobe extending into the bladder <1 cm
* No prior or concurrent malignancy unless disease-free for at least 5 years

Exclusion Criteria:

* Evidence of regional or distant metastatic disease on pre-treatment bone scan, pelvic MRI, and/or CT of the abdomen/pelvis
* Prior pelvic radiation therapy

Study Plan

EBRT + BTX + ADT, PET and MRI

EXPERIMENTAL

Standard of care EBRT + BTX + ADT, with mid-treatment PET and MRI (or PET and CT) scans for research.

  • RADIATION:

    External beam radiation therapy

    Description:

    Standard of care EBRT
  • RADIATION:

    Prostate brachytherapy boost

    Description:

    Standard of care BTX
  • DRUG:

    Androgen deprivation therapy

    Description:

    Standard of care ADT
  • DIAGNOSTIC_TEST:

    Positron emission tomography (PET)/magnetic resonance imaging (MRI)

    Description:

    Pelvic PET scanning with tracer will take approximately 45 minutes. This will be followed by the injection of a contrast agent followed by whole body PET/MRI scanning which will take approximately 30 minutes.

Outcome Measures

Primary Outcome Measures

Imaging markers for mid-treatment response

Time Frame: Mid-treatment (approximately 3 months into treatment)

Secondary Outcome Measures

Genomic signatures correlated with imaging response

Time Frame: Baseline and mid-treatment (approximately 3 months into treatment)

Establish a correlation between PET imaging response and pathologic response

Time Frame: Baseline and mid-treatment (approximately 3 months into treatment)

Establish a correlation between MRI imaging response and pathologic response

Time Frame: Baseline and mid-treatment (approximately 3 months into treatment)

Imaging and genomic markers for prostate specific antigen (PSA) recurrence.

Time Frame: Baseline, 3 months post therapy, every 6 months for 5 years

Evaluate blood-based biomarkers for treatment response.

Time Frame: Baseline and mid-treatment (approximately 3 months into treatment)

Timeline

  • Last Updated
    March 5, 2024
  • Start Date
    July 28, 2022
  • Today
    February 5, 2025
  • Completion Date ( Estimated )
    August 1, 2027

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