MRI Based Active Selection for Treatment Trial (MAST)
MRI-Guided Active Selection for Treatment of Prostate Cancer: The Miami MAST Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Florida
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Miami, Florida, United States, 33136
- University of Miami
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Biopsy confirmed adenocarcinoma of the prostate within 18 months prior to enrollment;
- Pre-enrollment prostate biopsy must consist of at least 8 cores;
- Biopsy reviewed by a University of Miami Pathologist;
- Serum Prostate-Specific Antigen (PSA) ≤ 20 ng/ml within 3 months of study enrollment;
- Age ≥ 35 and ≤ 85 years;
- Ability to understand and willingness to sign a written informed consent document;
- Patients must agree to undergo serial multiparametric MRI and MRI-guided biopsy;
- Patients must agree to fill out the longitudinal psychosocial questionnaires assessing health related quality of life.
Exclusion Criteria:
- Greater than 4 cores positive, of any Gleason score, on the University of Miami (UM) review,
- Greater than 2 cores positive for Gleason 3+4 cancer,
- Gleason 4+3 or higher cancer in any single biopsy core.
- Extracapsular extension suspected on digital rectal exam with confirmation on MRI. Suspicion of extracapsular extension on MRI alone is not an exclusion for study enrollment.
- Subject is not a candidate for multiparametric MRI with contrast. Some reasons may include (but are not limited to): renal insufficiency, foreign body or pacemakers.
- No prior pelvic radiotherapy.
- No prior surgery to the prostate, other than transurethral procedures for benign prostatic hyperplasia (e.g., transurethral resection, green light laser treatment).
- No concurrent, active malignancy, other than non-metastatic skin cancer of any type, superficial bladder cancer, or early stage chronic lymphocytic leukemia (well-differentiated small cell lymphocytic lymphoma) or <stage IV follicular lymphoma. If a prior malignancy is in remission for ≥ 3 years then the patient is eligible.
- Bilateral hip replacement.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Active Surveillance
Participants in this group will receive a Multi-Parametric Magnetic Resonance Imaging (MP-MRI) of the prostate/pelvis and MRI-guided prostate biopsy at baseline (0-3 months from enrollment) and at the 12th, 24th and 36th month follow up.
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Multi-Parametric MRI
MRI-Guided Biopsy
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Rate of Disease Progression Within the First Two Surveillance Biopsies
Time Frame: 24 months
|
The rate of disease progression among participants within the first two surveillance biopsies will be reported. Progression refers to a repeat surveillance biopsy indicating any one of the following:
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24 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Health-Related Quality of Life Scores: MAX-PC
Time Frame: Up to 36 months
|
Health-Related Quality of Life will be assessed using scores from validated questionnaires.
The Memorial Anxiety Scale for Prostate Cancer (MAX-PC) will be used to measure anxiety from pre-treatment to post-treatment.
The scale consists of 18 items (e.g.
"I thought about prostate cancer even though I didn't mean to.") scored on a scale from 0 ("not at all") to 3 ("often").
Total scores range from 0 to 54, with higher scores indicating higher levels of anxiety.
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Up to 36 months
|
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Time-to-Biochemical Recurrence (BCR)
Time Frame: Up to 36 months
|
Biochemical recurrence (BCR) is defined as prostate-specific antigen (PSA) of 0.2 or higher on two or more separate measures after surgery or an increase of nadir + 2ng/ml or more after radiation.
Time-to-BCR is defined as duration in days between date of treatment and date of BCR, if BCR occurs.
The investigators will follow participants who have progressed and gone on to treatment.
|
Up to 36 months
|
|
Health-Related Quality of Life Scores: EPIC SF-12
Time Frame: Up to 36 months
|
Health-Related Quality of Life will be assessed using scores from validated questionnaires.
The Expanded Prostate Cancer Index Composite and Medical Outcomes Study Short Form-12 (EPIC SF-12) will be used to evaluate patient function and satisfaction after prostate cancer treatment.
Response options for each item form a Likert scale, and multi-item scale scores are transformed linearly to a 0-100 scale, with higher scores representing better HRQOL.
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Up to 36 months
|
|
Discriminative Performance of NCCN Risk and Clinical Markers for Predicting Progression on Active Surveillance
Time Frame: Up to 36 months
|
The investigators will assess the incremental benefit of multiparametric MRI (mpMRI), genomic risk test, and molecular markers compared to baseline National Comprehensive Cancer Network (NCCN) risk classification for predicting progression on active surveillance.
Area under the receiver operating characteristic Curve (ROC) curves produced from logistic regression modeling will be used to evaluate the performance of NCCN risk and other variables (MRI, genomic testing, and molecular markers) for predicting progression on surveillance.
Participants will be categorized at baseline by NCCN risk class ranging from very low risk to intermediate risk; and into those who progressed while on the trial.
Additionally, MRI results, PSA density, 4K score, and Decipher Score in combination with NCCN risk were analyzed to see their additive value on determining who will experience progression on active surveillance.
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Up to 36 months
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Sanoj Punnen, MD, MAS, University of Miami
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 20140372
- 1R01CA189295-01 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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