MRI in PROstate Cancer Diagnosis With Prior Risk Assessment (MR-PROPER)

September 6, 2023 updated by: Ivo G. Schoots, Erasmus Medical Center
To evaluate the diagnostic performance and cost-effectiveness of the MRI-driven diagnostic pathway of prostate cancer, with upfront individual multivariate risk stratification.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Screening for prostate cancer (PCa) remains one of the most controversial issues in urological practice. Although robust data from the European Randomised study of Screening for Prostate Cancer (ERSPC) suggest a disease specific survival benefit in favor of prostate-specific antigen (PSA)-based PCa screening, the coinciding unfavorable harm-benefit precludes that PCa screening can be adopted as a public health policy. The diagnostic pathway needs to be optimized to reduce unnecessary testing and to avoid diagnosing those cancers that will never harm a patient if not detected through screening. Some men may thus benefit from PCa screening, but with the currently used diagnostics (i.e. the PSA test and systematic TRUS (transrectal ultrasound )-guided prostate biopsy) many more men are harmed by unnecessary testing and the cascade of diagnostic and treatment related events that follow.

Further refinements to screening strategies, focusing on detecting only those PCa that are potentially life threatening (clinically significant) are needed to become acceptable to the general population and health care providers. The investigators propose such a refinement within this protocol, with upfront individual risk prediction and in addition a MRI-driven diagnostic pathway in only those men that are considered to be at intermediate/high-risk of having a potentially life threatening PCa (in general defined as Gleason sum Score (GS) =7).

Study Type

Observational

Enrollment (Actual)

2558

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

    • Zuid Holland
      • Rotterdam, Zuid Holland, Netherlands, 3015CE
        • ErasmusMC

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

50 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Sampling Method

Probability Sample

Study Population

Men are eligible for the study if there is a clinical suspicion of harbouring prostate cancer without previous prostate biopsies. This essentially includes men with an elevated PSA (≥ 3 ng/ml) and/or a suspicious DRE, or family history of prostate cancer.

Description

Inclusion criteria:

  • men ≥ 50 years,
  • no prior prostate biopsies,
  • suspected of having prostate cancer based on PSA blood test (≥ 3 ng/ml) and/or DRE( digital rectal examination) and/or family history of prostate cancer,
  • fit to undergo all protocol procedures,
  • signed informed consent.

Exclusion criteria:

  • contra-indications to MRI or TRUS biopsy procedures,
  • any medical condition precluding procedures described in the protocol

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Low-risk PCa
No TRUS-guided biopsy
Intermediate/high-risk PCa (Control)
TRUS-guided biopsy 'only' (current standard practice).
prostate biopsy
Intermediate/high-risk PCa (Intervention 1)
TRUS-guided biopsy 'first'; if indicated followed by MRI and targeted biopsies.
prostate biopsy
Intermediate/high-risk PCa (Intervention 2)
MRI-'first', followed by TRUS-guided and targeted biopsies.
prostate biopsy

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Proportion of detected csPCa
Time Frame: 36 months
Proportion of study population with clinically significant prostate cancer (csPCa), correctly identified by Risk-assessment + MRI-driven pathway
36 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of biopsy procedures in relation to detected csPCa.
Time Frame: 36 months
Number of prostate biopsy procedures in relation to the detection of clinically significant prostate cancer.
36 months
Proportion of unnecessary TRUS-guided and targeted biopsies
Time Frame: 36 months
Proportion of TRUS-guided and targeted biopsies that could have been avoided safely.
36 months
CEA Risk stratification-MRI
Time Frame: 36 months
Diagnostic health care cost-effectiveness analysis (CEA) of Risicowijzer-MRI-driven pathway.
36 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Principal Investigator: Ivo Schoots, Dr, Erasmus Medical Center

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 1, 2017

Primary Completion (Actual)

January 31, 2021

Study Completion (Actual)

January 31, 2021

Study Registration Dates

First Submitted

July 12, 2017

First Submitted That Met QC Criteria

July 20, 2017

First Posted (Actual)

July 21, 2017

Study Record Updates

Last Update Posted (Actual)

September 7, 2023

Last Update Submitted That Met QC Criteria

September 6, 2023

Last Verified

September 1, 2023

More Information

Terms related to this study

Other Study ID Numbers

  • OZBS92.16132

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

IPD Plan Description

Still under consideration

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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