Biodistribution/Reproducibility Ga-68 PSMA-HBED-CC

August 30, 2024 updated by: University of Iowa

Biodistribution and Reproducibility of Ga-68 PSMA-HBED-CC Positron Emission Tomography in Patients With Biopsy Proven Metastatic Prostate Cancer

The purpose of this Radioactive Drug Research Committee (RDRC) study is to collect initial data regarding biodistribution, reproducibility, and dosimetry for the radiotracer Ga-68 PSMA-HBED-CC, an agent which may be useful for the early detection of metastatic prostate cancer. Investigators will use a test and re-test design in all patients to determine reproducibility of lesion detection and signal intensity, and will include dynamic imaging in some patients for the purposes of dosimetry. Patients with known metastatic prostate cancer will be recruited and imaged on two occasions within the course of 15 days.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Prostate cancer (PCa) represents the most common noncutaneous cancer and second most common cause of cancer related death among men in the United States and worldwide. Individual PCa tumor behavior is variable. Some tumors show slow indolent growth patterns and may never become clinically significant while others are aggressive and lead to metastases and death. PCa most commonly metastasizes to bone and lymph nodes. Lungs, liver, and adrenal glands are less frequent metastatic sites.

Accurate staging and risk stratification is essential to optimal management. Pelvic lymph node dissection (PLND) which is performed along with radical prostatectomy is the gold standard for detection of occult nodal metastases but is invasive and has associated morbidity. PLND offers an additional therapeutic benefit in some patients, but is also associated with potential complications and can still underestimate the extent of nodal metastases as 40-50% fall outside the traditional dissection zones [6]. Furthermore, fewer patients are presenting with nodal metastases at initial presentation due to stage migration, so more PLNDs need to be performed to benefit one patient. Therefore there is a clear need for noninvasive imaging options to assist with early and accurate detection of nodal metastases.

68Ga PSMA-HBED-CC is a urea-based small molecular inhibitor that targets an enzymatic site on the extracellular domain of the PSMA membrane protein. Based on strong preclinical evidence, a number of clinical studies of 68Ga PSMA-HBED-CC PET/CT have been performed. Afshar-Oromieh et al. showed detection of lesions suspicious for PCa metastases in 84% of a cohort of patients (n=37) being investigated for biochemical relapse, clarification of suspicious findings on other modalities, or evaluation for possible 131I PSMA ligands. In a larger retrospective study (n=319) Afshar-Oromieh et al. showed that 68Ga PSMA-HBED-CC PET/CT detected PCa in 83% of patients with suspected recurrence. In another study Afshar-Oromieh et al compared 68Ga PSMA-HBED-CC PET/CT to 18F fluoromethylcholine (FCH) PET/CT. At least one PCa lesion was detected in 87% of patients with 68Ga PSMA-HBED-CC versus 70% of patients with 18F FCH. Among patients in whom PSA values were <2.82 ng/ml at least one lesion could be detected in 69% of patients with 68Ga PSMA-HBED-CC and 44% patients with 18F FCH. Tumor-to-background ratios were higher for 68Ga PSMA-HBED-CC. In the aforementioned studies by Afshar-Oromieh et al. 49 patients with positive scans were further evaluated by biopsy or surgery and were confirmed as PCa with no false positives. Morigi et al. also showed the superiority of 68Ga PSMA-HBED-CC over 18F FCH in PET/CT. Detection rates 68Ga PSMA-HBED-CCPET/CT in multiple studies are higher than for rates reported in the literature for 11C Choline, 18F Choline, and 11C Acetate [20]. Most importantly the detection rates 68Ga PSMA-HBED-CCPET/CT in patients with low PSA (<0.5 ng/ml) are more favorable.

Thus preclinical and clinical studies show that 68Ga PSMA-HBED-CC PET/CT is a promising radiotracer for the early detection of metastatic or recurrent PCa even with low serum PSA levels.

Study Type

Interventional

Enrollment (Actual)

22

Phase

  • Early Phase 1

Contacts and Locations

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

Study Locations

  • United States
    • Iowa
      • Iowa City, Iowa, United States, 52242
        • Holden Comprehensive Cancer Center

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

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Description

There will be no control group. For the study group the following inclusion and exclusion criteria will be followed.

INCLUSION CRITERIA

  • Male
  • Aged ≥ 18 years
  • Histological diagnosis of adenocarcinoma of the prostate OR have a clinical diagnosis of prostate cancer and on active therapy or have received treatment for prostate cancer.
  • Multifocal metastatic disease in either castrate sensitive or castrate resistant patients.
  • May or may not be on hormonal therapy, chemotherapy, or radium therapy.
  • If on hormonal therapy or chemotherapy, must be on it for at least 3 months.
  • No plans to undergo prostate cancer therapy administration (with hormone therapy, chemotherapy, radium therapy, external radiation) between the two study exams.
  • At least 2 metastatic soft tissue or bone lesions identified on conventional imaging (CT, MRI or bone scan).
  • Karnofsky performance status of ≥ 50 (or ECOG/WHO equivalent)
  • Ability to understand and willingness to sign a consent document.

EXCLUSION CRITERIA

  • Uncontrolled intercurrent illness including, but not limited to ongoing or active infection requiring hospitalization, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
  • Physical limitation that would limit compliance with the study requirements
  • Current enrollment in a therapeutic clinical trial

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

  • Primary Purpose: Diagnostic
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: (68Ga)PSMA-HBED-CC
Intervention: positron emission tomography / computed tomography (PET/CT) scan using a experimental radiotracer for imaging prostate-specific membrane antigen
Drug: (68Ga)PSMA-HBED-CC
Experimental radiotracer for imaging prostate cancer
Other Names:
  • (68Ga)Glu-urea-Lys(Ahx)-HBED-CC

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Reproducibility assessment
Time Frame: up to 15 days from first imaging
A second PET imaging assessment will be performed (test/retest) to confirm
up to 15 days from first imaging

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Biodistribution assessment
Time Frame: 60 minutes post-injection
PET imaging assessment of systemic drug distribution using dynamic data
60 minutes post-injection

Collaborators and Investigators

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

Sponsor

University of Iowa

Investigators

  • Principal Investigator: Janet Pollard, M.D., University of Iowa

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

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)

July 14, 2016

Primary Completion (Actual)

April 25, 2022

Study Completion (Actual)

April 25, 2022

Study Registration Dates

First Submitted

October 28, 2016

First Submitted That Met QC Criteria

November 1, 2016

First Posted (Estimated)

November 2, 2016

Study Record Updates

Last Update Posted (Actual)

September 3, 2024

Last Update Submitted That Met QC Criteria

August 30, 2024

Last Verified

August 1, 2024

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 201605762

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

Yes

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

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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