- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03601143
Liquid Biopsy-based Detection of Resistance to Targeted Therapy in Prostate Cancer Patients (PEARL)
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Androgen receptor signaling inhibitors (ARSi) have become available in the past years for the treatment of patients with metastatic castration-resistant prostate cancer (mCRPC) and have significantly improved their survival. Despite this improvement, initial or emerging resistance to ARSi poses a major challenge in the treatment of these patients. There is therefore an urgent medical need for early detection of treatment resistance.
Liquid biopsies - blood samples containing circulating tumor cells (CTCs) and nucleic acids from the tumor - can provide information about such resistance. The investigators of this study and others have shown that liquid biopsies can be used to detect the messenger RNA (mRNA) of AR-V7, a splice variant of the androgen receptor (AR) that is insensitive to ARSi, in whole blood, and that high levels of AR-V7 mRNA in mCRPC patients are predictive to non-response to ARSi. Several liquid biopsy approaches involving different blood compartments such as CTCs, exosomes, and whole blood have been used so far to detect AR-V7. However, it is unclear which liquid biopsy approach or which combination of approaches is best to predict resistance under ARSi therapy in the clinical setting. In addition, current approaches explain only about half of resistant cases, suggesting that there are important non-AR-V7-mediated causes of resistance.
In this study, the investigators aim at determining the optimal liquid biopsy approach to detect AR-V7 and exploring novel ones for best possible prediction of resistance to ARSi. To this end, the investigators will systematically explore relevant blood compartments in a prospective cohort of mCRPC patients, quantify AR-V7 mRNA levels in each compartment, and determine the diagnostic value of compartment-specific AR-V7 mRNA levels for predicting response to subsequent ARSi therapy. The investigators will further explore the clinical relevance of AR-V7 protein subcellular localization in CTCs for prediction of ARSi resistance. In addition, novel other, AR-V7 independent mechanisms of resistance and their predictive value for proper treatment will be explored. These are based on further AR splice variants, and on neuroendocrine differentiation of prostate cancer cells.
Study Type
Enrollment (Anticipated)
Contacts and Locations
Study Contact
- Name: Matthias M Heck, MD
- Phone Number: 2508 +49894140
- Email: matthias.heck@tum.de
Study Contact Backup
- Name: Christof Winter, MD PhD
- Phone Number: 4765 +49894140
- Email: christof.winter@tum.de
Study Locations
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-
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Munich, Germany, 81675
- Recruiting
- Technical University of Munich, Klinikum rechts der Isar, Department of Urology and Institute of Clinical Chemistry
-
Contact:
- Matthias M Heck, MD
- Phone Number: 2508 +49894140
- Email: matthias.heck@tum.de
-
Contact:
- Christof Winter, MD PhD
- Phone Number: 4765 +49894140
- Email: christof.winter@tum.de
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Histologically confirmed prostate adenocarcinoma
- Castrate serum testosterone <50ng/ml or <1.7nmol/l under continued androgen-deprivation therapy or surgical castration
Progressive disease at study entry in accordance with Prostate Cancer Working Group 3 criteria (PCWG3):
- Biochemical progression: Three consecutive rises in PSA at least one week apart resulting in two 50% increases over the nadir, and a PSA >1.0 ng/ml as minimal starting value, or
- Radiologic progression: either two or more new bone lesions on bone scan or a new soft tissue lesion using RECIST (Response evaluation criteria in solid tumors).
- Metastatic disease confirmed on computed tomography (CT) or bone scan
- Planned treatment with ARSi (androgen-receptor signaling receptors)
- Written informed consent of the patient
Exclusion Criteria:
- Persons who are in a dependency or employment relationship with the investigator or sponsor
- Planned additional concurrent anticancer therapy
Study Plan
How is the study designed?
Design Details
- Observational Models: Cohort
- Time Perspectives: Prospective
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Prostate-specific antigen (PSA) decline >=50%
Time Frame: 24 months
|
The optimal liquid biopsy-based test method to predict PSA response under AR-targeted therapy will be determined.
|
24 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Clinical progression-free survival
Time Frame: 24 months
|
The optimal liquid biopsy-based test method to predict clinical progression-free survival under AR-targeted therapy will be determined.
|
24 months
|
Overall survival
Time Frame: 36 months
|
The optimal liquid biopsy-based test method to predict overall survival under AR-targeted therapy will be determined.
|
36 months
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Matthias M Heck, MD, Technical University of Munich
- Principal Investigator: Christof Winter, MD PhD, Technical University of Munich
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- HE 7386/1-1
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
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.
Clinical Trials on Castration-resistant Prostate Cancer
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