A Prospective Study Based on Spatial Multi-omics to Predict the Efficacy of ADT Combined With Second-generation Novel Hormonal Agents in Metastatic Hormone-sensitive Prostate Cancer.

August 26, 2026 updated by: Sheng Tai, Anhui Medical University

A Prospective Study Based on Spatial Multi-Omics for Predicting the Efficacy of Androgen Deprivation Therapy Combined With Second-Generation Novel Endocrine Therapeutic Agents in Metastatic Hormone-Sensitive Prostate Cancer.

This study plans to enroll patients with newly diagnosed metastatic hormone-sensitive prostate cancer (mHSPC) and conduct a prospective, single-center, observational study. By performing whole-exome sequencing (WES), Xenium spatial transcriptomics, and PhenoCycler-Fusion spatial single-cell proteomics (PCF analysis) on tumor tissue samples, we aim to comprehensively delineate the molecular landscape of patients with different spatial multi-omic profiles in the real-world setting. We will investigate the associations between these molecular features and differential treatment responses to various therapeutic regimens, and further construct predictive models of treatment response. Ultimately, this will enable precise evaluation of treatment outcomes across distinct molecular subtypes and provide evidence to support individualized precision diagnostics and therapeutics for patients with mHSPC.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

1、Baseline sample collection: Tumor tissues will be collected via prostate biopsy from enrolled patients. The specimens will be tripartite: one aliquot for standard histopathology, one for WES, and one for spatial multi-omic profiling (Xenium and PhenoCycler-Fusion).2、Follow-up: Patients will be assessed every 3 months during therapy, with CBC, biochemistry, sex hormones, and serum PSA. Prostate mpMRI will be repeated every 3 months. PSA testing frequency may be modified if PSA progression occurs. Follow-up continues until CRPC development or death.3、（1）Primary: Build a prognostic model integrating Xenium, WES, and PCF data.（2）Secondary: bPFS and OS.（3）Progression: PSA rise to ≥0.2 ng/mL confirmed on repeat testing after prior undetectable levels.

Study Type

Interventional

Enrollment (Estimated)

40

Phase

  • Phase 2

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

  • Name: Sheng Tai, M.D.
  • Phone Number: 0551-62922234 86-18355159268
  • Email: Taishengwk@163.com

Study Contact Backup

Study Locations

  • China
    • Anhui
      • Hefei, Anhui, China, 230022
        • Universitythe First Affiliatedhospital of Anhuimedical
        • Contact:
        • Contact:
        • Principal Investigator:
          • Sheng Tai, M.D.

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

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  1. Age > 18 years and < 85 years.
  2. Histopathologically confirmed prostate adenocarcinoma, ductal adenocarcinoma, or intraductal carcinoma.
  3. Imaging evidence of definite distant metastases (according to RECIST criteria).
  4. Pre-biopsy PSA ≥ 20 ng/mL or Gleason score ≥ 4+4.
  5. No prior hormonal therapy or other systemic anti-tumor regimens.
  6. ECOG performance status 0-2, with an estimated life expectancy > 6 months.
  7. Adequate organ function.h. Ability and willingness to provide written informed consent, and capability to comply with the study visit schedule.

Exclusion Criteria:

  1. Histopathological diagnosis of neuroendocrine or small cell prostate cancer.
  2. No definite distant metastases detected on imaging.
  3. Prior history of anti-tumor therapy (including neoadjuvant, adjuvant, or other treatments).
  4. Submitted biopsy samples fail to meet quality control requirements.
  5. Concurrent severe endocrine or metabolic disorders, or other severe digestive system diseases.
  6. Concurrent chronic hepatitis, cirrhosis, chronic nephritis, renal insufficiency, or other relevant conditions.
  7. History of immunodeficiency or organ transplantation.
  8. History of other concurrent malignancies.
  9. Concurrent enrollment in other clinical trials.
  10. Other conditions that the investigator deems unsuitable for study enrollment.

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

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Newly diagnosed mHSPC patients who meet the inclusion criteria
Eligible patients will be enrolled after providing written informed consent. Individualized therapy (ADT plus abiraterone or other ARPIs) will be prescribed by the investigators according to each patient's financial situation, drug availability, and clinical needs, with regular follow-ups performed following routine real-world practice
Drug: ADT plus abiraterone or other ARPIs（apalutamide, enzalutamide, rezvilutamide, darolutamide)
The spatial heterogeneity of the tumor microenvironment in mHSPC-encompassing immune cell infiltration patterns, tumor-stroma interface features, and the regional activation status of critical signaling pathways-is intimately linked to clinical outcomes with ADT plus ARPI therapy. Through comprehensive spatial multi-omic profiling, these spatial attributes can be systematically dissected to uncover pivotal predictive biomarkers, facilitate the development of accurate response prediction models, and ultimately guide personalized therapeutic strategies for patients with mHSPC
Other Names:
  • ADT plus abiraterone
  • ADT plus Apalutamide
  • ADT plus Enzalutamide
  • ADT plus Darolutamide
  • ADT plus rezvilutamide

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Biochemical Progression-Free Survival (bPFS)
Time Frame: From treatment initiation until biochemical progression or last follow-up, assessed every 3 months (±1 month) for up to 24 months.
Time from initiation of ADT plus ARPI therapy to biochemical progression or death from any cause, whichever occurs first. Biochemical progression is defined as a PSA rise to ≥0.2 ng/mL after having reached an undetectable level, confirmed by a second measurement at least 2 weeks apart. Participants without an event will be censored at the date of last follow-up.
From treatment initiation until biochemical progression or last follow-up, assessed every 3 months (±1 month) for up to 24 months.
Overall Survival (OS)
Time Frame: From treatment initiation until death or last follow-up, assessed up to 24 months.
Time from treatment initiation to death from any cause. Participants alive or lost to follow-up will be censored at the date last known alive.
From treatment initiation until death or last follow-up, assessed up to 24 months.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Mutation Frequency of Key Genes Assessed by Whole-Exome Sequencing (WES)
Time Frame: Baseline (at enrollment, from biopsy tissue).
Baseline tumor tissue from prostate biopsy will be analyzed by WES. The mutation status (including variant allele frequency) of AR, TP53, PTEN, RB1, and other relevant genes will be reported as the proportion of participants with each mutation.
Baseline (at enrollment, from biopsy tissue).
Spatial Gene Expression Signatures Measured by Xenium Platform
Time Frame: Baseline (at enrollment).
Baseline biopsy tissue will be processed for Xenium in situ spatial transcriptomics. The average expression levels of a pre-specified gene panel (including AR-signaling and immune-related genes) in tumor, immune, and stromal compartments will be reported.
Baseline (at enrollment).
Spatial Protein Marker Expression Measured by PhenoCycler-Fusion (PCF)
Time Frame: Baseline (at enrollment).
Using cyclic immunofluorescence on baseline biopsy tissue, the platform quantifies the density (cells/mm²) and proportion of positive cells for a panel of protein markers (e.g., AR, PSMA, PD-L1, CD8, CD68) within the tumor microenvironment.
Baseline (at enrollment).
Area Under the Receiver Operating Characteristic Curve (AUC) of the Multi-omics Prediction Model for 6-Month Undetectable PSA（ PSA <0.2 ng/mL ）
Time Frame: Baseline data used to predict outcome at 6 months after treatment initiation.
Baseline WES, Xenium, and PCF data will be integrated using a machine-learning algorithm (e.g., random forest or LASSO-Cox) to build a model predicting Undetectable PSA at 6 months ( defined as serum PSA <0.2 ng/mL confirmed at two consecutive visits). Model performance will be evaluated by cross-validation, and the mean AUC with 95% confidence interval will be reported, along with sensitivity, specificity, and positive predictive value.
Baseline data used to predict outcome at 6 months after treatment initiation.

Collaborators and Investigators

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

Sponsor

Anhui Medical University

Investigators

  • Principal Investigator: Sheng Tai, M.D., The First Affiliated Hospital of Anhui Medical University
  • Principal Investigator: Hongzhi Wang, M.D., The First Affiliated Hospital of Anhui Medical University

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 (Estimated)

October 1, 2026

Primary Completion (Estimated)

April 30, 2028

Study Completion (Estimated)

June 30, 2028

Study Registration Dates

First Submitted

August 13, 2026

First Submitted That Met QC Criteria

August 26, 2026

First Posted (Actual)

August 31, 2026

Study Record Updates

Last Update Posted (Actual)

August 31, 2026

Last Update Submitted That Met QC Criteria

August 26, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • KY2026-09-81

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

IPD Plan Description

Genetic information from patients will be analyzed.The research involves genetic/genomic profiling of patient samples.

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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