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Effects of Direct Artery Injection on Prostate Cancer Drug Delivery and Tumor Uptake: Imaging-Based Prediction of Treatment Effectiveness (IAPSMA)

15 giugno 2026 aggiornato da: Rūta Dubeikaitė, Lithuanian University of Health Sciences

Impact of Intra-Arterial PSMA Injection on Distribution and Tumor Uptake: Texture Analysis and Dose Radicality Prediction in Prostate Cancer

The goal of this clinical trial is to learn whether intra-arterial (IA) administration of 68Ga-PSMA improves tumor uptake and distribution compared with standard intravenous (IV) administration in patients with localized high-risk prostate cancer. The study will also evaluate the safety of the IA procedure and investigate whether advanced PET/CT imaging features can help predict the radiation dose needed for future personalized 177Lu-PSMA radioligand therapy.

The main questions it aims to answer are:

  • Does intra-arterial 68Ga-PSMA administration result in higher and more homogeneous tumor uptake than standard intravenous administration?
  • Can PET/CT texture analysis and dosimetric modeling predict the radiation dose required to achieve a curative effect with 177Lu-PSMA therapy?
  • What radiation exposure and procedure-related risks are associated with intra-arterial administration for patients and medical staff?

Researchers will compare PSMA uptake and distribution after intravenous and intra-arterial administration of 68Ga-PSMA using PET/CT imaging.

Participants will:

  • Undergo a standard intravenous 68Ga-PSMA PET/CT scan.
  • Undergo a second 68Ga-PSMA PET/CT scan following selective intra-arterial administration through the prostatic artery.
  • Have imaging data analyzed using advanced texture analysis and voxel-based dosimetry methods.
  • Undergo radical prostatectomy according to standard clinical care, with pathological analysis of surgical specimens.
  • Be monitored for adverse events, radiation exposure, and procedural safety throughout the study.

Panoramica dello studio

Stato

Non ancora reclutamento

Condizioni

Intervento / Trattamento

Descrizione dettagliata

PSMA-targeted radioligands have become an important tool for imaging and treatment of prostate cancer. Intravenous (IV) administration is the current standard route of administration; however, intra-arterial (IA) delivery through the prostatic artery may increase local radioligand concentration within the tumor while reducing systemic distribution.

This prospective, single-center, interventional study aims to evaluate the effect of IA administration of 68Ga-PSMA on tracer distribution and tumor uptake in patients with localized high-risk prostate cancer undergoing radical prostatectomy.

Participants will undergo standard-of-care 68Ga-PSMA PET/CT imaging following intravenous administration and a second PET/CT examination following selective intra-arterial administration of 68Ga-PSMA through the prostatic artery. Quantitative PET/CT analysis will be used to compare tumor uptake, tumor-to-background ratios, and intratumoral distribution between the two administration routes.

The study will also establish and evaluate a standardized technique for selective prostatic artery catheterization and IA radioligand administration. Procedural feasibility, technical success, adverse events, and radiation exposure to patients and medical personnel will be assessed.

Advanced radiomic texture analysis and voxel-based dosimetry will be performed on PET/CT datasets to characterize intratumoral heterogeneity and investigate imaging biomarkers associated with radiotracer distribution. These data will be used to develop predictive models estimating the radiation dose required to achieve a curative ("radical") effect with future 177Lu-PSMA radioligand therapy.

Following imaging, participants will undergo radical prostatectomy according to standard clinical practice. Histopathological findings will be correlated with imaging-derived uptake and texture parameters.

The study is designed to determine whether IA administration improves PSMA uptake and distribution compared with IV administration and to explore imaging-based approaches for personalized radioligand therapy planning in localized prostate cancer.

Tipo di studio

Interventistico

Iscrizione (Stimato)

10

Fase

  • Non applicabile

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Contatto studio

Backup dei contatti dello studio

Luoghi di studio

  • Lituania
      • Kaunas, Lituania, LT-50103
        • Lithuanian University of Health Sciences Kaunas Clinics
        • Contatto:

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

  • Adulto
  • Adulto più anziano

Accetta volontari sani

No

Descrizione

Inclusion Criteria:

  • Adult male patients with biopsy-proven prostate adenocarcinoma up to stages ≤T3bN1 by initial preoperative examination, with no distant metastases (M0) on ⁶⁸Ga-PSMA PET/CT.
  • Systemic therapy-naive patients scheduled for radical prostatectomy with/without pelvic lymph node dissection with curative intent.

  • High-risk localized or locally-advanced prostate cancer according to European Association of Urology criteria, including one of the following:

    1. Prostate-specific antigen > 20ng/mL2 or ISUP grade 4/5.
    2. Clinical T stage cT3-4* and/or N1 disease (involvement of lymph nodes at or below the bifurcation of the common iliac arteries), any ISUP grade, and any
  • High PSMA avidity on ⁶⁸Ga-PSMA PET/CT, defined as SUVmax ≥20.
  • Normal baseline hematological function.
  • Normal serum biochemistry.
  • Signed informed consent form.

Exclusion Criteria:

  • Patients with other (non-adenocarcinoma) biopsy-proven histology of prostate cancer.

  • Patients with low-risk prostate cancer according to European Association of Urology criteria, including any of the following:

    1. Prostate-specific antigen <10 ng/ml.
    2. International Society of Urological Pathology grade group 1.
    3. Clinical T stage T1-T2a digital rectal examination.
  • Prior radiotherapy or systemic therapy for prostate cancer.
  • Prostate cancer with low PSMA avidity (SUVmax <20) on ⁶⁸Ga-PSMA PET/CT.
  • Evidence of distant metastatic spread (M1) on ⁶⁸Ga-PSMA PET/CT.
  • Contraindications for radical prostatectomy.
  • Major comorbidities and laboratory abnormalities that might confound the results of the trial or interfere with the patient's ability to participate.
  • Refusal to participate in the trial.

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Diagnostico
  • Assegnazione: N / A
  • Modello interventistico: Assegnazione di gruppo singolo
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: IA-PSMA

All enrolled participants receive the same sequence of interventions:

  • Intravenous 68Ga-PSMA PET/CT
  • Intra-arterial 68Ga-PSMA PET/CT
  • Radical prostatectomy (standard of care) Each participant serves as their own control when comparing IV versus IA uptake and distribution.
Procedura: Intraarterial injection of 68Ga-PSMA
Additional intervention to the standard of care for prostate cancer treatment - prostate artery catheterization and intra-arterial injection of 68Ga-PSMA with subsequent PET/CT scan.

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Relative increase in intratumoral PSMA uptake after intra-arterial versus intravenous ⁶⁸Ga-PSMA administration
Lasso di tempo: Up to 6 weeks from enrollment.
To determine whether selective intra-arterial (IA) administration of ⁶⁸Ga-PSMA results in superior tumor targeting compared with standard intravenous (IV) administration. Uptake will be quantified using PET/CT-derived parameters, including SUVmax, SUVmean, tumor-to-background ratio (TBR), and volumetric uptake metrics obtained from paired IV and IA scans performed in the same patient.
Up to 6 weeks from enrollment.

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Technical success rate of selective intra-arterial prostate artery catheterization
Lasso di tempo: Up to 6 weeks from enrollment.
To evaluate the feasibility and reproducibility of the developed IA delivery protocol by assessing successful selective catheterization of the target prostatic artery and completion of radiotracer administration according to protocol.
Up to 6 weeks from enrollment.
Procedural safety of intra-arterial PSMA administration
Lasso di tempo: From IA administration until radical prostatectomy at up to 3 months from enrollment.
To assess the safety profile of IA radioligand administration, including procedure-related complications and adverse events. Number, type, and severity of adverse events graded according to CTCAE v5.0; incidence of vascular complications, non-target administration, bleeding, infection, or other procedure-related events
From IA administration until radical prostatectomy at up to 3 months from enrollment.
Patient and operator radiation exposure during intra-arterial versus intravenous procedures
Lasso di tempo: Up to 6 weeks from enrollment.
To compare the radiation burden associated with IA and IV administration pathways. Absorbed radiation dose (mSv) derived from measurement during and after the procedure.
Up to 6 weeks from enrollment.
Identification of PET texture biomarkers associated with optimal tumor saturation
Lasso di tempo: Up to 1 year from enrollment.
To identify radiomic features predictive of favorable intratumoral radiotracer distribution and complete lesion saturation. Association between extracted texture features and dosimetric endpoints using regression and machine-learning analyses.
Up to 1 year from enrollment.
Predicted absorbed tumor dose achievable with ¹⁷⁷Lu-PSMA therapy
Lasso di tempo: Up to 1 year from enrollment.
To estimate the radiation dose that would be delivered to tumor tissue during therapeutic ¹⁷⁷Lu-PSMA administration based on diagnostic PET-derived biodistribution. Voxel-based absorbed dose estimates (Gy) and dose-volume histogram parameters.
Up to 1 year from enrollment.

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Lithuanian University of Health Sciences

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Stimato)

1 agosto 2026

Completamento primario (Stimato)

31 gennaio 2028

Completamento dello studio (Stimato)

31 ottobre 2028

Date di iscrizione allo studio

Primo inviato

4 giugno 2026

Primo inviato che soddisfa i criteri di controllo qualità

15 giugno 2026

Primo Inserito (Effettivo)

18 giugno 2026

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

18 giugno 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

15 giugno 2026

Ultimo verificato

1 giugno 2026

Maggiori informazioni

Termini relativi a questo studio

Parole chiave

Termini MeSH pertinenti aggiuntivi

Altri numeri di identificazione dello studio

  • PSMA 1.0

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

SÌ

Descrizione del piano IPD

Only IPD used in the results publications.

Periodo di condivisione IPD

Beginning 3 months and ending 1 year after the publication of results.

Tipo di informazioni di supporto alla condivisione IPD

  • ICF
  • RSI

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

prodotto fabbricato ed esportato dagli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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