PET/MRI for Men Being Considered for Radiotherapy for Suspected Prostate Cancer Recurrence Post-Prostatectomy (PROPS)
PROPS (PET/MRI Pre-Radiotherapy for Post-Prostatectomy Salvage)
The PROPS trial is for men being considered for radiotherapy due to the suspicion that their prostate cancer has recurred following the surgical removal of their prostate (prostatectomy). This suspicion is based on rises seen on Prostate Specific Antigen (PSA) blood tests. Only men who demonstrate the absence of disease on standard imaging scans (Computed Tomography (CT) and bone scans) will be invited to participate.
This study will be assessing if the imaging probe 18-F Fluorocholine (18F-FCH) used during Positron Emission Tomography (PET) and Magnetic Resonance Imaging (MRI) scans, can better predict who will benefit from radiotherapy by identifying the source of cancer recurrence. This will be determined by measuring the number of men who have disease identified outside of the prostate bed (the small pocket or depression where the prostate used to be) on their 18F-FCH PET scan. Since F-18-FCH has been shown to be more sensitive in detecting prostate cancer that may have spread into lymph nodes or bone, it may potentially identify areas of prostate cancer spread not seen with standard imaging.
調査の概要
詳細な説明
The study will be a non-randomized, prospective study of men with suspected local recurrence of prostate cancer post-prostatectomy with negative conventional re-staging studies (bone scan and CT of the abdomen and pelvis; MRI of the pelvis as part of re-staging is allowed where it is the institutional standard of care). The clinician will develop an initial treatment plan based on conventional re-staging information.
Patients enrolled onto trial will undergo hybrid PET/MR imaging using 18F-FCH (sites without access to a hybrid PET/MR scanner will conduct a 18F-FCH PET/CT in addition to a full body MRI). A consensus staging report based on local and centralized review of the 18F-FCH PET imaging will be provided to the attending clinician, who will document a second treatment plan based on this additional information. The treatment plan to be implemented (initial or second) will be left to clinician discretion, but will be documented.
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
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London、イギリス、SW3 6JJ
- Royal Marsden Hospital
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London、イギリス、NW1 2BU
- University College London Hospital
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South Glamorgan
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Cardiff、South Glamorgan、イギリス
- Velindre Cancer Centre
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New South Wales
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Sydney、New South Wales、オーストラリア、2010
- St. Vincent's Hospital
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Victoria
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Melbourne、Victoria、オーストラリア、3002
- Peter MacCallum Cancer Centre
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Melbourne、Victoria、オーストラリア、3084
- Austin Hospital
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Melbourne、Victoria、オーストラリア、3128
- Eastern Health
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Ontario
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London、Ontario、カナダ、N6A 5W9
- Lawson Health Research Institute, London Health Sciences Centre
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Toronto、Ontario、カナダ、M5G 2M9
- University of Toronto
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Quebec
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Laval、Quebec、カナダ、G1V 0A6
- Université Laval Quebec
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Male, aged 18 years or older.
- Confirmation of prostate cancer on prostatectomy pathology report.
- No lymph node involvement (N0 or Nx) reported on prostatectomy pathology report.
- Documented PSA rise measured on 3 occasions.
- PSA ≥ 0.2 ng/ml at enrolment.
- At least one adverse feature: Current PSA > or equal to 1.0, Initial Gleason Grade > or equal to 8, Positive surgical margin, pT3b (seminal vesicle involvement), or PSA doubling time < 10 months.
- Bone scan and CT scan within 12 weeks of enrolment negative or equivocal for metastatic disease.
- Suitable candidate for radiotherapy and not yet had any salvage treatment post-prostatectomy.
Exclusion Criteria:
- Prostate cancer with significant sarcomatoid or spindle cell or neuroendocrine small cell components.
- Proven metastatic disease.
- Patients who refuse salvage prostate bed radiotherapy.
- Patients who refuse to join the trial or are unable to consent.
- Patients not being considered for further therapy.
- Patients who cannot lie still for at least 30 minutes or comply with imaging.
- Unequivocal evidence of disease outside the prostate bed on conventional imaging
- Allergy to MRI contrast agent (exclusion for MRI component only) or PET tracer to be used as part of the imaging
- Sickle cell disease or other anemias
- Insufficient renal function (eGFR < 30 mL/min/1.73 m2)
- Residual bladder volume > 150 cc (determined by post-void ultrasound)
- Hip prosthesis, vascular grafting or other conditions affecting imaging or delivery of therapeutic radiation
- Contraindication to MRI, including but not restricted to: pacemaker or other electronic implants, known metal in the orbit, MR incompatible surgical or cerebral aneurysm clips, Shrapnel, tattoos, non-removable body piercings (relative contraindications)
- Hormone Androgen deprivation therapy of any type within 6 months prior to enrollment
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：診断
- 割り当て：なし
- 介入モデル：単一グループの割り当て
- マスキング：なし（オープンラベル）
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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実験的：18F-FCH PET/MRI Scan
Patients will undergo an injection of 18F-fluoromethyl-choline at 3.6 MBq/kg followed by whole body PET/CT imaging.
Patients will also undergo a whole body MRI including T2 weighted, Diffusion weighted and Gadolinium Contrast Enhanced sequences.
Patients with suspicion for recurrence may undergo biopsy if lesions identified on PET/CT or MRI are accessible for biopsy
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Patients will first undergo screening to ensure eligibility.
If eligible, they will undergo a PET/MRI scan using 18F-FCH as the radiolabeled tracer.
If prostate cancer is detected outside the prostate, patients may undergo a biopsy or follow-up 18F-FCH PET/MRI to confirm the results.
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
時間枠 |
|---|---|
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Proportion of men with negative or equivocal conventional restaging imaging (bone scan + CT scan of abdomen and pelvis) with uptake identified outside of the prostate bed on 18F-FCH PET
時間枠：Within 2 weeks of 18F-FCH PET scan
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Within 2 weeks of 18F-FCH PET scan
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Biochemical disease free survival at 3 years post-treatment
時間枠：3 years post-treatment
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Whether biochemical (PSA) control rates 3 years post-treatment are improved for participants with 18F-FCH PET imaging that was negative or demonstrated uptake confined to the prostate bed and received salvage pelvic radiotherapy compared to published results for men with adverse features.
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3 years post-treatment
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協力者と研究者
捜査官
- 主任研究者：Glenn Bauman, MD、London Regional Cancer Program
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
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