Radio-guided Surgery With DROP-IN Beta Probe for 68Ga-PSMA, in High-risk Prostate Cancer Patients Eligible for Robotic-assisted Radical Prostatectomy.

Recruiting

• Conditions: Positron Emission Tomography; PSMA; Prostate Cancer

• Registration Number: NCT05596851
• Lead Sponsor: European Institute of Oncology

Brief Summary

The goal of this observational study is to evaluate the diagnostic efficacy and the safety of the combined approach with β-probe and 68Ga-PSMA-11 PET/CT in the correct identification of lymph node metastases, in high-risk prostate cancer patients undergoing radical prostatectomy and pelvic lymph node dissection.

Detailed Description

Study Phase: Phase II

Primary Objective:

To evaluate the diagnostic accuracy of the combined approach with β-probe and 68Ga-PSMA-11 PET/CT in the correct identification of lymph node metastases, in high-risk prostate cancer patients undergoing radical prostatectomy and pelvic lymph node dissection. The histopathological analysis of the surgical specimens will be considered the standard of reference and diagnostic accuracy will be evaluated in terms of sensitivity and specificity.

Secondary Objectives:

* the identification of the most appropriate tumor-to-background ratio (TBR) able to correctly locate the signal emitted by PSMA-positive lymph nodes compared with the signal derived by the background rumor.

* safety and toxicity analysis regarding the intraoperative application of the β-probe.

* the comparison between the signal detected by the β-probe and 68Ga-PSMA-11 PET/CT images.

* the correlation of the signal detected by the β-probe with the PSMA expression (PSMA staining) in lymph node metastases assessed by immuno-histochemical analysis on the surgical specimens

Drug Dosage, Formulation, Administration: Intravenous administration of 1.1 MBq/Kg of 68Ga-PSMA-11.

Primary Endpoint: Primary: sensitivity and specificity in a per-region analysis.

Secondary Endpoints:

* comparison of β-probe intra-operatory measurements with ex-vivo ones.

* comparison of β-probe measurements and 68Ga-PSMA-11 semi-quantitative parameters (SUVmax and PSMA-TV).

* comparison of β-probe measurements and PSMA expression assessed by IHC (PSMA staining).

Study Timeline

• Study Start: 2022-03-21
• Status Verified: 2022-10
• Study First Submitted: 2022-10-24
• Study First Submitted QC: 2022-10-24
• Last Update Submitted: 2022-10-24
• Study First Posted: 2022-10-27
• Last Update Posted: 2022-10-27
• Primary Completion: 2023-09-01
• Study Completion: 2023-12-01

Recruitment & Eligibility

• Status: RECRUITING
• Sex: Male
• Target Recruitment: 15

Inclusion Criteria

• Histologically proven prostate cancer
• High-risk prostate cancer (T>T2c and/or PSA>20 and/or ISUP>3)
• Patients suitable for radical prostatectomy + pelvic lymph node dissection
• 68Ga-PSMA-11 PET/CT performed within 4 weeks prior to surgery
• PSMA positive pelvic lymph nodes detected at 68Ga-PSMA-11 PET/CT
• Age >18 years old
• Willing to sign informed consent

Exclusion Criteria

• Patient unfit for surgery
• M1 stage (any M) detected at 68Ga-PSMA-11 PET/CT or other imaging modalities performed during diagnostic wok-up evaluation
• Unable to tolerate PET scan

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Sensitivity, specificity and positive predictive value in a per-region analysis	March 2022 - March 2023

Secondary Outcome Measures

Name	Time	Method
Comparison of β-probe intra-operatory measurements with ex-vivo ones.	March 2022 - March 2023
Comparison of β-probe measurements and 68Ga-PSMA-11 semi-quantitative parameters	March 2022 - March 2023	SUVmax and PSMA-TV will be evaluated as semi-quantitative parameters
Comparison of β-probe measurements and PSMA expression assessed by immunohistochemical analysis (IHC).	May 2022 - December 2023	IHC will be evaluated by PSMA staining on the surgical specimens.

Trial Locations

Locations (1)

IEO European Institute of Oncology; 🇮🇹 Milan, Italy