Phase II Monocentric Study to Evaluate a Novel Approach for Staging Prostate Cancer Patients by Using a Fully Integrated Hybrid PET/MRI
Overview
- Phase
- Phase 2
- Intervention
- 68Ga-PSMA
- Conditions
- Prostate Cancer
- Sponsor
- IRCCS San Raffaele
- Enrollment
- 50
- Locations
- 1
- Primary Endpoint
- To define the diagnostic accuracy of PET/MRI system with the novel tracers 68Ga-PSMA and 68Ga-RM2 for the localization of primary prostate cancer
- Status
- Recruiting
- Last Updated
- last year
Overview
Brief Summary
The main goal of this phase II clinical trial is to define a novel approach of staging prostate cancer (PCa) patients by using a fully integrated positron emission tomography/ magnetic resonance imaging (PET/MRI) system with 68Ga-prostate specifica membrane antigen (PSMA) and 68Ga-RM2 (bombesin antagonist).
50 patients with biopsy proven PCa will be studied by PET/MRI with 68Ga-PSMA and with 68Ga-RM2 and then will undergo prostatectomy and pelvic lymphadenectomy.
Detailed Description
This is a prospective monocentric open study (Phase II study). The study will include 50 consecutive PCa patients who will be recruited in the first 36 months of the study. All clinical and pathological variables available at the time of PET/MRI will be recorded for each patient and all patients will take a blood sample before the first PET/MRI study. All patients will undergo 68Ga-PSMA and 68Ga-RM2 PET/MRI studies at San Raffaele Hospital in two different days (\> 48 hours between the two studies) and within one month from each other. Then, patients will undergo surgical intervention (prostatectomy and pelvic/retroperitoneal lymphadenectomy) and the surgically removed prostate will be fixated and processed. Ex-vivo 3T-MRI study will be performed on the processed specimen (prostate gland) and afterwards, the prostate will be examined by a dedicated pathologist. Spatial coregistration of in vivo, ex-vivo and histopathological images will be performed so that the annotation (dominant tumor lesion) made by the pathologist will be translated onto in vivo PET/MR images and semi-quantitative and radiomic features will be extracted from PET and mp-MRI images
Investigators
Maria Picchio
Associate professor
IRCCS San Raffaele
Eligibility Criteria
Inclusion Criteria
- •Age ≥ 18 years-old
- •Biopsy proven high-grade PCa referred to prostatectomy and pelvic/retroperitoneal lymphadenectomy.
- •Willing to provide a signed informed consent
Exclusion Criteria
- •Age \< 18 years-old
- •Inability to complete the needed imaging examinations (i.e. severe claustrophobia)
- •Any additional medical condition that may significantly interfere with study compliance
- •All the contraindications for MRI study (i.e. pacemaker)
- •Evidence of metastatic disease on conventional imaging contraindicating the surgical procedure
Arms & Interventions
Arm 1
Dual tracer PET/MRI
Intervention: 68Ga-PSMA
Arm 1
Dual tracer PET/MRI
Intervention: 68Ga-RM2
Outcomes
Primary Outcomes
To define the diagnostic accuracy of PET/MRI system with the novel tracers 68Ga-PSMA and 68Ga-RM2 for the localization of primary prostate cancer
Time Frame: baseline
All patients will undergo PET/MRI with 68Ga-PSMA and 68Ga-RM2 and then imaging findings will be correlated to histopathological findings gathered after prostatectomy. Specifically, at the patient level, we will count the number of patients where the different imaging modalities identified at least one intraprostatic cancer lesion. At the lesion level, on the other hand, we will match the intraprostatic lesions identified at imaging with those detected at histopathological examination. Therefore, providing measures of sensitivity, specificity, PPV, NPV for each imaging modality investigated ( 68Ga-PSMA PET, 68Ga-RM2 PET and MRI) at the lesion level.
Secondary Outcomes
- To optimize PET/MRI with 68Ga-PSMA and 68Ga-RM2 protocol by using novel imaging technique to stage PCa patients.(baseline)
- To characterize the primary PCa phenotype in high-grade patients(baseline)
- To evaluate patient management based on PET/MRI studies.(24 months)
- To evaluate the stability and reproducibility of imaging features in mp-MRI with test-retest procedure.(baseline)
- To evaluate the diagnostic accuracy of PET/MRI with 68Ga-PSMA and 68Ga-RM2 to stage T, N and M parameters in PCa patients.(24 months after baseline)