NCT04742972撤回不适用
PSMA-PET Guided Stereotactic Ablative Body Radiotherapy for Oligometastasis in Metastatic Castration-resistant Prostate Cancer (mCRPC) With Progression on Enzalutamide (PMSABR Study)
Darren Poon0 个研究点开始时间: 2021年2月25日最近更新:
适应症
干预措施
试验速览
- 阶段
- 不适用
- 状态
- 撤回
- 发起方
- 主要终点
- The 6-month progression-Free Survival rate
研究概览
简要总结
In this study, the investigator aim to evaluate the role of PMSA-PET guided SABR on progression free survival (PFS) in patients with oligoprogressive mCRPC with Enzalutamide. The potential improvement in PFS with SABR while continuing the initial-responding Enzalutamide is potentially benefiting to patients in terms of overall disease control.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- Male
- 接受健康志愿者
- 否
入选标准
- •Histological confirmation of prostate adenocarcinoma
- •Evidence of stage IV disease (as defined by AJCC criteria) on previous bone, CT, and/or MRI scan
- •Ongoing ADT with a gonadotropin-releasing hormone (GnRH) analogue or bilateral orchiectomy (ie, surgical or medical castration) confirmed by testosterone level ≤ 1.73 nmol/L (50 ng/dL) at the screening visit
- •ECOG performance score 0-2
- •History/physical examination within 2 weeks prior to registration
- •Able to sign informed-consent
- •Patient with mCRPC who received Enzalutamide during the past 6-8 weeks and must have been delivered for a total of at least 3 months with an initial ≥50% decline of PSA from baseline.
- •Documented disease progression with Enzalutamide as defined by PCWG3 with at least one of the followings:
- •PSA progression: defined by PSA increase that is ≥ 25% and ≥ 2 ng/mL above the nadir. A minimum of 2 rising PSA levels with an interval of ≥ 1 week between each determination.
- •Radiographic disease progression in soft tissue based on RECIST 1.1 criteria. Participants whose disease spread is limited to regional pelvic lymph nodes (N1) measuring at least 2 cm in short axis will be considered eligible.
- •Radiographic disease progression in bone defined as appearance of 2 or more new bone lesions on bone scan
- •A maximum of 5 extracranial metastases in any organ system (except brain), with ≤ 4 tumours within any given organ system, confirmed with PSMA PET-CT scan
- •All sites of oligometastasis can be safely treated with SABR
- •Adequate baseline organ function to allow SABR to all relevant targets
- •Participants already receiving agents for the management of skeletal-related events (SREs) are allowed to continue with anti-bone resorptive therapy (including, but not limited to bisphosphonate or receptor activator of nuclear factor kappa ligand inhibitor) if on stable dose for more than 28 days prior to treatment arm assignment
排除标准
- •Patients with active cancer other than prostate cancer and non-melanoma skin cancer.
- •Prior treatment with docetaxel, another chemotherapy agent or second generation hormonal therapy (e.g. abiraterone acetate or enzalutamide) for metastatic castration-resistant prostate cancer. Prior docetaxel, abiraterone acetate or enzalutamide for metastatic hormone-sensitive prostate cancer is allowed if ≥ 12 months elapsed from last dose of these treatments.
- •PSA at inclusion >20 ng/ml
- •Serum creatinine and total bilirubin > 3 times the upper limit of normal
- •Liver Transaminases > 5-times the upper limit of normal
- •Unstable angina and/or congestive heart failure requiring hospitalization, transmural myocardial infarction within the last 6 months, acute bacterial or fungal infection requiring intravenous antibiotics, chronic obstructive pulmonary disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy at the time of registration
- •Patients with oligometastases that have been previously treated with SABR.
- •Serious medical comorbidities precluding radiotherapy, such as ataxia-telangiectasia or scleroderma. For patients with oligoprogressive lesions in the lung or thorax, this includes interstitial lung disease
- •Clinical or radiological evidence of spinal cord compression or tumor within 1.5mm of spinal cord on MRI
- •Malignant pleural effusion
- •Malignant peritoneal disease
- •Intra-cranial metastases
研究组 & 干预措施
SABR
Experimental
干预措施: SABR (Radiation)
SOC
Placebo Comparator
干预措施: SOC (Other)
结局指标
主要结局
The 6-month progression-Free Survival rate
时间窗: up to 2 years
次要结局
- Local control rate of the SABR-treated oligometastasis at 6 months after SABR(up to 2 years)
- Time to next systemic treatment(2 years)
- The number of participants with treatment-related adverse event as assessed by CTCAE v4.0(2 years)
- Overall survival(2 years)
- The proportion of patients in both arms who have AR-V7 (CTCs)(2 years)
- Progression-Free Survival(2 years)
- Time to progression(2 years)
- Local control rate of the SABR-treated oligometastasis at 6 months after SABR based on the PERCIST criteria(up to 2 years)
- QOL (EORTC QLQ-C30)(2 years)
研究者
Darren Poon
Principal Investigator
Chinese University of Hong Kong
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