Prostate Cancer
Conditions
Keywords
J17149, PSMA, 18F-DCFPyL PET/CT
Brief summary
This is a phase II, single-center, open-label, trial to evaluate the diagnostic accuracy of PSMA-targeted 18F-DCFPyL PET/CT for detecting clinically significant prostate cancer in a screening population.
Detailed description
This is a phase II, single-center, open-label, trial to evaluate the diagnostic accuracy of PSMA-targeted 18F-DCFPyL PET/CT for detecting clinically significant prostate cancer in a screening population. 150 biopsy-naïve patients with an elevated PSA (2-10 ng/mL) will be enrolled in this study. Within 28 days of informed consent, patients will undergo an 18F-DCFPyL PET/CT. All scans will be read by a single experienced radiologist who will identify regions of interest (ROI) with discrete radiotracer uptake. The maximum SUV value (SUVmax) of each ROI will be recorded. For patients without a detectable ROI, the mean SUV (SUVmean) of a 1-2 cm volume of the prostate will instead be recorded. One to 28 days following PET/CT imaging, a systematic 12 to 14 core TRUS-guided prostate biopsy will be performed. Immediately following completion of systematic TRUS biopsies, fusion-targeted biopsies of all PET and/or MRI visible lesions will be performed, taking an additional 2 to 3 cores from each radiographic ROI. All biopsy cores will be assessed for Gleason score and percent cancer involvement.
Interventions
A bolus of \~9 mCi (333 MBq) of 18F-DCFPyL will be injected by slow IV push.
Sponsors
Study design
Eligibility
Inclusion criteria
* ≥18 years of age * PSA of 2-10 ng/mL * Clinical stage T1c-T2a on digital rectal exam * Elect to undergo TRUS-guided prostate biopsy as part of routine clinical care * Willingness to sign informed consent and comply with all protocol requirements
Exclusion criteria
* History of prior prostate biopsy * Administered a radioisotope ≤5 physical half-lives prior to the date of study PET/CT * Administered IV X-ray contrast medium ≤24 hours prior to the date of study PET/CT * Administered oral contrast medium ≤120 hours prior to the date of study PET/CT * Any medical condition or other circumstances that in the opinion of the investigators compromise obtaining reliable data or achieving the study objectives
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Sensitivity of 18F-DCFPyL PET/CT to detect clinically significant prostate cancer on prostate biopsy relative to serum prostate specific antigen (PSA) | 4 years | Measure the diagnostic accuracy of 18F-DCFPyL PET/CT and compare it with serum PSA for detecting clinically significant prostate cancer on prostate biopsy |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Sensitivity of 18F-DCFPyL PET/CT relative to PSA | 4 years | Measure the diagnostic accuracy of 18F-DCFPyL PET/CT relative to serum PSA for detecting clinically significant prostate cancer as defined by the following alternative definitions: Gleason score ≥4+3=7; Gleason score ≥3+4 or \>50% involvement of ≥1 core with Gleason score ≥3+3=6 prostate cancer; Gleason score ≥3+4 or \>70% involvement of ≥1 core with Gleason score ≥3+3=6 prostate cancer; Gleason score ≥3+4=7, or \>2 cores with Gleason score ≥3+3=6, or \>50% involvement of ≥1 core with Gleason score ≥3+3=6 prostate cancer. |
| Sensitivity of 18F-DCFPyL PET/CT for detecting clinically significant prostate cancer relative to mpMRI | 4 years | Measure the diagnostic accuracy of 18F-DCFPyL PET/CT relative to mpMRI for detecting clinically significant prostate cancer by the various tested definitions |
| Sensitivity and diagnostic accuracy of 18F-DCFPyL PET/CT relative to the phi blood test for detecting clinically significant prostate cancer by the various tested definitions | 4 years | Measure the diagnostic accuracy of 18F-DCFPyL PET/CT relative to the phi blood test for detecting clinically significant prostate cancer by the various tested definitions |
Countries
United States
Contacts
Johns Hopkins University