99mTc-MIP-1404 SPECT/CT in Primary Staging of Prostate Cancer

Официальное название

99mTc-MIP-1404 SPECT/CT for Primary PROstate Cancer STAging: Comparative Prospective, Randomized Trial to Present Guideline Imaging

Обзор

Prostate cancer (PCa) is currently the most common cancer in men in Finland (www.cancerregistry.fi). Although prognosis is very good in majority of men, it is noteworthy that still up to 20% of PCa cases are metastatic at the time of initial diagnosis and yearly 900 men die because of prostate cancer. Robust primary staging is, therefore, one of the most important prognostic factors, and it is crucial for treatment decision. Despite their low sensitivity to detect metastasis, bone scintigraphy (BS) and contrast enhanced whole body computed tomography (ce-wbCT) are recommended by current guidelines for primary staging in men at risk of metastasis. MIP-1404 is a small-molecule PSMA inhibitor that can be used in SPECT systems (99mTc-MIP- 1404 SPECT/CT). 99mTc-MIP-1404 SPECT/CT is performed by a single IV bolus of 99mTc-MIP-1404, which binds with high affinity to extracellular domain of PSMA molecule. As of March 2020, a total of 629 subjects have received 99mTc-MIP-1404 injection averaging 740 ±111 MBq (20 ± 3 mCi) per administration in prospective clinical trials. 99mTc MIP-1404 has been well tolerated following a single IV dose at 740 ± 111 MBq in both healthy volunteers and patients with confirmed metastatic prostate adenocarcinoma. In prospective and retrospective studies, it has shown high potential to detect prostate cancer lesions in primary staging. In fact, Goffin et al. reported a sensitivity of 50% and specificity of 87% detecting local lymph node metastasis in radically operated patients when histopathology was used as a reference. This corresponds closely to the sensitivity of PSMA-PET. PROSTAMIP is a randomized prospective single-institutional study to demonstrate superiority of 99mTc-MIP-1404 SPECT/CT compared to traditional imaging modalities (99mTc-HMDP planar BS plus ce-wbCT).

Вмешательства

• Диагностический тест PSMA-imaging
  Subjects undergo additional imaging i.e. PSMA/SPECT/CT and PSMA/PET/CT

Первичные конечные точки

• Number of subjects with local lymph node metastasi(e)s [Срок оценки: Baseline]

Вторичные конечные точки (11)

• Number of subjects with metastasis [Срок оценки: Baseline]
• Diagnostic accuracy of detecting subjects with metastasis between PSMA-SPECT/CT and conventional imaging [Срок оценки: Baseline]
• True positive rate in lesion level between PSMA-SPECT/CT and conventional imaging [Срок оценки: Baseline]
• False positive rate in lesion level between PSMA-SPECT/CT and conventional imaging [Срок оценки: Baseline]
• False negative rate in lesion level between PSMA-SPECT/CT and conventional imaging [Срок оценки: Baseline]
• Diagnostic accuracy of detecting subjects with metastasis between PSMA-SPECT/CT and PSMA-PET/CT [Срок оценки: Baseline]
• True positive rate in lesion level between PSMA-SPECT/CT and PSMA-PET/CT [Срок оценки: Baseline]
• False positive rate in lesion level between PSMA-SPECT/CT and PSMA-PET/CT [Срок оценки: Baseline]
• False negative rate in lesion level between PSMA-SPECT/CT and PSMA-PET/CT [Срок оценки: Baseline]
• Inter-rater agreement [Срок оценки: Baseline]
• Effect on treatment decision [Срок оценки: Baseline]

Критерии участия

Критерии включения

• Subjects must be able and willing to give written informed consent and to comply with the requirements of this study protocol
• Subjects must be male, aged 18 years or above at Baseline
• Histopathologically confirmed high risk (Gleason ≥4+4, PSA ≥20 and/ or cT≥3a) acinar or ductal adenocarcinoma of prostate

Критерии исключения

• Allergy/sensitivity to study medications or their ingredients
• Subjects unable to provide written informed consent
• Subjects who have any other significant disease or disorder which, in the opinion of the investigator, may either put the subject at risk by participation in the study, or may influence the result of the study.
• Subjects who have a history of drug or alcohol use that, in the opinion of the investigator, would interfere with adherence to study requirements.
• Subjects who have androgen deprivation therapy initiated before enrolment
• Subjects who have claustrophobia

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Открытое

Основная цель

Диагностика

Центры проведения

Финляндия · 1 центр

• University Hospital of Turku, Hospital Distric of Southwest Finland — Turku

Идентификаторы

NCT: NCT06219746 · T19/2021

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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