E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Clinical suspected prostate cancer |
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E.1.1.1 | Medical condition in easily understood language |
Clinical suspected prostate cancer |
Verdacht auf Prostatakarzinom |
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E.1.1.2 | Therapeutic area | Analytical, Diagnostic and Therapeutic Techniques and Equipment [E] - Diagnosis [E01] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10060862 |
E.1.2 | Term | Prostate cancer |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
We hypothesize that the image guided biopsy using multiparametric metabolic hybrid imaging with [18F]Fluoroethylcholine (FEC)/[68]Ga-PSMA-PET/MRI is superior in the detection of primary localized prostate cancer than the conventional biopsy approach with transrectal ultrasound in patients with suspected prostate cancer (according to the inclusion criteria) and could therefore significantly improve the detection rate of the dominant intraprostatic tumor lesion and reduce the number of biopsies needed for a correct histopathological diagnosis to a minimum in the future (PET/MRI guided biopsy). |
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E.2.2 | Secondary objectives of the trial |
• This method should enable improved tumor characterization. A diagnostic accuracy of >80% is assumed in lesions >5mm (in axial, sagittal and coronal extension) for the ability of the multiparametric metabolic method to differentiate between Gleason ≤3+4=7 (7a) tumors and ≥4+3=7 (7b) tumors (as compared to histological whole mount tumor mapping) and to identify patients with a high risk of developing metastatic disease (as compared to the loss of the transcription factor STAT3(signal transducer and activator of transcription 3) and cell cycle regulator p14 in a molecular pathological workout of the radical prostatectomy specimen). • To evaluate, if the applied parameters of multiparametric metabolic imaging with FEC- and PSMA-PET/MRI are associated with the evidence of an early biochemical relapse after a PSA nadir <0.2ng/ml after primary treatment in a two years follow up.
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
• Clinical suspicion of prostate cancer: • blood PSA level > 4.0 ng/ml and/or • free-to-total PSA ratio <22% and/or • progressive rise of PSA levels in two consecutive blood samples despite antibiotics
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E.4 | Principal exclusion criteria |
• antiandrogen therapy • prostate needle biopsy <21 days before PET/MRI • known active secondary cancer • endorectal coil not applicable (e.g. anus praetor with short rectal stump) • known active prostatitis (e.g. painful DRE) • known anaphylaxis against gadolinium-DTPA • patient’s written informed consent not given |
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary endpoint is the tumor status after standard and/or image guided biopsy (when positive) or combined standard and image guided biopsy (when negative). |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Tumor status will be evaluated after needle biopsy. |
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E.5.2 | Secondary end point(s) |
Prognosis quality of the aggressiveness of carcinoma compared between the standard and the image guided study arm measured via dichotomized Gleason score. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Evaluation of the secondary endpoint will be done after end of study visit (Visit 1, when no surgery is planned for the patient; End of Study visit for patients who undergo surgery) |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | Yes |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | No |
E.6.5 | Efficacy | No |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | Yes |
E.8.1.7.1 | Other trial design description |
PET/MRI images are evaluated by 4 readers who are blinded of the respective results among each other |
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E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | Yes |
E.8.2.3.1 | Comparator description |
min. 12 core standardized needle biopsy (PET/MRI blinded) without BiopSee© system (standard method) |
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E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 5 |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |