Virtual Prostate Biopsy Protocol for Patients on Active Surveillance and at Risk of Prostate Cancer

Case Comprehensive Cancer Center (Case CCC)

Status: Withdrawn

Conditions: Prostate Cancer

Treatments: Diagnostic Test: virtual biopsy (VB) monitoring protocol

Study type: Interventional

Funder types: Other

Identifiers

NCT03823001

CASE9818

Details and patient eligibility

About

The purpose of this study is to examine the use of MRI surveillance for patients with no prostate cancer, potential prostate cancer, or diagnosed low-grade prostate cancer.

Full description

This study will use MRI instead of prostate biopsy in combination with regularly scheduled urologist visits, interval PSA checks, and annual DRE to help establish a non-invasive method for 1) participants with a negative prostate MRI (PI-RADS 1 or 2) who have never had a biopsy; 2) participants with a positive MRI (PI-RADS score of 3, 4, or 5) and negative MRI-targeted biopsy pathology; and 3) monitoring participants with clinically diagnosed low risk prostate cancer who are on active surveillance. However, if at any point, clinical suspicion indicated either by the presence of suspicious lesions on the MRI, rising PSA, and/or positive DRE arises, then an immediate biopsy will be performed.

Sex: Male

Volunteers: No Healthy Volunteers

Inclusion criteria

• Biopsy-naive patients with a negative prostate MRI (PI-RADS score 1 or 2); or
• Patients with a PI-RADS score of 3, 4, or 5 on MRI and a negative MR-targeted biopsy; or
• Patients on active surveillance with a negative prostate MRI (PI-RADS 1 or 2).

Exclusion criteria

• Positive DRE;
• PSA > 10 ng/ml or unstable PSA (doubling time <3 years) during the last year prior to enrolling in this study;
• PSAD > 0.15 (calculated using most recent PSA divided by MRI prostate volume);
• First degree relative diagnosed with prostate cancer
• First degree relative diagnosed with a BRCA2 or Lynch syndrome associated gene causing any cancer.
• Patient carries a mutation on BRCA2 or a mismatch repair gene associated with Lynch syndrome (MLHl, MSH2, MSH6, PMS2); known BRCA2 or known mismatch repair gene mutation in the family (Lynch Syndrome) and patient has not had testing; or family history consistent with BRCA2 or Lynch syndrome and there is no known BRCA2 or mismatch repair gene in the family.

Trial design

Primary purpose: Diagnostic

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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0 participants in 1 patient group

Virtual prostate biopsy (VB) monitoring

Experimental group

Description:

Prostate-specific antigen (PSA) and digital rectal exam (DRE) are standard of care for monitoring patients on active surveillance or at risk of having low-risk prostate cancer. A novel virtual biopsy (VB) monitoring protocol will be implemented: 1. PSA bi-annually or more often according to the discretion of the urologist. 2. Annual DRE. 3. Visit with the urologist bi-annually. 4. Multi-parametric MRI (mpMRI) every year for 3 years. 5. Transrectal ultrasound (TRUS) biopsy at the end of the 3rd year.

Treatment:

Diagnostic Test: virtual biopsy (VB) monitoring protocol