About this trial
This early phase I trial evaluates whether a new imaging technique using flotufolastat F 18 (a type of prostate specific membrane antigen \[PSMA\] imaging agent) with positron emission tomography (PET)/computed tomography (CT) can be used to guide targeted prostate biopsies in men with prostate cancer. Flotufolastat F 18 is a radioactive imaging agent that binds to prostate tumor cells that express PSMA. This allows for visualization of PSMA-expressing tumor cells on imaging scans such as PET/CT. PET is an established imaging technique that utilizes small amounts of radioactivity attached to very minimal amounts of tracer, in the case of this research, flotufolastat F 18. Because prostate cancer takes up flotufolastat F 18, it can be seen with PET. CT utilizes X-rays that track the body from the outside. CT images provide an exact outline of organs and potential inflammatory tissue where it occurs in the body. The PET/CT scanner combines the PET and the CT scanners into a single device. A targeted prostate biopsy refers to using advanced imaging for guidance when taking samples (biopsies) of the prostate. This method can fuse (combine) PET/CT images with real-time ultrasound during a prostate biopsy. PSMA PET/CT scans have the potential for guiding prostate biopsies. Using image fusion technology, they can increase detection of prostate cancer by providing anatomical information and guidance during a prostate biopsy. Improved detection of prostate cancer using PSMA PET/CT guidance may better inform men and their clinicians about prostate cancer risk and management. This study attempts to determine how often prostate cancer is found when using PSMA PET/CT scan images during a biopsy versus the conventional magnetic resonance imaging-guidance.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Men aged 18-90 at study enrollment
Have at least one PI-RADS 3-5 lesion on MRI within the 12 months prior to enrollment
Disqualifiers
Contraindication to flotufolastat F 18 PET CT
Contraindication to ultrasound-guided prostate biopsy
Previous treatment of prostate cancer
Unable to discontinue blood thinners for 7 days prior to biopsy
Trial design
Single group
Treatments tested in this trial
Biopsy of Prostate
Procedure/SurgeryUndergo biopsy
Biospecimen Collection
Procedure/SurgeryUndergo collection of blood samples
Computed Tomography
Procedure/SurgeryUndergo PET/CT
Flotufolastat F-18 Gallium
RadiationGiven IV
Positron Emission Tomography
Procedure/SurgeryUndergo PET/CT
Treatment groups
Trial outcomes
Primary outcomes
Detection of high-grade cancer (grade group [GG] ≥ 2)
Results of prostate specific membrane antigen (PSMA)- and magnetic resonance imaging (MRI)-guided biopsy will be compared to the results of systematic biopsy in the same patient.
Secondary outcomes
Proportion of subjects with incidental GG1 prostate cancer detected through systematic biopsy when the region of interest is benign on MRI and PSMA-positron emission tomography (PET)
Rate of detection of GG ≥ 2 prostate cancer in relation to increasing standardized uptake value and Prostate Imaging-Reporting and Data System scores
Percentage of cases where the intraprostatic tumor location identified by MRI-guided and PSMA-guided biopsies matches
Accuracy and predictive value of the MRI + PSMA-PET composite score for detecting clinically significant prostate cancer during biopsy
Sponsors and contacts
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Jonsson Comprehensive Cancer Center
Lead sponsor
Blue Earth Diagnostics
Collaborator