Assessing the Efficacy of Neoadjuvant Androgen Deprivation Therapy (ADT) Utilizing 18F-Flotufolastat PSMA PET/CT in Patients With High-Risk Localized Prostate Cancer (LHRPC)
Baptist Health South Florida
Summary
The purpose of this research study is to test the efficacy of ADT on prostate-specific membrane antigen (PSMA), a marker of prostate cancer, before and after scheduled ADT. Follow up will be 48 months your prostate removal to do a blood test and log if any new or worsening symptoms have occurred as a part of your standard-of-care (SOC).
Description
This is a single-arm, phase II, open label study in patients with localized high- risk prostate cancer (LHRPC) treated with neoadjuvant ADT (leuprolide, degarelix, relugolix, or triptorelin) followed by radical prostatectomy (RP). This study aims to evaluate the efficacy of neoadjuvant ADT based on maximal standardized uptake value (SUVmax) changes on 18F-Flotufolastat prostate- specific membrane antigen (PSMA) PET/CT scan in patients with LHRPC. Additionally, it will investigate the prognostic value of SUVmax changes in predicting biochemical recurrence-free survival.
Eligibility
- Age range
- 18+ years
- Sex
- Male
- Healthy volunteers
- No
Inclusion Criteria: * Signed informed consent must be obtained prior to participation in the study. * Males aged ≥18 years. * ECOG performance status ≤ 1 * Histologically confirmed adenocarcinoma of the prostate in a patient amenable to radical prostatectomy * Pathologically proven prostate adenocarcinoma with ≥ 1 High-risk feature based on NCCN guidelines. 1. cT3-cT4 2. International Society of Urological Pathology (ISUP) Grade group 4 (Gleason score 8) or grade group 5 (Gleason score 9-10) 3. PSA \>20 ng/mL * Clinically negative lymph nodes as established by PSMA PET/CT imaging. Pati…
Interventions
- DrugLeuprolide
22.5 mg IM every 3 months × 2 doses
- DrugDegarelix
240 mg SC loading dose, then 80 mg SC q28 days × 6 months
- DrugRelugolix
360 mg PO Day 1, then 120 mg PO daily × 6 months
- DrugTriptorelin
11.25 mg IM every 3 months × 2 doses
- DrugBicalutamide
Given only with leuprolide or triptorelin; 50 mg PO daily for 30 days
- Diagnostic Test18-F Flotufolastat PSMA PET
296 MBq (8mCi) administered as an intravenous bolus injection prior to PSMA PET scan. May be administered diluted in normal saline (NS) or undiluted. The maximum volume of undiluted 18F-flotufolastat is 5mL. After administration, a flush with 0.9% NS will be given to ensure full delivery of the dose.
Location
- Miami Cancer Institute at Baptist Health, Inc.Miami, Florida