The aim of this study is to investigate safety and diagnostic performance of the 68Ga labeled PET tracer \[68Ga\]RM2 for detection and localization of primary prostate cancer confirmed by histopathology of the prostate as a standard of truth. This is an open-label, multi center PET/CT (positron emission tomography/computed tomography) non-randomized study. The study comprises 2 parts with an interim analysis after Part 1. In Part 1 a total of 30 subjects with biopsy-proven primary prostate cancer will be enrolled. Three strata of patients for the first part will be enrolled based on their pretreatment recurrence risk assessment according to the NCCN guidelines: 10 patients with low, 10 patients with intermediate and 10 patients with high pretreatment risk of recurrence.
For inclusion, the prostate cancer needs to be histologically confirmed and MRI and PET/CT with \[18F\]-choline (18F-choline is not mandatory) should be available for comparison. Diagnostic \[68Ga\]RM2 will be injected intravenously into the subjects, and PET/CT imaging performed. Images will be assessed visually and quantitatively. Subjects should be scheduled for subsequent prostatectomy within 4 weeks after PET scan. Prostate cancer will be confirmed by histopathological step-section analysis following prostatectomy and used as Standard of Truth. Based on the results of the initial 30 patients, an expansion cohort of 50 patients for Part 2 will be enrolled to increase the safety and tolerability database and to further characterize the uptake of \[68Ga\]RM2 in specific subsets.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
30
Krankenhaus der Barmherzigen Schwestern
Linz, Austria
Turku PET Centre/Department of Oncology and Radiotherapy
Turku, Finland
Sensitivity and specificity of [68Ga]RM2 PET to identify lesions in comparison to whole-mount histopathology (number of histologically verified cancer lesions identified)
Time frame: 60-80 min post injection
Accumulation and tumor detection-rate
Evaluation of \[68Ga\]RM2 accumulation and tumor detection-rate in patients with low, intermediate and high likelihood of recurrence according to pre-treatment risk stratification (NCCN guidelines).
Time frame: 60-80 min post injection
Accumulation of [68Ga]RM2 in BPH
Assessment of the accumulation of \[68Ga\]RM2 in benign prostate hyperplasia (BPH) areas using whole mount sections of the prostate as standard of truth (SOT)
Time frame: 60-80 min post injection
Proportion of lesions detected by [68Ga]RM2 PET in comparison to MRI and [18F]-choline (whenever available)
Comparison of \[68Ga\]RM2 findings to MRI, and \[18F\]-choline whenever available (\[18F\]-choline not mandatory)
Time frame: 60-80 min post injection
Quantitative determination (Standardized Uptake Value [SUV]) of [68Ga]RM2 uptake in cancer lesions, stratified according to risk groups
Quantitative comparison of \[68Ga\]RM2 uptake in patients with low, intermediate or high likelihood of recurrence
Time frame: 60-80 min post injection
Evaluation of SUV threshold
Exploratory evaluation of a quantitative (SUV) threshold to distinguish low, intermediate and high risk patients based on comparison with post-surgery histopathology
Time frame: 60-80 min post injection
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