This prospective registry aims to assess outcome and toxicity of targeted radionuclide therapies in patients with advanced prostate cancer in clinical routine. While the major investigated treatment modality is prostate-specific membrane antigen (PSMA)-targeted radioligand therapy, also other radionuclide therapies such as Ra223 and liver-directed radioembolization are included. The investigators believe that prospectively assessed long-term outcome data on implementation of radionuclide therapy, especially in the palliative setting of advanced mCRPC, help to better define the real benefits and risks of the respective treatment modalities for patients regarding survival and quality-of-life.
Targeted radionuclide therapy is comprised of different modalities that may be applied in advanced prostate cancer, either targeting bone metastases (mainly using Radium-223), any site of metastases with PSMA-expression (ß- / alpha-emitter labelled radioligands) or loco-regionally applying internal radiation (Yttrium-90 microspheres) to metastatic liver disease. While in Germany, each form of treatment is used in clinical routine, data is sparse regarding the real benefits and risks of respective modalities, also when used in a sequential order. As an example, patients receiving Ra223 treatment may later undergo PSMA targeted radioligand therapy, with little data available on dependent response relationships or cumulative risks. Prospective assessment of outcomes and toxicities in a radionuclide therapy registry is apparently superior over retrospective analyses of selected patient populations. The goal of the REALITY study is to gain a better understanding of the real-life clinical application of radionuclide therapies, with a focus on PSMA-targeted radioligand therapy in a high-volume treatment centre, and the impact of each treatment for patient outcome. Based on primary and secondary outcome measures the potential prediction of treatment benefit by baseline patient and tumor characteristics, and early changes of biomarkers will be of interest.
Study Type
OBSERVATIONAL
Enrollment
500
Dept. of Nuclear Medicine, Saarland University
Homburg, Saarland, Germany
RECRUITINGPSA response
Best PSA response and PSA response after 3 months from start of radionuclide therapy
Time frame: up to 10 years
PSA-PFS
PSA-based progression-free survival (PFS) according to PCWG3 criteria. From date of start of radionuclide therapy until documented and confirmed PSA-progression
Time frame: up to 10 years
OS
Overall survival. From date of start of radionuclide therapy until the date of death from any cause assessed
Time frame: up to 10 years
Toxicity (adverse events)
All toxicity occurring after start of radionuclide treatment will be registered according to the Common Terminology Criteria for Adverse Events (CTCAE version 4.03).
Time frame: up to 10 years
Toxicity-related discontinuation of radionuclide treatment
Rate of toxicity-related discontinuation of radionuclide therapy
Time frame: up to 10 years
Conventional imaging response
Response to radionuclide therapy based on conventional imaging according to RECIST 1.1
Time frame: up to10 years
Molecular imaging response
Response to radionuclide therapy based on molecular imaging
Time frame: up to 10 years
Quality-of-life in patients receiving radionuclide therapy
Quality-of-life assessed from start of radionuclide treatment by EORTC QLQ-C30 questionaires
Time frame: up to 10 years
Pain control achieved by radionuclide therapy
Based on VAS-BPI patient questionaires from start of radionuclide treatment
Time frame: up to 10 years
Absorbed doses achieved by radionuclide therapy
Absorbed doses in Gy/GBq based on intra- / posttherapeutic dosimetry when available
Time frame: up to 10 years
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