Contact information
Type
Public
Primary contact
Mrs Kathleen Riddle
ORCID ID
Contact details
Scottish Clinical Trials Research Unit
Information Services Division
NHS National Services Scotland
Gyle Square
1 South Gyle Crescent
Edinburgh
EH12 9EB
United Kingdom
+44 131 275 7074
phs.psma@nhs.net
Type
Scientific
Additional contact
Prof Hing Leung
ORCID ID
Contact details
CRUK Beatson Institute and University of Glasgow
Garscube Estate
Switchback Road
Bearsden
Glasgow
G61 1BD
United Kingdom
+44 141 330 3658
phs.psma@nhs.net
Additional identifiers
EudraCT number
ClinicalTrials.gov number
Protocol/serial number
PANORAMA version 2.0, 27th May 2019
Study information
Scientific title
Analysis of PSMA expressioN in prOstate cancer and its Relationship with the presence of nodAl MetastAses
Acronym
PANORAMA
Study hypothesis
Current hypothesis as of 27/08/2019:
The aim of this study is to evaluate if the PSMA PET/CT scan will identify whether or not the cancer has spread to the lymph nodes. This will mean that for future patients, whose cancer shows no evidence of spread to the lymph nodes, can have less extensive surgery. They will not have to have their pelvic lymph nodes removed at the time of surgery.
Previous hypothesis:
The aim of this study is to evaluate if the PSMA PET/CT scan will identify whether or not the cancer has spread to the lymph nodes. This will mean that for future patients, whose cancer without evidence of having spread to the lymph nodes, can have less extensive surgery. They will not have to have their pelvic lymph nodes removed at the time of surgery.
Ethics approval
1. Approved 07/11/2018 West of Scotland REC 1 (West of Scotland Research Ethics Service, Ward 11
Dykebar Hospital, Grahamston Road, Paisley, PA2 7DE; +44(0)141-314-0212; WosRec1@ggc.scot.nhs.uk), ref: 17/WS/0201
2. Amendment approved 03/06/2019
Study design
Interventional non-randomised study
Primary study design
Interventional
Secondary study design
Non randomised study
Trial setting
Hospitals
Trial type
Other
Patient information sheet
Not available in web format, please use contact details to request a participant information sheet.
Condition
Prostate Cancer
Intervention
PSMA Imaging is a feasibility study looking at patients who have high risk prostate cancer (in the absence of clinical evidence for distant metastasis) opting for surgical intervention with radical prostatectomy and extended pelvic lymphadenectomy. 60 patients will be recruited over a 6 month period from 4 centres within the United Kingdom.
Patients who have signed informed consent and who have met all eligibility criteria will be enrolled into the trial.
Once enrolled all patients will have a PSMA PET/CT scan prior to (and within 2 weeks of) surgery, in addition to standard of care imaging as per local clinical practice.
Participants attend a screening visit. Informed consent, medical history, a physical examination and a number of blood tests are taken at this visit.
Participants receive only one extra scan (out with any other standard care scans required) which is called a (Ga68) PSMA PET/CT scan. Participants then have their elective surgery as schedules.
Participants attend a six week follow up visit. A physical examination and the same blood tests will be done again six weeks after their surgery. The surgeon will also discuss the outcome of the surgery that they have had and will discuss any future management of care.
Intervention type
Other
Phase
Drug names
Primary outcome measure
Current primary outcome measure as of 24/06/2019:
1. To establish whether prostate tumours with high PSMA expression have enhanced risk of pelvic nodal metastasis.
2. To establish best practice and optimise protocols for multi-centre application of PSMA PET/CT imaging.
Previous primary outcome measure:
1. SUVmax is measured for each lesion using the 68Ga-PSMA PET/CT within 2 weeks of a scheduled RP and ePLND this will be used along with independent nuclear medicine physicians to determine the sensitivity, specificity, positive predictive and negative predictive values of 68Ga-THP-PSMA imaging in detecting pelvic nodal metastasis
2. The establishment of best practice will be measured by the production of protocols for multi-centre application of PSMA PET/CT imaging
Secondary outcome measures
Current secondary outcome measures as of 24/06/2019:
1. To evaluate the feasibility of a future large scale randomised controlled trial (RCT), and develop quality assurance measures across the study team/network.
2. To develop a platform to carry out RCT to study the usefulness of novel imaging/biomarkers for evidence-based treatment decisions in patients at risk of pelvic nodal prostate cancer.
Previous secondary outcome measures:
1. The use of novel 68Ga-THP-PSMA radiopharmaceutical is measured using the successful assessment of 60 patients through to the end of study and inclusion in the study analysis
2. Feasibility of a future large scale randomised controlled trial is measured using recruitment of 60 patients into the study within the proposed timelines and by the development of quality assurance measures across the study team/network
3. The development of a platform to carry out RCT to study the usefulness of novel imaging/biomarkers for evidence-based treatment decisions in patients at risk of pelvic nodal prostate cancer is measured by the future development of RCT’s in this area.
Overall trial start date
01/01/2017
Overall trial end date
31/07/2021
Reason abandoned (if study stopped)
Eligibility
Participant inclusion criteria
1. High risk prostate cancer with no detectable metastasis using standard of care imaging (MRI prostate/pelvis, isotope bone scan, CT, non-PSMA PET/CT) undergoing radical prostatectomy and pelvic lymph node dissection
2. Histologically proven prostate cancer
3. No prior prostate cancer treatment including androgen deprivation therapy
4. Male aged 18 or over
5. Considered suitable candidate for radical surgery for prostate cancer
6. Adequate hepatic, bone marrow, coagulation and renal function as defined by the following criteria:
6.1. Haemoglobin > 9.0 g/dL
6.2. Platelets > 100 x 109 L
6.3. Creatinine <2 x ULN
6.4. Hepatic function: total bilirubin ≤ 2 x ULN; ALT and AST ≤ 3 x ULN
6.5. Prothrombin time ≤ 1.5 x ULN; APTT ≤ 1.5 x ULN
7. Willingness to comply with scheduled visits (including an additional PET/CT scan)
Participant type
Patient
Age group
Adult
Gender
Male
Target number of participants
60
Participant exclusion criteria
1. Evidence of demonstrable metastasis on standard of care imaging using combination of MRI, CT and isotopic bone scan
2. Patients not willing to receive surgical treatment with radical prostatectomy and pelvic node dissection
3. Patients not able to undergo PET/CT scan because of weight (e.g. >180 kg), claustrophobia, or not able to lie still during the scanning duration
4. Patients who already had PSMA PET/CT scan for diagnosis of prostate cancer
5. Patients who are unable or unwilling to give informed consent
Recruitment start date
01/10/2020
Recruitment end date
31/03/2021
Locations
Countries of recruitment
United Kingdom
Trial participating centre
St Bartholomew's Hospital
West Smithfield
London
EC1A 7BE
United Kingdom
Trial participating centre
Addenbrooke's Hospital
Hill's Road
Cambridge
CB2 0QQ
United Kingdom
Trial participating centre
University College London Hospital
235 Euston Road
Bloomsbury
London
NW1 2BU
United Kingdom
Trial participating centre
Beatson West of Scotland Cancer Centre
1053 Great Western Road
Glasgow
G12 0YN
United Kingdom
Funders
Funder type
Charity
Funder name
Cancer Research UK
Alternative name(s)
CRUK
Funding Body Type
private sector organisation
Funding Body Subtype
Other non-profit organizations
Location
United Kingdom
Results and Publications
Publication and dissemination plan
Planned publication in a high-impact peer reviewed journal. Intent to publish approximately 01/10/2020.
IPD sharing statement:
The data sharing plans for the current study are unknown and will be made available at a later date.
Intention to publish date
30/08/2021
Participant level data
To be made available at a later date
Basic results (scientific)
Publication list