NCT05919329

Brief Summary

This clinical trial investigates the change in prostate-specific membrane antigen (PSMA) expression in response to hormonal therapy in both, Castration Sensitive Prostate Cancer (CSPC) and Castration Resistant Prostate Cancer (CRPC), and whether this change in PSMA expression changes tumor staging after therapy initiation. Understanding these effects can help define the best timing to perform the PSMA positron emission tomography (PET) relative to the start of therapy.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
80

participants targeted

Target at P25-P50 for phase_4

Timeline
52mo left

Started Jun 2024

Longer than P75 for phase_4

Geographic Reach
1 country

1 active site

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

Study Progress30%
Jun 2024Sep 2030

First Submitted

Initial submission to the registry

June 16, 2023

Completed
10 days until next milestone

First Posted

Study publicly available on registry

June 26, 2023

Completed
1 year until next milestone

Study Start

First participant enrolled

June 25, 2024

Completed
4.2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 1, 2028

Expected
2 years until next milestone

Study Completion

Last participant's last visit for all outcomes

September 1, 2030

Last Updated

October 24, 2025

Status Verified

October 1, 2025

Enrollment Period

4.2 years

First QC Date

June 16, 2023

Last Update Submit

October 23, 2025

Conditions

Outcome Measures

Primary Outcomes (1)

  • Change in maximum standardized uptake value (SUVmax) on post-therapy initiation PSMA PET (8 ± 2 days) compared to baseline.

    Evaluate the change in SUVmax between baseline and Day 8 using a paired t-test to determine how hormonal therapy affects the PSMA modulation.

    Baseline PSMA PET up to 8 days after therapy initiation

Secondary Outcomes (2)

  • Change in SUVmax on post-therapy initiation PSMA PET (28 ± 3 days) compared to baseline.

    Baseline PSMA PET up to 28 days after therapy initiation

  • Number of patients in whom the tumor staging changed on PSMA PET scans obtained post-therapy initiation relative to baseline PET scan

    Baseline PSMA PET up to 28 days after therapy initiation

Study Arms (2)

Cohort 1: CRPC

EXPERIMENTAL

Patients with CRPC will receive 18F-DCFPyL PET prior to start of therapy (standard of care), then again 8 days and 28 days after initiation of hormonal therapy.

Drug: PiflufolastatProcedure: PSMA PET/CT ScanProcedure: PSMA PET/MRI scanProcedure: Biospecimen CollectionOther: Electronic Health Record Review

Cohort 2: CSPC

EXPERIMENTAL

Patients with CSPC will receive 18F-DCFPyL PET prior to start of therapy (standard of care), then again 8 days and 28 days after initiation of hormonal therapy.

Drug: PiflufolastatProcedure: PSMA PET/CT ScanProcedure: PSMA PET/MRI scanProcedure: Biospecimen CollectionOther: Electronic Health Record Review

Interventions

Given IV

Also known as: Piflufolastat F-18, Pylarify, 18F-DCFPyL, Fluorine F 18 DCFPyL
Cohort 1: CRPCCohort 2: CSPC

Undergo PSMA PET/CT

Also known as: Prostate-Specific Membrane Antigen PET/CT, PSMA PET/CT, PSMA-Positron emission tomography/CT
Cohort 1: CRPCCohort 2: CSPC

Undergo PET/MRI

Also known as: Prostate-Specific Membrane Antigen PET/MRI, PSMA PET/MR, PSMA-Positron emission tomography/magnetic resonance imaging
Cohort 1: CRPCCohort 2: CSPC

Undergo collection of blood samples

Also known as: Biological Sample Collection, Specimen Collection, Lab draw
Cohort 1: CRPCCohort 2: CSPC

Ancillary studies

Cohort 1: CRPCCohort 2: CSPC

Eligibility Criteria

Age18 Years+
Sexmale
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Participant or legally authorized representative (LAR) must provide written informed consent before any study-specific procedures or interventions are performed.
  • Participants must have confirmed prostate adenocarcinoma, histologically, or by combined imaging and biochemical markers.
  • Age \>= 18 years. Given the nature of the disease in question, only men will be included. Members of all races and ethnic groups will be included.
  • Participants must have sites of prostate cancer showing uptake on an initial PSMA PET scan.
  • Participants are planned to receive hormonal therapy within eight weeks of the initial PSMA PET. The hormonal therapy agents include:
  • For CSPC: GnRH agonists, GnRH antagonists, first-generation antiandrogen (e.g. bicalutamide), or androgen receptor (AR)-targeted agent (e.g. Abiraterone, Enzalutamide, Apalutamide, Darolutamide)
  • For CRPC: this group of patients are typically on continuous ADT (GnRH agonists or antagonists), which will be continued, and the hormonal therapy they will be started on is an androgen receptor (AR)-targeted agent (e.g. Abiraterone, Enzalutamide, Apalutamide, Darolutamide)
  • Life expectancy \> 3 months.
  • Cohort 1: Castration resistant prostate cancer with rising PSA (confirmed by two PSA values at least 1 week apart), testosterone \< 50 ng/dL, on continuous ADT at least 4 months, no AR targeted agent in the prior 4 months.
  • Cohort 2: Castration sensitive prostate cancer with no ADT or AR targeted agents use in the past 12 months, testosterone \>50 ng/dL

You may not qualify if:

  • Uncontrolled serious infection.
  • Intercurrent illness or condition that would limit compliance with study requirements.
  • Participants who have undergone any cancer treatment other than the hormonal therapy (systemic or radiation therapy) or who have started any supplements or herbal medications intended to treat cancer between the baseline PSMA PET and PSMA PET at day 28.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

OHSU Knight Cancer Institute

Portland, Oregon, 97239, United States

RECRUITING

MeSH Terms

Interventions

2-(3-(1-carboxy-5-((6-fluoropyridine-3-carbonyl)amino)pentyl)ureido)pentanedioic acidMagnetic Resonance SpectroscopySpecimen Handling

Intervention Hierarchy (Ancestors)

Spectrum AnalysisChemistry Techniques, AnalyticalInvestigative TechniquesClinical Laboratory TechniquesDiagnostic Techniques and ProceduresDiagnosis

Study Officials

  • Nadine Mallak, MD

    OHSU Knight Cancer Institute

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Study Design

Study Type
interventional
Phase
phase 4
Allocation
NON RANDOMIZED
Masking
NONE
Purpose
DIAGNOSTIC
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Principal Investigator

Study Record Dates

First Submitted

June 16, 2023

First Posted

June 26, 2023

Study Start

June 25, 2024

Primary Completion (Estimated)

September 1, 2028

Study Completion (Estimated)

September 1, 2030

Last Updated

October 24, 2025

Record last verified: 2025-10

Locations