Multi-institutional Evaluation of the Cost-effectiveness of PSMA-PET/CT for the Detection of Pelvic Lymph Node Invasion in Newly Diagnosed Prostate Cancer Patients (PSMA-SELECT).

2024-518171-59-00 Protocol NL76042.091.21 Phase III and Phase IV (Integrated) Ongoing, recruitment ended

Start 23 Jan 2025 · Status Ongoing, recruitment ended · 1 EU/EEA countries · 17 sites · Protocol NL76042.091.21

Overview

Sponsor-declared trial summary

Phase Phase III and Phase IV (Integrated)
Status Ongoing, recruitment ended
Participants planned 742
Countries 1
Sites 17

Prostate Cancer

To determine if the use of Prostate-Specific Membrane Antigen Positron Emission Computer Tomography (PSMA PET/CT) as a selection tool for performing extended pelvic lymph node dissection (ePLND) for prostate cancer (PCa) in the primary staging setting results in fewer ePLND procedures and therefore lower overall health…

Key facts

Sponsor
Canisius Wilhelmina Ziekenhuis
Participant type
Patients
Age range
18-64 years, 65+ years
Gender
Male
Therapeutic area
Diseases [C] - Male Urogenital Diseases [C12]
Trial duration
23 Jan 2025 → ongoing
Decision date (initial)
2025-01-23
Transition trial
Yes
Low-intervention
Yes
Rare-disease indication
No
Vulnerable population
No

External identifiers

EU CT number
2024-518171-59-00
EudraCT number
2021-002055-12

Trial design

CTIS Part I — objectives, methods, condition coding

Main objective

Scope: Diagnosis

To determine if the use of Prostate-Specific Membrane Antigen Positron Emission Computer Tomography (PSMA PET/CT) as a selection tool for performing extended pelvic lymph node dissection (ePLND) for prostate cancer (PCa) in the primary staging setting results in fewer ePLND procedures and therefore lower overall healthcare costs, lower patient burden in terms of intervention-related complications and morbidity, with comparable (non-inferior) disease prognosis, compared to the current European Guideline-recommended standard practice which includes performing ePLND in PCa patients who are candidates for active treatment with a nomogram-calculated lymph node involvement (LNI) risk >5%.

Secondary objectives 1

  1. If use of PSMA PET/CT as a selection tool for ePLND in the primary PCa staging setting results in fewer ePLND procedures and therefore lower overall healthcare costs and less patient burden in terms of intervention-related complications and morbidity compared to the current standard practice.

Conditions and MedDRA coding

Prostate Cancer

Study design 1 period

#TitleAllocationBlindingRoles blindedArms
1 PSMA-SELECT study
Study design: Randomized controlled trial Study population: Patients with newly-diagnosed PCa, without evidence of distant metastasis (any T, M0), who are candidates for treatment with radical prostatectomy and ePLND based on a nomogram-calculated risk of LNI >5%. Intervention: The PSMA selected ePLND (intervention) is compared to the nomogram-based ePLND which is the standard of care according to the guideline on PCa of the European Urologic Association (EAU).
Randomised Controlled None

Eligibility criteria

Principal inclusion / exclusion criteria as submitted by sponsor

Inclusion criteria 1

  1. In order to be eligible to participate in this study, a subject must meet all of the following criteria: 1. Age ≥18 years 2. Biopsy proven adenocarcinoma of the prostate 3. Indication for ePLND combined with RARP 4. Suitable for robot-assisted ePLND + RARP 5.. Mentally competent and understanding of benefits and potential burden of the study 6. Written informed consent

Exclusion criteria 1

  1. A potential subject who meets any of the following criteria will be excluded from participation in this study: 1. History of prior diagnosed or treated PCa 2. Known concomitant malignancies (except Basal Cell Carcinoma of the skin) 3.Unwillingness or inability to undergo PSMA PET/CT and/or ePLND 4. PSMA non-avid PCa (local tumor activity) 5. Presence of distant metastasis (M1)

Endpoints

Primary and secondary outcome measures (English text)

Primary endpoints 1

  1. Biochemical recurrence rate within two years after surgery, defined as a PSA > 0.2 ng/ml.

Secondary endpoints 1

  1. - Total number of ePLNDs and PSMA PET/CTs performed and their intervention-related healthcare costs, costs of complication-related interventions and associated (prolonged) hospital stay. - Biochemical persistence, defined as PSA >0.1 within half a year after surgery - Surgical complications within 6 months after surgery. - Total nodes resected on ePLND and number of positive and negative nodes within and outside of the standard ePLND template. The necessity for a second PSMA PET / CT.

Investigational products

Investigational medicinal products (IMPs), comparators, placebo, auxiliary

Test 3

Locametz 25 micrograms kit for radiopharmaceutical preparation

PRD10117083 · Product

Active substance
Gozetotide
Substance synonyms
AAA517, OH-Glu-CO-Lys(Ahx-CC-HBED)-OH
Pharmaceutical form
SOLUTION FOR INJECTION
Route of administration
INTRAVENOUS INJECTION
Max daily dose
360 MBq megabecquerel(s)
Max total dose
360 MBq megabecquerel(s)
Max treatment duration
1 Day(s)
Authorisation status
Authorised
ATC code
V09IX14 — -
Marketing authorisation
EU/1/22/1692/001
MA holder
NOVARTIS EUROPHARM LIMITED
MA country
EU
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

18F-PSMA-1007

SUB208557 · Substance

Active substance
18F-PSMA-1007
Pharmaceutical form
SOLUTION FOR INJECTION
Route of administration
INTRAVENOUS INJECTION
Max daily dose
400 MBq megabecquerel(s)
Max total dose
400 MBq megabecquerel(s)
Max treatment duration
1 Day(s)
Authorisation status
Authorised
ATC code
- — -
Marketing authorisation
-
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Piflufolastat (18F)

SUB189818 · Substance

Active substance
Piflufolastat (18F)
Pharmaceutical form
SOLUTION FOR INJECTION
Route of administration
INTRAVENOUS BOLUS INJECTION/IV INFUSION
Max daily dose
360 MBq megabecquerel(s)
Max total dose
360 MBq megabecquerel(s)
Max treatment duration
1 Day(s)
Authorisation status
Authorised
ATC code
- — -
Marketing authorisation
-
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Sponsors and contacts

Sponsor organisations, regulatory contacts, third parties

Canisius Wilhelmina Ziekenhuis

Sponsor organisation
Canisius Wilhelmina Ziekenhuis
Address
Weg Door Jonkerbos 100
City
Nijmegen
Postcode
6532 SZ
Country
Netherlands

Scientific contact point

Organisation
Canisius Wilhelmina Ziekenhuis
Contact name
Liselot Ribbert

Public contact point

Organisation
Canisius Wilhelmina Ziekenhuis
Contact name
Liselot Ribbert

Locations

1 EU/EEA country · 17 investigational sites

By country

CountryMS statusPlanned subjectsSites
Netherlands Ongoing, recruitment ended 742 17
Rest of world 0

Investigational sites

Netherlands

17 sites · Ongoing, recruitment ended
Canisius Wilhelmina Ziekenhuis
urology, Weg Door Jonkerbos 100, 6532 SZ, Nijmegen
Bravis Ziekenhuis
Urologie, Boerhaavelaan 25, 4708 AE, Roosendaal
Amsterdam UMC Stichting
Urology, De Boelelaan 1117, 1081 HV, Amsterdam
Amphia Hospital
Urology, Molengracht 21, 4818 CK, Breda
Catharina Ziekenhuis Stichting
Urology, Michelangelolaan 2, 5623 EJ, Eindhoven
Medisch Centrum Leeuwarden B.V.
Urologie, Henri Dunantweg 2, 8934 AD, Leeuwarden
Jeroen Bosch Ziekenhuis Stichting
Urology, Henri Dunantstraat 1, 5223 GZ, 'S-Hertogenbosch
Sint Antonius Ziekenhuis Stichting
Urology, Koekoekslaan 1, 3435 CM, Nieuwegein
Reinier de Graaf Groep
Urology, Reinier De Graafweg 5, 2625 AD, Delft
Rijnstate Ziekenhuis Stichting
Urology, Wagnerlaan 55, 6815 AD, Arnhem
Het Nederlands Kanker Instituut-Antoni van Leeuwenhoek Ziekenhuis Stichting
Urology, Plesmanlaan 121, 1066 CX, Amsterdam
Meander Medisch Centrum
Urology, Maatweg 3, 3813 TZ, Amersfoort
Maasstad Ziekenhuis Stichting
Urology, Maasstadweg 21, 3079 DZ, Rotterdam
Zuyderland Medisch Centrum Stichting
Urology, Henri Dunantstraat 5, 6419 PC, Heerlen
Maxima Medisch Centrum
Urology, Ds Theodor Fliednerstraat 1, 5631 BM, Eindhoven
Isala Klinieken Stichting
Urology, Dokter Van Heesweg 2, 8025 AB, Zwolle
Ziekenhuisgroep Twente Stichting
Urology, Zilvermeeuw 1, 7609 PP, Almelo

Country notifications

Trial-start, recruitment-start, end and early-termination notifications submitted per Member State

Country Trial startTrial end Recruitment startRecruitment end Early termination
Netherlands 2025-01-23 2025-01-23 2025-10-09

Results and documents

Annex IV summary of results, Annex V layperson summary, and all documents registered in CTIS for this trial

Documents 8 files

Public protocol annexes, IB summaries, regulatory submissions and post-authorisation documents registered in CTIS.

TypeTitleVersion
Protocol (for publication) D1_Protocol 2024-518171-59-00_redacted 7.1
Recruitment arrangements (for publication) K1_Recruitment arrangements V2 15DEC2024 2
Subject information and informed consent form (for publication) L1_SIS and ICF_redacted 3.1
Summary of Product Characteristics (SmPC) (for publication) E2_SmPC 18F-DCFPyL 1
Summary of Product Characteristics (SmPC) (for publication) E2_SmPC 18F-PSMA-1007 1
Summary of Product Characteristics (SmPC) (for publication) E2_SmPC Ga68-PSMA 1
Synopsis of the protocol (for publication) D1_Protocol synopsis_ENG 2024-518171-59-00 1
Synopsis of the protocol (for publication) D1_Protocol synopsis_NL 2024-518171-59-00 1

Application history

2 submissions — initial application plus substantial / non-substantial modifications

#TypeCodeSubmittedReference MSConclusionDecision date
1 INITIAL IN 2024-11-23 Netherlands Acceptable with conditions
2025-01-23
2025-01-23
2 SUBSTANTIAL MODIFICATION SM-2 2025-07-25 Netherlands Acceptable
2025-07-31
2025-07-31