Clinical trial NCT02564549: MRI-Based Active Surveillance to Avoid the Risks of Serial Biopsies in Men With Low-Risk Prostate Ca
Official title: Multiparametric MRI-Based Active Surveillance to Avoid the Risks of Serial Biopsies in Men With Low-Risk Prostate Cancer (MAVERICK)
Study type: INTERVENTIONAL
Overall status: TERMINATED
Phase: NA
Conditions: Prostate Cancer
Prostate Adenocarcinoma
Multiparametric MRI
Gleason's Score 6
Keywords: low risk prostate cancer
Lead sponsor: Virginia Commonwealth University
Sponsor class: OTHER
Collaborators: name: Massey Cancer Center
name: Hunter Holmes Mcguire Veteran Affairs Medical Center
First posted: 2015-09-30
Enrollment: 28
Sex: MALE
Minimum age (years): 40
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: DIAGNOSTIC

Brief summary: Phase II non-inferiority randomized trial of annual systematic biopsies versus mpMRI and targeted biopsies for men with low risk prostate cancer on active surveillance with any volume Gleason's Score 6, but no prior MRI imaging of the prostate.

Detailed description: This is an unblinded, randomized trial of TRUS biopsy-based active surveillance versus mpMRI-based active surveillance. Patients on the TRUS biopsy-based arm will undergo annual systematic biopsies without any MRI staging or guidance. Patients on the mpMRI- based arm will undergo annual mpMRI surveillance imaging, with image-guided targeted biopsies only as indicated by radiographic findings.

Eligibility criteria: Inclusion Criteria:

* Prostate adenocarcinoma diagnosed by biopsy within 12 months prior to study registration.
* Gleason score ≤ 6
* PSA \< 10 ng/mL
* Completed and documented history and physical addressing all inclusion/exclusion criteria.

Exclusion Criteria:

* A diagnosis of prostate adenocarcinoma on more than one set of prostate biopsies, on separate calendar dates.
* Previous MRI imaging of the prostate.
* Prior history of pelvic radiotherapy.
* Prior history of prostatectomy.
* Contraindication to prostate mpMRI (renal failure, hip prosthesis, pacemaker, etc).
* Contraindication to prostate biopsy via transrectal or transperineal approaches (including coagulopathy).
* Patients on testosterone replacement therapy who are unwilling to discontinue.
* Medical, psychological, or social condition that, in the opinion of the investigator, may increase the patient's risk or limit the patient's adherence with study requirements.
* Unable to understand, or unwilling to complete the informed consent process.

Primary outcomes:
measure: To asses the detection rate of Gleason score ≥ 4+3 in patients with low-risk prostate cancer who undergo transrectal ultrasound (TRUS) biopsy-based active surveillance (Group 1) versus patients who undergo mpMRI-based active surveillance (Group 2).
timeFrame: 3 years
Secondary outcomes:
measure: Percentage of patients in Group 1 versus Group 2 who remain on active surveillance from the time of randomization until the end of study participation.
timeFrame: 3 years
measure: To compare the rate of biopsy-related infections in Group 1 versus Group 2.
timeFrame: 3 years
measure: To compare the missed rate of occult Gleason score ≥ 4+3 by template biopsy at end of study in Group 1 versus Group 2.
timeFrame: 3 years
Other outcomes:
Locations:
city: Richmond
country: United States
facility: Hunter Holmes Mcguire Veteran Affairs Medical Center
state: Virginia
Study officials:
affiliation: Massey Cancer Center
name: Drew Moghanaki, MD, MPH
role: PRINCIPAL_INVESTIGATOR
References: