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Castration-resistant Metastatic Prostate CancerPSMA-PREDNCT06600802

Intrinsic Validity of Molecular Marker(s) Detection on Tissular Tumoral DNA to Predict the Efficacy of 177Lutetium-PSMA-617 (Lu-PSMA) Treatment for Castration-resistant Metastatic Prostate Cancer

A study testing Blood samples in people with Castration-resistant Metastatic Prostate Cancer and Treated by 177Lutetium-PSMA-617 (Lu-PSMA), run by Centre Jean Perrin at 5 sites in France.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

Prostate cancer is the most common cancer in men. Its incidence is rising as the population ages. In the localized stage, the 5-year overall survival rate (OS) is 98%. Metastatic progression and resistance to castration have a negative impact on prognosis. Read more about this study

Who is it for?
Ages 18 years and older, men only
What is being tested?
Blood samples
Could I receive a placebo?
No, everyone receives an active treatment
How many people
120 participants
Where
5 sitesFrance
Study dates
8 Oct 2024to 30 Jun 2034
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • Men only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male >18 years of age
  • ECOG ≤ 2
  • Patient with histologically confirmed of metastatic castration resistant prostatic adenocarcinoma and with tumor biological material available (prostatic biopsies or prostatectomy)
  • Patient who received at least one taxane line and a second generation hormone therapy line
  • Patient receiving androgen deprivation therapy with serum testosterone < 50 ng/dL or < 1.7 nmol/L or having undergone surgical castration
  • Progressive mCRPC based based on at least 1 of the following criteria :
Show all 30Show fewer
  • Serum or plasma PSA progression defined as 2 consecutive increases in PSA measured at least 1 week prior. The minimal start value is 2.0 ng/mL ; 1,0 ng/mL is the minimal start value if confirmed increase in PSA is the only indication of progress
  • Soft-tissue progression by RECIST 1.1 criteria
  • Progression of bone disease : two new lesions ; only the positivity of bone scan defines metastatic bone disease, according to PCWG3 criteria.
  • Patients with at least one metastasis, bone and/or soft tissue and/or visceral, documented by the following methods in the 43 days prior to inclusion :
  • Bone metastasis (regardless of location) highlighted by bone scan AND/OR
  • Lymph nodes metastasis, regardless of size and location; if the metastasis are only lymph nodes, the short axis of at least one node should be at least 15 mm AND outside the pelvis ; AND/OR
  • Visceral metastasis, regardless of size and location; a history of visceral metastasis at any time prior to randomization should be encoded as the presence of visceral metastasis at baseline (i.e., a patient with visceral metastasis prior ADT introduction which are disappeared at baseline will be counted as having visceral metastasis and will be considered to have a high tumor volume during stratification)
  • Patient with Lu-PSMA treatment indication, confirmed by PET 68Ga-PSMA-11. Eligibility for 68Ga-PSMA-11 PET is defined as:
  • At least one lesion with a binding intensity greater than that of the liver parenchyma (definition of positivity),
  • All lymph node lesions larger than 25 mm in the short axis must be positive on PSMA PET
  • All bone metastases with a soft tissue component ≥ 10 mm in the largest diameter must be positive on PSMA-PET
  • All solid organ metastases (e.g., lung, liver, adrenal glands, etc.) ≥ 10 mm in the largest diameter must be positive on PSMA-PET.
  • Adequate organ function :
  • Bone marrow reserve :
  • Absolute neutrophil count ≥ 1.5 x 10^9/L
  • Platelets ≥ 100 x 10^9/L.
  • Hemoglobin ≥ 9 g/dL
  • Hepatic function :
  • Total bilirubin ≤ 2 x the upper limit of normal (ULN). For participants with known Gilbert's Syndrome ≤ 3 x ULN is permitted.
  • Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 3.0 x ULN OR ≤ 5.0 x ULN for patients with liver metastases.
  • Albumin > 2.5 g/dL
  • Renal function : Glomerular Filtration Rate (GFR) ≥ 50 mL/min/1.73m2 according to MDRD equation.
  • Obtaining the patient's free and informed consent
  • Social security scheme or beneficiary.

Who cannot join

  • Continuation of second-generation hormone therapy Patient
  • Other cancer in the last 3 years likely to change life expectancy or interfere with the assessment of the disease
  • Protected adult
  • History of somatic or psychiatric illness/condition that may interfere with study objectives and evaluations
  • Patient unable to understand and comply with study instructions and requirements
  • ECOG > 2
Show all 17Show fewer
  • Dilation of pyelocalicial cavities not previously supported
  • Obstruction of bladder discharge or uncontrollable and simultaneous urinary incontinence
  • Symptomatic spinal cord compression or clinical or radiological findings indicating imminent spinal cord compression
  • Fractured risk of bone damage
  • Active and symptomatic brain injury
  • Concurrent participation in a therapeutic trial and administration of any investigational agent within 28 days of inclusion
  • Metastatic tumor tissue as the only material available for prostate cancer diagnosis
  • Previous treatment with any of the following in the 6 months prior to inclusion : Strontium-89, Samarium-153, Rhenium-186, Rhenium-188, Radium-223, hemi-cyclic irradiation
  • Previous treatment with radioligands targeting PSMA
  • Known hypersensitivity to one of the study treatments or its excipients or similar class drugs
  • Transfusion or use of bone marrow stimulating agents for the sole purpose of making a participant eligible for inclusion in the study

Trial locations and contacts

5 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Judith PASSILDAS JAHANMOHAN, PhD contact

0473278005

judith.passildas@clermont.unicancer.fr

5 sites in 1 country

France5 sites, 5 recruiting
  • Centre Jean PERRIN

    Clermont-Ferrand, 63011

    Judith PASSILDAS JAHANMOHAN, PhD, 0473278005, judith.passildas@clermont.unicancer.fr

    Tressie HERRMANN, Dr

    Recruiting
  • CHU de Grenoble

    La Tronche, 38700

    Loic DJAILEB, Dr

    Not yet recruiting
  • Hospices Civiles de Lyon

    Pierre-Bénite, 69310

    Denis MAILLET, Dr

    Not yet recruiting
  • Hôpital privé de la Loire

    Saint-Etienne, 42100

    Aline GUILLOT, Dr

    Not yet recruiting
  • Centre Paul STRAUSS

    Strasbourg, 67091

    Francois SOMME, Dr

    Not yet recruiting

Other trials in France

About this study

Official title: Intrinsic Validity of Molecular Marker(s) Detection on Tissular Tumoral DNA to Predict the Efficacy of 177Lutetium-PSMA-617 (Lu-PSMA) Treatment for Castration-resistant Metastatic Prostate Cancer (PSMA-PRED)

Prostate cancer is the most common cancer in men. Its incidence is rising as the population ages. In the localized stage, the 5-year overall survival rate (OS) is 98%. Metastatic progression and resistance to castration have a negative impact on prognosis. Despite recent advances in management, the 5-year OS is around 30%. Therapeutic advances in this indication have been made mainly by the use of taxanes and second-generation hormone therapy. These treatments have improved OS and progression-free survival (PFS). They are now used as standard therapy.

More recently, the Phase III VISION trial confirmed the improvement in OS and radiological PFS achieved by treatment with the radioligand 177Lutetium-PSMA-617 (Lu-PSMA) in patients with advanced metastatic castration-resistant prostate cancer (mCRPC).

Read more

This treatment is currently available in early access in France. Despite encouraging results, 40% of patients will not respond to Lu-PSMA, and there are currently no validated predictive factors. Studies are currently on going, but the identification of biomarkers seems necessary to better stratify risk in these patients.

Numerous tissue prognostic tests based on molecular characteristics or cell proliferation are emerging with this in mind. At present, molecular profiling is not a routine technique for prostate cancer, as it is for other solid cancers. At an early stage, the Decipher® Genomic classification tool has shown prognostic utility independently of therapeutic and clinico-pathological data.

According to recent studies, methylome analysis would enable the subdivision of mCRPCs and could help identify new therapeutic targets.

In the metastatic phase, certain molecular abnormalities involving DNA repair genes are predictive of response to PARP inhibitors.

Molecular analysis (mutations, copy number alterations, gene expression, DNA methylation) could therefore be useful in optimizing the management of mCRPC patients treated with Lu-PSMA.

If reliable molecular abnormalities are identified on tissue, a diagnostic technique based on circulating tumor DNA (ctDNA) analysis will be useful in decision-making for these patients. A biological collection will therefore be created during the course of this study, with a view to using ctDNA analysis in subsequent research.

Read the detailed description

Prostate cancer is the most common cancer in men. Its incidence is rising as the population ages. In the localized stage, the 5-year overall survival rate (OS) is 98%. Metastatic progression and resistance to castration have a negative impact on prognosis. Despite recent advances in management, the 5-year OS is around 30%. Therapeutic advances in this indication have been made mainly by the use of taxanes and second-generation hormone therapy. These treatments have improved OS and progression-free survival (PFS). They are now used as standard therapy.

More recently, the Phase III VISION trial confirmed the improvement in OS and radiological PFS achieved by treatment with the radioligand 177Lutetium-PSMA-617 (Lu-PSMA) in patients with advanced metastatic castration-resistant prostate cancer (mCRPC).

This treatment is currently available in early access in France. Despite encouraging results, 40% of patients will not respond to Lu-PSMA, and there are currently no validated predictive factors. Studies are currently on going, but the identification of biomarkers seems necessary to better stratify risk in these patients.

Numerous tissue prognostic tests based on molecular characteristics or cell proliferation are emerging with this in mind. At present, molecular profiling is not a routine technique for prostate cancer, as it is for other solid cancers. At an early stage, the Decipher® Genomic classification tool has shown prognostic utility independently of therapeutic and clinico-pathological data.

According to recent studies, methylome analysis would enable the subdivision of mCRPCs and could help identify new therapeutic targets.

In the metastatic phase, certain molecular abnormalities involving DNA repair genes are predictive of response to PARP inhibitors.

Molecular analysis (mutations, copy number alterations, gene expression, DNA methylation) could therefore be useful in optimizing the management of mCRPC patients treated with Lu-PSMA.

If reliable molecular abnormalities are identified on tissue, a diagnostic technique based on circulating tumor DNA (ctDNA) analysis will be useful in decision-making for these patients. A biological collection will therefore be created during the course of this study, with a view to using ctDNA analysis in subsequent research.

This is an interventional, multi-center study. The study is prospective, single-arm, open-label and non-randomized.

Its primary objective is to identify biomarkers of interest, in primary tissue, predictive of response to Lu-PSMA treatment in patients with mCRPC, through the detection of molecular abnormalities in DNA/RNA and methyloma.

Being tested
Blood samples
Keywords
mCRPC, Lu-PSMA, biomarkers, response, prediction

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Blood samplesBiological

    A total of 3 blood samples (2 tubes of 9mL each) are added. The first sample will be taken at the inclusion visit, the 2nd at the end of the 2nd treatment cycle and the last at the end of Lu-PSMA treatment.

Study groups in NCT06600802
Study groupRoleWhat they receive
InterventionalExperimentalGenetic analysis will be conducted on intial tumor sample in order to identify biomarkers
Receives: Biological: Blood samples

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Molecular abnormalities retained on primary tumor sample predicting response to Lu-PSMA in metastatic castration resistant prostate cancer patients assessed according to RECIST 1.1 and/or PCWG3 criteria

    Biological interpretation and response to Lu-PSMA treatment on bone scan and CT scan according to RECIST 1.1 and/or PCWG3 criteria

    Measured: From enrollment to 24 months after Lu-PSMA treatment

Secondary outcomes (9)
  1. Correlation between biomarker(s) (molecular abnormalities retained on primary tumor sample for the first outcome measure) and survival without radiological progression

    Radiological progression free survival defined as the duration between the start date of treatment and the date of the first progression of the disease according to criteria RECIST V1.1 and criteria PCWG3; or the date of death whatever the cause.

    Measured: From enrollment to 24 months after Lu-PSMA treatment

  2. Correlation between biomarker(s) (molecular abnormalities retained on primary tumor sample for the first outcome measure) and survival without biological progression

    Biological progression free survival defined as the duration between the start date of treatment and the date of the first PSA progression

    Measured: From enrollment to 24 months after Lu-PSMA treatment

  3. Correlation between biomarker(s) (molecular abnormalities retained on primary tumor sample for the first outcome measure) and survival without clinical progression

    Clinical progression free survival, definieds as the duration between the treatment start date and the date of the first clinical progression

    Measured: From enrollment to 24 months after Lu-PSMA treatment

  4. Correlation between biomarker(s) (molecular abnormalities retained on primary tumor sample for the first outcome measure) and overall survival

    Overall survival definied as the time interval between the start date of treatment and the date of death whatever the cause

    Measured: From enrollement to the end of the study, up to 58 months

  5. Correlation between the biomarker(s) (molecular abnormalities retained on primary tumor sample for the first outcome measure) and adverse effects during treatment.

    Toxicities related to treatment of grade 3 or higher according to CTCAE v. 5.0 and any EIG

    Measured: From enrollment to the end of Lu-PSMA treatment, up to 58 months

  6. Assess whether consideration of clinical characteristics improves biomarker performance

    Performance status (0 to 4), pain and adverse events evaluations as assessed by CTCAE v4.0

    Measured: From enrollement to end of Lu-PSMA treatment, up to 58 months

  7. Assess whether consideration of radiological characteristics improves biomarker performance

    Radiological evaluation as assessed by RECIST criteria V1.1 and PCWG3 criteria

    Measured: From enrollement to end of Lu-PSMA treatment, up to 58 months

  8. Assess whether consideration of biological characteristics improves biomarker performance

    Biological evaluation as assessed with PSA level

    Measured: From enrollement to end of Lu-PSMA treatment, up to 58 months

  9. Biological interpretation and response to Lu-PSMA treatment on PET scan

    Radiological progression free survival defined as the duration between the start date of treatment according to RECIP 1.0 criteria for patients who underwent 68Ga-PSMA-11 PET scans

    Measured: From enrollment to 24 months after Lu-PSMA treatment

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted19 Sep 2024
  2. Study start8 Oct 2024
  3. Primary completion30 Jun 2034 (estimated)
  4. Study completion30 Jun 2034 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Other
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
120 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06600802
Sponsor's protocol ID
2024-A00246-41
Acronym
PSMA-PRED
Status last verified
Dec 2025
First submitted
22 Jul 2024
Last updated
31 Dec 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A study testing Blood samples in people with Castration-resistant Metastatic Prostate Cancer and Treated by 177Lutetium-PSMA-617 (Lu-PSMA), run by Centre Jean Perrin at 5 sites in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 30 inclusion and 17 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 31 Dec 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 5 sites in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Judith PASSILDAS JAHANMOHAN, PhD (0473278005, judith.passildas@clermont.unicancer.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Molecular abnormalities retained on primary tumor sample predicting response to Lu-PSMA in metastatic castration resistant prostate cancer patients assessed according to RECIST 1.1 and/or PCWG3 criteria (time frame: From enrollment to 24 months after Lu-PSMA treatment). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 31 Dec 2025.

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