PROMOTE: Identifying Predictive Markers of Response for Genitourinary Cancer

  • STATUS
    Recruiting
  • End date
    Dec 31, 2025
  • participants needed
    750
  • sponsor
    University of California, San Francisco
Updated on 28 January 2021
gonadotropin
androgens
carcinoma
testosterone
metastasis
antiandrogen therapy
androgen suppression
bone scan
prostate specific antigen
antiandrogens
metastatic prostate cancer
luteinizing hormone-releasing hormone agonist
enzalutamide
testosterone level
serum testosterone
luteinizing hormone
prostate carcinoma
gonadorelin
immunological adjuvant
prostate cancer metastatic

Summary

This is a tissue and blood collection protocol requiring image-guided biopsies of metastatic prostate cancer and other genitourinary malignancies including renal cell carcinoma and urothelial carcinoma. Whenever possible, a new bone lesion or new/progressing soft tissue lesion will be chosen for biopsy as opposed to radiographically stable lesion. Patients will be enrolled in into one of several parallel cohorts based upon disease status or type and the planned systemic therapy following baseline tumor biopsy: (A) Androgen signaling inhibition, (B) Immunotherapy, (C) Radiotherapy, (D) Targeted Therapy/Investigational therapeutic, (E) DNA damage response pathway, (F) Aggressive variant disease, (G1) Castration-sensitive ADT nave and ADT < 3 months), or (G2) Castration-sensitive pre-treated with sub-optimal PSA nadir >0.2 ng/ml, (R) metastatic renal cell carcinoma and metastatic and (U) urothelial carcinoma.

Description

After performing tumor biopsies and blood collection and processing the biopsies and research blood for comprehensive molecular analysis using established methods for RNA and DNA analysis, we will use Pathway Recognition using Data Integration on Genomic Models (PARADIGM) and Differential Pathway Signature Correlation (DiPSC), computational approaches to pathway activity and predictive signature identification developed at University of California, Santa Cruz. We will also collect blood samples (for circulating tumor DNA, plasma, and serum) and circulating tumor cells from participating patients. Residual paraffin- embedded blocks, frozen tissue, and blood products (serum, plasma, and circulating cells) will be stored in a repository for future testing of candidate predictive markers identified during microarray analysis. We will utilize only Clinical Laboratory Improvement Amendments (CLIA)-certified laboratories(e.g. Strata Oncology) to identify genetic mutations within mCRPC tumors to provide genetic information that can be returned to patient to potentially inform treatment decisions.

Certain genomic sequencing will be performed by Strata Oncology.

Following biopsy and baseline peripheral blood collection, patients will be treated per investigator discretion, with treatment corresponding to assigned patient cohort and initiated within 42 days following baseline tumor biopsy and/or research blood collection. Patients will be evaluated for response to therapy per the standard of care for their specific disease type; such as with monthly serum PSA measurements (may be done at UCSF or at local laboratory) and/or restaging scans (bone scan + CT abdomen/pelvis) (UCSF or local radiology facility). Outcomes on treatment post-biopsy will be recorded, including maximal PSA decline, date of radiographic progression.

At the time of disease progression by Prostate Cancer Working Group 2 (PCWG2) criteria for prostate cancer patients, or by RECIST v1.1 for patients with metastatic renal or urothelial cancer, patients may undergo optional repeat assessment for metastatic tumor biopsy, along with mandatory blood collection for analysis of circulating tumor DNA and circulating tumor cells (CTCs). Following second biopsy at progression, patients should continue to be followed for response to subsequent therapy.

Patients will be followed every 6 months for updates on disease status including post-study therapies and survival status via telephone calls and/or chart review.

Details
Condition Malignant neoplasm of prostate, Prostatic disorder, Genitourinary Neoplasms, Prostate Disorders, Prostate Cancer, Early, Recurrent, Advanced Renal Cell Carcinoma, Advanced Urothelial Cancer, Prostate Cancer, Genitourinary Cancer, Advanced Urothelial Carcinoma, prostate carcinoma, prostate cancers
Treatment Systemic therapy, StrataNGS
Clinical Study IdentifierNCT02735252
SponsorUniversity of California, San Francisco
Last Modified on28 January 2021

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