MRI to be tested in management of suspected prostate cancer

TORONTO | The Canadian urologist who pioneered the adoption of active surveillance for low-risk prostate cancer is now leading a trial testing the ability of MRI scans to reduce the need for prostate biopsies.Dr. Laurence Klotz, who was named to the Order of Canada in 2014 for his contributions to the treatment of prostate cancer, is leading the multicentre PRECISE trial, for which $3 million in funding was announced this week."If positive, this trial would support a change in practice from relying on biopsies for all men with suspected prostate cancer to providing MRI first with selective targeted biopsy," Dr. Klotz, a urologist at Toronto's Sunnybrook Health Sciences Centre, said in a news release. "This would allow 250,000 men per year in the U.S. and Canada to avoid unnecessary biopsies and the associated complications including hospitalization, without compromising our ability to identify clinically significant cancers."In the trial, approximately 450 men with a clinical suspicion of prostate cancer, based on prostate-specific antigen levels or the results of a digital rectal exam, and with no prior biopsy, will be randomized to MRI only, MRI plus MRI-targeted biopsy, or the current standard of trans-rectal ultrasound-guided biopsy of the prostate.The primary endpoint is the detection rate of clinically significant prostate cancer (the proportion of men in each group with a Gleason score of 7 or higher). Patients will be followed for two years, but the primary endpoint will be reached within a month of the last patient being randomized (around December 2018).Participating centres currently include Sunnybrook, Princess Margaret Hospital, the University of Western Ontario, McMaster University, Queen's University and the University of Ottawa. A spokesman for Prostate Cancer Canada said there is the possibility that sites outside of Ontario could later join the trial.Once ethical approval for the trial is finalized, further information will be posted at www.clinicaltrials.gov and www.canadiancancertrials.ca.The PRECISE trial is being funded by the Movember Foundation, the Ontario Institute for Cancer Research and Prostate Cancer Canada.

MRI to be tested in management of suspected prostate cancer

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