Trial results for the 'MRI Based Active Selection for Treatment Trial' in prostate cancer were posted on 2025-07-11, revealing a disease progression rate of 36.1% within the first two surveillance biopsies among 208 participants.
Background
Prostate cancer is a common malignancy, with many patients opting for active surveillance, a strategy that monitors the disease rather than immediately treating it. This approach aims to avoid overtreatment and its associated side effects for low-risk disease. However, accurately identifying patients who will progress and require intervention remains a clinical challenge. The study investigated the utility of MRI and MRI-targeted biopsy to better select patients for active surveillance and detect those likely to need earlier treatment.
Trial design
The 'MRI Based Active Selection for Treatment Trial' (NCT02242773) was a completed study that enrolled 208 participants with Prostate Cancer. The primary purpose of this study was to determine if Magnetic Resonance Imaging (MRI), along with MRI targeted biopsy of suspicious lesions, is of value in detecting patients who would be likely to require treatment earlier. The trial focused on patients undergoing active surveillance.
Key results
The study reported several key measurements for participants under active surveillance:
- Rate of Disease Progression Within the First Two Surveillance Biopsies: 36.1% of participants.
- Time-to-Biochemical Recurrence (BCR): Median of 169 days (Inter-Quartile Range).
- Health-Related Quality of Life Scores:
- EPIC SF-12: Median of 31 (Inter-Quartile Range) score on a scale.
- MAX-PC: Median of 15 (Inter-Quartile Range) score on a scale.
- MAX-PC: Median of 12 (Inter-Quartile Range) score on a scale.
- Discriminative Performance of NCCN Risk and Clinical Markers for Predicting Progression on Active Surveillance: 0.6717, 0.7398, 0.7168, 0.6858, and 0.7412 probability.
What this means
The results from this trial provide insights into the outcomes for prostate cancer patients undergoing active surveillance. A progression rate of 36.1% within the first two surveillance biopsies highlights the proportion of patients who may require a change in management during early follow-up. The median time to biochemical recurrence of 169 days offers a benchmark for disease activity. The reported quality of life scores (EPIC SF-12 median of 31, MAX-PC medians of 15 and 12) provide valuable patient-reported data on their experience during active surveillance. The discriminative performance values (ranging from 0.6717 to 0.7412) indicate the predictive capability of NCCN risk and clinical markers in identifying patients at risk of progression, which could inform clinical decision-making regarding surveillance intensity or intervention.
Source
The information for this condition update was sourced from ClinicalTrials.gov, a public database of clinical studies. The results for the study titled 'MRI Based Active Selection for Treatment Trial' (NCT02242773) were posted on 2025-07-11 on clinicaltrials.gov.