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RecruitingLast updated: 23 September 2025

PIAS study: A study for people with newly diagnosed prostate cancer who are suitable for active surveillance that is evaluating a new diagnostic testDiagnostic accuracy of 68Ga-PSMA PET/CT in addition to mpMRI in men undergoing 12-month confirmatory biopsy during Active Surveillance for low- or intermediate-risk prostate cancer

Trial purpose

Medical clipboardDiagnostic

Tumor type

Urinary System Cancers Genitourinary

Age

People18+

Trial acronym

PIAS study

Clinical summary

Summary

This study is evaluating the value of a new diagnostic test (PSMA PET) in addition to, and in combination with, the current gold-standard reference in men undergoing 12-month confirmatory biopsy during Active Surveillance for low- or intermediate-risk prostate cancer.

You might be eligible for this study if you are aged 18 and above, have been newly diagnosed prostate cancer deemed suitable for active surveillance by your treating urologist, and not yet had a 12-month confirmatory biopsy on active surveillance.

All eligible participants will undergo a limited (pelvic only) PSMA PET/CT in addition to their standard of care surveillance mpMRI within 3 months prior to their 12-month (range 6-18 months) confirmatory biopsy.

The diagnostic accuracy of PSMA PET will be compared to the current gold-standard reference test of mpMRI and saturation transperineal confirmatory biopsy.

Although recent studies have demonstrated the value of mpMRI as a surveillance tool, it has a propensity to miss a small proportion of clinically significant prostate cancer which has limited its ability to safely replace surveillance biopsies. To date, the additive value of PSMA PET in active surveillance has not been evaluated. Given its promising performance in the detection of both metastatic prostate cancer in a BCR setting and the primary diagnosis of intraprostatic PCa, we propose the evaluation of its use in active surveillance.

Conditions

This trial is treating people with newly diagnosed prostate cancer who are suitable for active surveillance

Eligibility

Inclusion

 

1 18 years or greater of age
2 Life expectancy of 10 years or greater
3 Newly diagnosed PCa deemed suitable for AS by treating urologist and not yet had a 12-month confirmatory biopsy on AS
4 A diagnosis of PCa meeting the following histopathological criteria:
o Organ-confined PCa: cT1-2a, cN0 and/or cM0/x
o ISUP Grade Group 2 PCa with < 20% Gleason pattern 4 overall and in each location; or
o ISUP Grade Group 1 PCa with ANY of the following high-risk features:
> 30% maximum cancer core involvement of any single core; or
> 6 mm cancer in any core; or
> 4 locations with cancer on biopsy; or
PI-RADS V2.1 4 or 5 lesion on baseline mpMRI
Focus on PSMA PET suspicious for PCa (SUVmax > 4 in PZ or > 5 in TZ)
5 No evidence of intraductal or cribriform architecture or EPE
6 No previous PCa treatment
7 Able to provide written informed consent to and willing to remain on AS
8 Planned for confirmatory biopsy within next 12 months following enrolment onto the study
9 Able to give written informed consent to, willing to participate and comply with the study

Exclusion

 

• Inability/incapacity to provide written informed consent to either AS or study
• Unwilling to remain on AS for the duration of study
• Has a diagnosis of PCa deemed not suitable for AS and treating urologist/not meeting ideal histological criteria
• Has had prior treatment for PCa
• Has had a prior normal or non-suspicious PSMA PET within 2 years of confirmatory biopsy
• Has a contraindication to mpMRI or PSMA PET

Inclusion

  • You have been diagnosed with cancer, but have not received any treatment.
  • You have the type of cancer, symptoms, or health risks that this clinical trial is focused on.

Exclusion

  • You have certain types of non-cancer medical conditions.
  • You have had certain treatments, surgical procedures or drugs.
Message

Clinical trials have complex eligibility criteria, and other criteria may apply for this trial. Ask your doctor about whether this trial could be right for you.

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Recruiting hospitals

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More information

Trial Identifiers

Information on this page is partially produced from ANZCTR *. View further details about this trial on the registry via the links below:

Trial sponsor

St. Vincent's Prostate Cancer Research Centre

Scientific Title

Diagnostic accuracy of 68Ga-PSMA PET/CT in addition to mpMRI in men undergoing 12-month confirmatory biopsy during Active Surveillance for low- or intermediate-risk prostate cancer

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