Safety and efficacy of genomic biomarker-guided neoadjuvant therapy for locally advanced and oligometastatic prostate cancer (SEGNO): study protocol for an open-label prospective phase II umbrella clinical trial

Abstract Background The management of locally advanced prostate cancer (PCa) and oligometastatic prostate cancer (OMPCa) remains a clinical challenge. The heterogeneous nature of PCa prompts a need for precision treatment. This study aims to verify whether genomic biomarker-guided neoadjuvant therap...

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Main Authors: Haichao Huang, Tao Wang, Wei Li, Zhun Wu, Xuegang Wang, Jinchun Xing, Bin Chen, Kaiyan Zhang
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Cancer
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Online Access:https://doi.org/10.1186/s12885-025-13826-5
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author Haichao Huang
Tao Wang
Wei Li
Zhun Wu
Xuegang Wang
Jinchun Xing
Bin Chen
Kaiyan Zhang
author_facet Haichao Huang
Tao Wang
Wei Li
Zhun Wu
Xuegang Wang
Jinchun Xing
Bin Chen
Kaiyan Zhang
author_sort Haichao Huang
collection DOAJ
description Abstract Background The management of locally advanced prostate cancer (PCa) and oligometastatic prostate cancer (OMPCa) remains a clinical challenge. The heterogeneous nature of PCa prompts a need for precision treatment. This study aims to verify whether genomic biomarker-guided neoadjuvant therapy for locally advanced PCa and OMPCa can result in an improvement in the pathological responses and survival outcomes in a Chinese population. Methods In this open-label prospective phase II umbrella clinical trial, 40 patients will be enrolled. Next-generation sequencing data analysis of PCa tissues from the diagnostic needle biopsies will be performed. The genomically evaluable patients will be divided into 4 groups on the basis of genomic testing results, and receive 6 cycles of patient-tailored neoadjuvant systemic therapy targeted to alternative molecular pathways (including parmiparib, cisplatin, tislelizumab or docetaxel, respectively), and both in combination with rezvilutamide and goserelin microspheres. The primary endpoint is the rate of pathologic complete response. Secondary endpoints include rates of clinical complete response and pathological minimal residual disease (defined as residual tumor 5 mm or less), overall survival, progression-free survival and safety outcomes. Discussion SEGNO, to the best of our knowledge, is the first umbrella clinical trial designed to provide high-level evidence to support the implementation of genomic biomarker-guided neoadjuvant therapy for locally advanced PCa and OMPCa. Trial registration Clinicaltrial.gov, NCT06387056.
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spelling doaj-art-44feb5197fcf446abf06cd75fd4be96c2025-08-20T03:01:37ZengBMCBMC Cancer1471-24072025-03-012511610.1186/s12885-025-13826-5Safety and efficacy of genomic biomarker-guided neoadjuvant therapy for locally advanced and oligometastatic prostate cancer (SEGNO): study protocol for an open-label prospective phase II umbrella clinical trialHaichao Huang0Tao Wang1Wei Li2Zhun Wu3Xuegang Wang4Jinchun Xing5Bin Chen6Kaiyan Zhang7Department of Urology, School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen UniversityDepartment of Urology, School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen UniversityDepartment of Urology, School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen UniversityDepartment of Urology, School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen UniversityDepartment of Urology, School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen UniversityDepartment of Urology, School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen UniversityDepartment of Urology, School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen UniversityDepartment of Urology, School of Medicine, The First Affiliated Hospital of Xiamen University, Xiamen UniversityAbstract Background The management of locally advanced prostate cancer (PCa) and oligometastatic prostate cancer (OMPCa) remains a clinical challenge. The heterogeneous nature of PCa prompts a need for precision treatment. This study aims to verify whether genomic biomarker-guided neoadjuvant therapy for locally advanced PCa and OMPCa can result in an improvement in the pathological responses and survival outcomes in a Chinese population. Methods In this open-label prospective phase II umbrella clinical trial, 40 patients will be enrolled. Next-generation sequencing data analysis of PCa tissues from the diagnostic needle biopsies will be performed. The genomically evaluable patients will be divided into 4 groups on the basis of genomic testing results, and receive 6 cycles of patient-tailored neoadjuvant systemic therapy targeted to alternative molecular pathways (including parmiparib, cisplatin, tislelizumab or docetaxel, respectively), and both in combination with rezvilutamide and goserelin microspheres. The primary endpoint is the rate of pathologic complete response. Secondary endpoints include rates of clinical complete response and pathological minimal residual disease (defined as residual tumor 5 mm or less), overall survival, progression-free survival and safety outcomes. Discussion SEGNO, to the best of our knowledge, is the first umbrella clinical trial designed to provide high-level evidence to support the implementation of genomic biomarker-guided neoadjuvant therapy for locally advanced PCa and OMPCa. Trial registration Clinicaltrial.gov, NCT06387056.https://doi.org/10.1186/s12885-025-13826-5Genomic biomarker-guidedNeoadjuvant therapyLocally advancedOligometastaticProstate cancer
spellingShingle Haichao Huang
Tao Wang
Wei Li
Zhun Wu
Xuegang Wang
Jinchun Xing
Bin Chen
Kaiyan Zhang
Safety and efficacy of genomic biomarker-guided neoadjuvant therapy for locally advanced and oligometastatic prostate cancer (SEGNO): study protocol for an open-label prospective phase II umbrella clinical trial
BMC Cancer
Genomic biomarker-guided
Neoadjuvant therapy
Locally advanced
Oligometastatic
Prostate cancer
title Safety and efficacy of genomic biomarker-guided neoadjuvant therapy for locally advanced and oligometastatic prostate cancer (SEGNO): study protocol for an open-label prospective phase II umbrella clinical trial
title_full Safety and efficacy of genomic biomarker-guided neoadjuvant therapy for locally advanced and oligometastatic prostate cancer (SEGNO): study protocol for an open-label prospective phase II umbrella clinical trial
title_fullStr Safety and efficacy of genomic biomarker-guided neoadjuvant therapy for locally advanced and oligometastatic prostate cancer (SEGNO): study protocol for an open-label prospective phase II umbrella clinical trial
title_full_unstemmed Safety and efficacy of genomic biomarker-guided neoadjuvant therapy for locally advanced and oligometastatic prostate cancer (SEGNO): study protocol for an open-label prospective phase II umbrella clinical trial
title_short Safety and efficacy of genomic biomarker-guided neoadjuvant therapy for locally advanced and oligometastatic prostate cancer (SEGNO): study protocol for an open-label prospective phase II umbrella clinical trial
title_sort safety and efficacy of genomic biomarker guided neoadjuvant therapy for locally advanced and oligometastatic prostate cancer segno study protocol for an open label prospective phase ii umbrella clinical trial
topic Genomic biomarker-guided
Neoadjuvant therapy
Locally advanced
Oligometastatic
Prostate cancer
url https://doi.org/10.1186/s12885-025-13826-5
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