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18F Fluciclovine (FACBC) PET/CT in Patients With Rising PSA After Initial Prostate Cancer Treatment

Phase 3
Completed
Conditions
Prostate Cancer
Interventions
Drug: 18F-fluciclovine PET CT
Registration Number
NCT02680041
Lead Sponsor
Blue Earth Diagnostics
Brief Summary

This prospective study will enroll up to 330 men with PSA-persistent or PSA-recurrent prostate cancer after curative-intent primary therapy and negative or equivocal findings on standard-of-care imaging. Consenting participants will be imaged with 18F-fluciclovine PET/CT. Site clinicians will manage study subjects per standard practices and will document any change in treatment based on review of 18F-fluciclovine PET/CT findings. All participants will be followed for up to 6 months, with clinical data collected for this study. An interdisciplinary panel will provide expert guidance to local readers on request. The final reporting of the PET/CT scan will be a single report by the local reader following any such discussion.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
Male
Target Recruitment
221
Inclusion Criteria
  • History of histologically confirmed adenocarcinoma of the prostate post curative-intent local treatment (radical prostatectomy, local radiotherapy, brachytherapy).
  • Suspicion of recurrent prostate carcinoma after previous presumed definitive therapy for organ confined disease defined as :
  • Post prostatectomy: Detectable or rising PSA level that is >0.2 ng/mL with a second confirmatory level of >0.2 ng/mL
  • Post non-prostatectomy: PSA rise ≥ 2ng/mL over nadir
  • Negative or equivocal findings on standard-of-care imaging for restaging of disease in the previous 60 days consisting of: Whole-body 99mTc bone scintigraphy or NaF PET-CT; and either CT or MRI of the pelvis (or the abdomen and pelvis).
  • Being considered for salvage therapy
  • Any non-surgical local treatment such as previous cryotherapy, external beam radiation, or HiFU (Ultrasound) must have occurred at least 1 year in the past.
  • Previous brachytherapy treatment will have occurred at least 2 years in the past
  • Ability to understand and the willingness to sign a written informed consent.
Exclusion Criteria
  • Ongoing treatment with any systemic therapy intended for the treatment of prostate cancer (e.g., antiandrogen or LHRH agonist or antagonist)
  • Androgen deprivation therapy (ADT) in the past 3 months
  • History of bilateral orchidectomy
  • Inability to tolerate 18F-fluciclovine PET/CT

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
18F-fluciclovine PET CT18F-fluciclovine PET CTSingle intravenous administration of 18F-fluciclovine PET CT.
Primary Outcome Measures
NameTimeMethod
The Fraction of Patients for Whom 18F-fluciclovine PET/CT Alters Patient Planned Treatment Through Detection of Disease.2-22 days post PET CT

The change of management will be based on referring physician questionnaires completed pre- and post- 18F-fluciclovine PET/CT

Secondary Outcome Measures
NameTimeMethod
The Fraction of Patients for Whom 18F-fluciclovine PET/CT Alters Patient Actual Treatment6 months

The change of management will be based on referring physician questionnaires completed pre- 18F-fluciclovine PET/CT and changes reported at 6 month follow-up.

Investigators were instructed to assess any clinically significant change from the revised management plan.

The Rate of Detection of Any Disease Site by 18F-fluciclovine PET/CT in the Study Population1 week

The percentage of subjects who have disease detectable by 18F-fluciclovine PET/CT

The Rate of Detection of Disease in 1) Prostate and Prostate Bed and 2) Extra-prostatic Regions With 18F-fluciclovine PET/CT in the Study Population1 week

The percentage of subjects who have disease detectable by 18F-fluciclovine PET/CT 1) in the pelvis and 2) distally

The Positive Predictive Value (PPV) of 18F-fluciclovine PET/CT for Regional Disease Compared to Biopsy in Those Patients Who Undergo Biopsy or in Case of Bony Disease a Correlation With MRI or Biopsy6 months

Based on the ratio of positive findings in the pelvis on 18F-fluciclovine PET/CT which are confirmed by histological examination of tissue or MRI

The PPV of 18F-fluciclovine PET/CT for Distant Disease Compared to Biopsy in Those Patients Who Undergo a Biopsy or in Case of Bony Disease a Correlation With MRI or Biopsy6 months

Based on the ratio of positive findings outside the pelvis on 18F-fluciclovine PET/CT which are confirmed by histological examination of tissue or MRI

Trial Locations

Locations (17)

Cedars-Sinai Medical Center

🇺🇸

Los Angeles, California, United States

Loyola University Medical Center

🇺🇸

Maywood, Illinois, United States

University of Pennsylvania

🇺🇸

Philadelphia, Pennsylvania, United States

Fox Chase Cancer Center

🇺🇸

Philadelphia, Pennsylvania, United States

City of Hope National Medical Center

🇺🇸

Duarte, California, United States

Manhattan Medical Research

🇺🇸

New York, New York, United States

Tower Urology

🇺🇸

Los Angeles, California, United States

Roudebush VA Medical Center

🇺🇸

Indianapolis, Indiana, United States

Urologic Consultants of SE Pennsylvania

🇺🇸

Bala-Cynwyd, Pennsylvania, United States

Icahn School of Medicine at Mount Sinai

🇺🇸

New York, New York, United States

University of Florida

🇺🇸

Jacksonville, Florida, United States

University of Louisville

🇺🇸

Louisville, Kentucky, United States

Coastal Urology Associates

🇺🇸

Brick, New Jersey, United States

Thomas Jefferson University Hospital

🇺🇸

Philadelphia, Pennsylvania, United States

Genesis Research, LLC

🇺🇸

San Diego, California, United States

University of Utah, Huntsman Cancer Institute

🇺🇸

Salt Lake City, Utah, United States

Washington University School of Medicine

🇺🇸

Saint Louis, Missouri, United States

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