[18F]-Fluoro-2-Deoxy-D-Glucose and -[18F] Dihydro-Testosterone Pet Imaging in Patients With Progressive Prostate Cancer

Study Description

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Brief Summary:

This study will use PET scans, which is a type of x-ray test that uses a radiotracer, to see whether these scans may be better able to find places in the body where your prostate cancer may have spread.

Condition or disease	Intervention/treatment	Phase
Prostate Cancer	Drug: [18F]-Fluoro-2-Deoxy-D-Glucose and -[18F] Dihydro-Testosterone	Not Applicable

Detailed Description:

Our preliminary studies have shown that whole body FDG-PET imaging identifies areas of abnormal metabolism in a majority of tumor sites in patients with progressive disease and that changes in FDG accumulation parallel changes in PSA after treatment. This suggests that changes in FDG metabolism may provide an early assessment of treatment outcomes. In previous work we established a methodology to examine a radiotracer in patients with progressive disease and abnormal imaging studies, which we have applied to the clinical states of non-castrate and castrate metastatic disease. This design is characterized by:

1) Evaluation of uptake on a site-by-site basis in relation to conventional studies 2) Standardization of uptake values in tumor relative to a normal organ 3) Controlling for progression using standard measures of progression including a rising PSA, new or enlarging lesions on bone or transaxial imaging, and new symptoms of disease. In the present study we are evaluating fluorinated dihydrotestosterone (FDHT) in addition to FDG. FDHT is targeted to the AR and has been shown in preliminary studies to visualize prostate cancers in man. This study will apply our established methods to investigate FDHT imaging in patients with progressive prostate cancer. In the selected cases where tumor is available, we will study associations between FDHT accumulation and AR expression.

Study Design

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Study Type :	Interventional (Clinical Trial)
Estimated Enrollment :	300 participants
Intervention Model:	Single Group Assignment
Masking:	None (Open Label)
Primary Purpose:	Diagnostic
Official Title:	[18F]-Fluoro-2-Deoxy-D-Glucose and -[18F] Dihydro-Testosterone Pet Imaging in Patients With Progressive Prostate Cancer
Actual Study Start Date :	February 2003
Estimated Primary Completion Date :	February 2019
Estimated Study Completion Date :	February 2019

Arms and Interventions

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Arm

Intervention/treatment

Experimental: 1; [18F]-Fluoro-2-Deoxy-D-Glucose and -[18F] Dihydro-Testosterone

Drug: [18F]-Fluoro-2-Deoxy-D-Glucose and -[18F] Dihydro-Testosterone; Registered patients will undergo PET scanning using either FDHT alone or FDG and FDHT depending on the clinical question being asked. Scans will be performed serially at baseline, week 4, week 12, and every 12 weeks of treatment up to a maximum of 8 FDHT/FDG scan set in a 12 month period (maximum 40 scan sets per lifetime) unless the therapeutic protocol or scientific rationale of the therapeutic drug being applied specifically dictates an alternative schedule. Patients may have blood drawn for the purposes of establishing the pharmacokinetics of FDHT and may also undergo an initial dynamic scan if further pharmacokinetic information is warranted, followed by a standard whole body image. If no further pharmacokinetic information is warranted, then patients will only undergo a standard whole body image.

Outcome Measures

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Primary Outcome Measures :

1. To study the accumulation and biodistribution of FDHT in patients with progressive prostate cancer. The accumulation and location of FDHT activity will be assessed on a site by site basis and correlated with radionuclide bone scan, CT and MRI. [ Time Frame: Baseline, 4 weeks and 12 weeks ]

Secondary Outcome Measures :

1. The kinetics, metabolism, and biodistribution will be assessed. [ Time Frame: Baseline. 4 weeks and 12 weeks ]
2. To correlate the accumulation of 18FDHT to 18FDG. [ Time Frame: 2 years ]
3. To study changes in 18FDHT accumulation over time in patients treated with: Castration and other hormones, Chemotherapy, Agents directed toward the androgen receptor [ Time Frame: 2 years ]
4. relationship between FDHT uptake and tumor diffusivity [ Time Frame: 2 years ]
   assessed by MRI.
5. relationship between FDHT uptake and tissue analyses [ Time Frame: 2 years ]
   of AR expression

Eligibility Criteria

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Ages Eligible for Study:	Child, Adult, Senior
Sexes Eligible for Study:	Male
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

• Patients with histologically confirmed prostate cancer.
• Progressive disease manifest by either:
• Imaging modalities:
• Bone Imaging: New osseous lesions on bone imaging (bone scintigraphy or NaF PET scan) and/or MRI or CT: An increase in measurable soft tissue disease, or the appearance of new sites of disease. Or
• Biochemical progression: A minimum of three rising PSA values from a baseline that are obtained 1 week or more apart, or 2 measurements 2 or more weeks apart.
• Visible lesions by either CT, bone imaging, or MRI consistent with disease.
• Informed consent.

Exclusion Criteria:

• Previous anaphylactic reaction to either FDHT or FDG
• Hepatic: Bilirubin > 1.5 x upper limit of normal (ULN), AST/ALT >2.5 x ULN, albumin < 2 g/dl, and GGT > 2.5 x ULN IF Alkaline phosphatase > 2.5 x ULN
• Renal: Creatinine >1.5 x ULN or creatinine clearance < 60 mL/min

Contacts and Locations

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Contacts

Contact: Michael Morris, M.D., PH.D.	646-422-4469

Locations

United States, New York
Memorial Sloan Kettering Cancer Center	Recruiting
New York, New York, United States, 10065
Contact: Michael Morris, M.D., Ph,D. 646-422-4469
Principal Investigator: Michael Morris, M.D., Ph.D.

Sponsors and Collaborators

Memorial Sloan Kettering Cancer Center

Investigators

Principal Investigator:	Michael Morris, M.D., Ph.D.	Memorial Sloan Kettering Cancer Center

More Information

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Additional Information:

Memorial Sloan Kettering Cancer Center 

Responsible Party:	Memorial Sloan Kettering Cancer Center
ClinicalTrials.gov Identifier:	NCT00588185 History of Changes
Other Study ID Numbers:	00-095
First Posted:	January 8, 2008
Last Update Posted:	March 23, 2018
Last Verified:	March 2018

Keywords provided by Memorial Sloan Kettering Cancer Center:

Progressive Prostate Cancer; [18F]-Fluoro-2-Deoxy-D-Glucose; [18F] Dihydro-Testosterone	Pet Imaging; Pet scan; 00-095

Additional relevant MeSH terms:

Prostatic Neoplasms; Genital Neoplasms, Male; Urogenital Neoplasms; Neoplasms by Site; Neoplasms; Genital Diseases, Male; Prostatic Diseases; Testosterone; Testosterone enanthate; Testosterone undecanoate; Testosterone 17 beta-cypionate; Dihydrotestosterone; Methyltestosterone	Deoxyglucose; Androgens; Hormones; Hormones, Hormone Substitutes, and Hormone Antagonists; Physiological Effects of Drugs; Antineoplastic Agents, Hormonal; Antineoplastic Agents; Anabolic Agents; Antimetabolites; Molecular Mechanisms of Pharmacological Action; Antiviral Agents; Anti-Infective Agents