Validation of FACBC for Detection of Metastasis Among High-risk Prostate Cancer Patients With Presumed Localized Disease (EDRN-FACBC)
|Study Design:||Intervention Model: Single Group Assignment
Intervention Model Description:
All participants will have the same interventionMasking: No masking
Primary Purpose: Diagnostic
|Official Title:||Validation of FACBC as an Early Indicator of Sub-clinical Metastatic Disease Among High-risk Prostate Cancer Patients With Presumed Localized Disease|
- Positivity rate of FACBC PET [ Time Frame: Day 1 ]To validate FACBC as an early indicator of occult metastatic disease among high risk prostate cancer patients with presumed localized disease, the positivity rate will be calculated for FACBC PET for extraprostatic disease.
- Correlation between FACBC PET findings and results of other tests [ Time Frame: Day 1, Day of surgery ]To validate FACBC as an early indicator of occult metastatic disease among high risk prostate cancer patients with presumed localized disease, the diagnostic performance of FACBC in the detection of extraprostatic disease as confirmed with histology and/or correlative imaging will be determined.
- Correlation between FACBC uptake in the prostate with presence of FACBC-detected metastasis [ Time Frame: Day 1 ]Using results from the FACBC PET scan, the uptake of known tumor within the prostate will be correlated with the uptake of FACBC outside of the main tumor.
|Actual Study Start Date:||March 1, 2017|
|Estimated Study Completion Date:||January 2027|
|Estimated Primary Completion Date:||January 2027 (Final data collection date for primary outcome measure)|
Experimental: FACBC PET-CT Imaging
Individuals who have been diagnosed with primary prostate carcinoma and do not have definitive findings of systemic metastasis with conventional imaging will have a whole body FACBC PET-CT scan.
Drug: FACBC PET-CT Imaging
Participants will fast for 4 hours to normalize their neutral amino acid levels. One hour prior to the scan, participants will drink up to 450ml of standard oral contrast. Participants will lie on the scanning bed while the bed moves through the PET/CT scanner for the CT portion of the exam. After completion of the CT scan, approximately 10 units of FACBC will be injected for the PET scan portion of the exam. The bed will move through the scanner again and the PET portion of the exam will take 30 minutes. The entire visit will take about two hours.
Standard of care procedures include conventional imaging (CT and/or MRI; bone scan and/or NaF PET per institutional standards) and radical prostatectomy with extended pelvic lymph node dissection.
Other Name: Fluciclovine
Approximately 50-80% of patients who are considered high-risk after being treated with definitive radical prostatectomy experience recurrent disease, often because of undetected extra-prostatic metastatic disease prior to treatment. There is increasing evidence that performing radical prostatectomy in patients with high-risk disease or locally advanced disease is feasible and has potential benefits in terms of local control, overall survival, and quality of life. Thus, improved imaging approaches for early detection of occult metastatic prostate cancer at the time of presentation could inform a directed treatment approach that would significantly improve patient outcomes, including use of extended lymphadenectomy as well as postoperative radiation therapy planning.
Amino acid transport is up-regulated in prostate and other cancers. Anti-1-amino-3-[18F]fluorocyclobutyl-1-carboxylic acid (FACBC) is a synthetic amino acid analog positron emission tomography (PET) radiotracer that has demonstrated promising results in the staging and restaging of prostate carcinoma, with high positive predictive value (PPV) in the identification of extraprostatic malignancy. Most of the prior studies of FACBC were in post-primary treatment recurrence, and this proposed trial will be the first comprehensive study to evaluate FACBC PET in detecting occult metastatic disease at initial diagnosis in patients with negative or equivocal conventional imaging, with the objective of developing a more effective primary treatment plan.
The goal of this study is to determine if FACBC PET will detect significant occult metastatic disease in patients with high risk primary prostate carcinoma who have negative or equivocal conventional imaging such as CT and/or MRI and bone scan. Participants will have a single scan prior to surgery for this study. Participants will be followed, through medical record reviews, for 10 years but no additional procedures related to this study will be performed.
Please refer to this study by its ClinicalTrials.gov identifier: NCT03081884
|Contact: Mehrdad Alemozaffar||404-778-5864|
|Contact: Almira Catic||404-778-7397|
|United States, Georgia|
|Emory University Hospital||Recruiting|
|Atlanta, Georgia, United States, 30322|
|Contact: Mehrdad Alemozaffar, MD 404-778-5864 firstname.lastname@example.org|
|Principal Investigator:||Mehrdad Alemozaffar||Emory University|