An Investigational Scan (18F-Fluciclovine PET-CT) for the Measurement of Therapeutic Response in Patients With Metastatic Prostate Cancer
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ClinicalTrials.gov Identifier: NCT04134208 |
Recruitment Status :
Recruiting
First Posted : October 22, 2019
Last Update Posted : October 22, 2019
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Condition or disease | Intervention/treatment | Phase |
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Metastatic Prostate Carcinoma Stage IVB Prostate Cancer AJCC v8 | Procedure: Computed Tomography Drug: Fluciclovine F18 Procedure: Positron Emission Tomography | Phase 4 |
PRIMARY OBJECTIVE:
I. Evaluate metabolic response by fluciclovine F18 (18F-fluciclovine) PET qualitatively and semi-quantitatively with standardized uptake values (SUV) following androgen deprivation therapy (ADT) plus abiraterone at 22-28 weeks (+/- 4 weeks), and correlate the findings with size changes as defined by conventional imaging and prostate-specific antigen (PSA) response.
SECONDARY OBJECTIVES:
I. To correlate pelvic 18F-fluciclovine PET imaging findings with pathologic findings at radical prostatectomy and pelvic lymph node dissection to determine 18F-fluciclovine PET imaging sensitivity and specificity for pelvic lymph node cancer involvement.
II. To evaluate 18F-fluciclovine PET imaging response and its correlation with progression free survival (defined by Prostate Cancer Working Group 2 [PCWG2] criteria).
III. To determine if sites of progressive disease develop at the initial/prior site (diagnostic site) of metastases or in newly developed sites at the time of metastatic progression.
IV. To evaluate metabolic response by 18F-fluciclovine PET semi-quantitatively with target to blood pool ratio (TBR) following ADT plus abiraterone at 22-28 weeks (+/- 4 weeks), and correlate the findings with size changes as defined by conventional imaging and PSA response.
OUTLINE:
Within 4 weeks before starting standard systemic therapy (SST), patients receive fluciclovine F18 intravenously (IV) then undergo a PET-CT scan over 30 minutes. Within 22-28 weeks after starting SST, patients receive fluciclovine F18 IV and undergo a second PET-CT scan over 30 minutes.
Study Type : | Interventional (Clinical Trial) |
Estimated Enrollment : | 45 participants |
Allocation: | N/A |
Intervention Model: | Single Group Assignment |
Masking: | None (Open Label) |
Primary Purpose: | Diagnostic |
Official Title: | 18F-Fluciclovine PET CT as an Indicator of Therapeutic Response in Metastatic Prostate Carcinoma (M1PCa) |
Actual Study Start Date : | September 19, 2019 |
Estimated Primary Completion Date : | February 28, 2021 |
Estimated Study Completion Date : | February 28, 2021 |

Arm | Intervention/treatment |
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Experimental: Diagnostic (fluciclovine F18, PET-CT)
Within 4 weeks before starting SST, patients receive fluciclovine F18 IV then undergo a PET-CT scan over 30 minutes. Within 22-28 weeks after starting SST, patients receive fluciclovine F18 IV and undergo a second PET-CT scan over 30 minutes.
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Procedure: Computed Tomography
Undergo PET-CT scan
Other Names:
Drug: Fluciclovine F18 Given IV
Other Names:
Procedure: Positron Emission Tomography Undergo PET-CT scan
Other Names:
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- Metabolic response by fluciclovine F18 (18F-fluciclovine) positron emission tomography (PET) with standardized uptake values (SUV) [ Time Frame: Up to 2 years ]Will evaluate metabolic response by 18F-fluciclovine PET qualitatively and semi-quantitatively with SUV and correlate the findings with size changes as defined by conventional imaging prostate specific antigen (PSA) response. The percentage of change in the 18F-fluciclovine maximum standardized uptake value (SUVmax) after therapy will be calculated as follows ([pretreatment corrected SUVmax - posttreatment corrected SUVmax]/pretreatment corrected SUVmax) x 100. Similar calculations will be performed for mean SUV, metabolic tumor volume, and total volume activity.
- 18F-fluciclovine PET imaging response [ Time Frame: Up to 2 years ]Will evaluate 18F-fluciclovine PET imaging response and its correlation with progression free survival defined by Prostate Cancer Working Group 2 criteria.
- Sites of progressive disease development [ Time Frame: Up to 2 years ]Will determine if sites of progressive disease develop at the initial/prior site (diagnostic site) of metastases or in newly developed sites at the time of metastatic progression.
- Metabolic response by 18F-fluciclovine PET with target to blood pool ratio (TBR) [ Time Frame: Up to 2 years ]Will evaluate metabolic response by 18F-fluciclovine PET semi-quantitatively with TBR and correlate the findings with size changes as defined by conventional imaging and PSA response.

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Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | Male |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Histologically or cytologically proven prostate carcinoma
- Documented evidence of M1 disease by American Joint Committee on Cancer (AJCC) staging by bone scan, CT and magnetic resonance imaging (MRI)
- Castration naive disease, no prior systemic therapy for prostate cancer
- Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0 or 1
- Ability to understand and willingness to sign informed consent
Exclusion Criteria:
- Psychiatric or medical conditions which, in the opinion of the treating physician, would not allow the patient to undergo the proposed treatments safely
- Known brain metastasis
- Small cell carcinoma of the prostate

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04134208
Contact: Gregory Ravizzini | 713-745-5721 | gravizzini@mdanderson.org |
United States, Texas | |
M D Anderson Cancer Center | Recruiting |
Houston, Texas, United States, 77030 | |
Contact: Gregory C. Ravizzini 713-745-5721 | |
Principal Investigator: Gregory C. Ravizzini |
Principal Investigator: | Gregory C Ravizzini | M.D. Anderson Cancer Center |
Responsible Party: | M.D. Anderson Cancer Center |
ClinicalTrials.gov Identifier: | NCT04134208 |
Other Study ID Numbers: |
2019-0030 NCI-2019-06047 ( Registry Identifier: CTRP (Clinical Trial Reporting Program) ) 2019-0030 ( Other Identifier: M D Anderson Cancer Center ) P30CA016672 ( U.S. NIH Grant/Contract ) |
First Posted: | October 22, 2019 Key Record Dates |
Last Update Posted: | October 22, 2019 |
Last Verified: | October 2019 |
Studies a U.S. FDA-regulated Drug Product: | Yes |
Studies a U.S. FDA-regulated Device Product: | No |
Carcinoma Prostatic Neoplasms Neoplasms, Glandular and Epithelial Neoplasms by Histologic Type Neoplasms |
Genital Neoplasms, Male Urogenital Neoplasms Neoplasms by Site Prostatic Diseases |