Evaluating Fluciclovine PET in Patients With Biochemical Recurrence of Prostate Cancer and a Negative PSMA PET

Sponsor
OHSU Knight Cancer Institute (Other)
Overall Status
Not yet recruiting
CT.gov ID
NCT05722925
Collaborator
Blue Earth Diagnostics, Inc (Other), Oregon Health and Science University (Other)
60
1
1
24
2.5

Study Details

Study Description

Brief Summary

The purpose of this prospective cohort study is to investigate the role of Fluciclovine Positron Emission Tomography (PET) in patients with biochemical recurrence of prostate cancer and a negative Prostate Specific Membrane Antigen (PSMA) PET, specifically, whether Fluciclovine PET can help detect local recurrence and whether the results of Fluciclovine PET can change management.

Condition or Disease Intervention/Treatment Phase
  • Drug: Fluciclovine PET/CT
Phase 4

Detailed Description

PRIMARY OBJECTIVE:
  1. To evaluate the detection rate of local recurrence of prostate cancer on Fluciclovine PET in patients with BCR and a negative or equivocal PSMA PET obtained within 30 days prior to the Fluciclovine PET.
SECONDARY OBJECTIVES:
  1. To evaluate the correct localization rate of Fluciclovine PET in patients with positive scans.

  2. To distinguish the detection rate by site of recurrence (local recurrence in the prostate bed, lymph node involvement, or distant metastatic disease), and stratify by PSA level at the time of the scan and tumor grade

  3. To evaluate the change in management based on the results of Fluciclovine PET, relative to intended management based on the result of negative PSMA PET alone, prior to obtaining the Fluciclovine PET.

OUTLINE:

Patients will be imaged with Fluciclovine PET within 30 days of the negative or equivocal PSMA scan.

A short questionnaire inquiring about the intended management will be sent to the referring physician at two timepoints: 1) the first is at the time of screening, prior to the Fluciclovine PET; and 2) the second is after the availability of the results of Fluciclovine PET.

Change in intended management will be recorded. Participants will be followed for 6 months and will be managed by their treating physician as per standard-of-care.

Study Design

Study Type:
Interventional
Anticipated Enrollment :
60 participants
Allocation:
N/A
Intervention Model:
Single Group Assignment
Masking:
None (Open Label)
Primary Purpose:
Diagnostic
Official Title:
Prospective Study Evaluating the Role of Axumin® (Fluciclovine or 18F-FACBC) PET in Patients With Biochemical Recurrence of Prostate Cancer and a Negative PSMA PET
Anticipated Study Start Date :
Mar 1, 2023
Anticipated Primary Completion Date :
Mar 1, 2024
Anticipated Study Completion Date :
Mar 1, 2025

Arms and Interventions

Arm Intervention/Treatment
Experimental: Fluciclovine PET/CT

Participants will undergo Fluciclovine PET/CT within 30 days of a negative or equivocal PSMA PET scan. After the Fluciclovine PET/CT, the patient will follow up with their treating physician as per standard-of-care. The research team will collect clinical and imaging data at 6 months post Fluciclovine-PET/CT.

Drug: Fluciclovine PET/CT
10 mCi (± 20%) of Fluciclovine administered as a bolus intravenous injection
Other Names:
  • 18F-FACBC
  • Axumin®
  • Outcome Measures

    Primary Outcome Measures

    1. Positive Fluciclovine PET in patients with BCR and a negative or equivocal PSMA PET obtained within 30 days [Start of PET scan to end of PET scan (up to 30 minutes)]

    Secondary Outcome Measures

    1. Correct localization rate (CLR) Fluciclovine PET in patients with positive scans. [Start of PET scan to 6 months post-PET]

      The CLR of Fluciclovine PET will be determined by the following formula: true positive/(true positive + false positive). This will be evaluated by patient, and only for patients in whom the standard-of-reference is available for analysis. Standard of reference, the combination of: Pathology, if site of recurrence is biopsied Drop in PSA levels if the site of recurrence undergoes radiation therapy Imaging follow up confirming the suspicious finding as true positive.

    2. Positive Fluciclovine PET summarized by site of recurrence: local recurrence in the prostate bed, lymph node involvement, or distant metastatic disease), stratified by PSA level [Start of PET scan to end of PET scan (up to 30 minutes)]

    3. Change in management based on the results of Fluciclovine PET, relative to intended management based on the result of negative PSMA PET alone, prior to obtaining the Fluciclovine PET. [Enrollment up to 1 month after scan]

      Questionnaire filled by the referring physician stating the intended management at 2 timepoints, before and after the Fluciclovine PET/CT.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years and Older
    Sexes Eligible for Study:
    Male
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:
    • Age >= 18 years.

    • Participant or legally authorized representative (LAR) must provide written informed consent before any study-specific procedures or interventions are performed.

    • Patients with suspected BCR of prostate cancer after initial treatment, and a negative or equivocal PSMA PET, regardless of the findings on conventional imaging. Initial treatment may include prostatectomy and/or radiation therapy.

    • PSA of 0.2 ng/mL or higher within 45 days of the scan.

    Exclusion Criteria:
    • Uncontrolled serious infection.

    • Intercurrent illness or condition that would limit compliance with study requirements.

    • Patients who have undergone any cancer treatment (systemic or radiation therapy) or who have started any supplements or herbal medications intended to treat cancer between the PSMA PET and Axumin PET/CT scans.

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Oreogn Health & Science University Portland Oregon United States 97239

    Sponsors and Collaborators

    • OHSU Knight Cancer Institute
    • Blue Earth Diagnostics, Inc
    • Oregon Health and Science University

    Investigators

    • Principal Investigator: Nadine Mallak, M.D., OHSU Knight Cancer Institute

    Study Documents (Full-Text)

    None provided.

    More Information

    Publications

    None provided.
    Responsible Party:
    Nadine Mallak, MD, Principal Investigator, OHSU Knight Cancer Institute
    ClinicalTrials.gov Identifier:
    NCT05722925
    Other Study ID Numbers:
    • STUDY00024659
    First Posted:
    Feb 10, 2023
    Last Update Posted:
    Feb 10, 2023
    Last Verified:
    Feb 1, 2023
    Studies a U.S. FDA-regulated Drug Product:
    Yes
    Studies a U.S. FDA-regulated Device Product:
    No
    Additional relevant MeSH terms:

    Study Results

    No Results Posted as of Feb 10, 2023