News | Prostate Cancer | June 13, 2018

PET/CT Changes Care for 59 Percent of Suspected Recurrent Prostate Cancer Cases

Topline results presented at AUA 2018 evaluate clinical utility of 18F fluciclovine PET/CT imaging in men with recurrent prostate cancer following prior treatment

PET/CT Changes Care for 59 Percent of Suspected Recurrent Prostate Cancer Cases

June 13, 2018 — A recently presented investigational clinical trial evaluated the impact of 18F fluciclovine positron emission tomography/computed tomography (PET/CT) imaging on patient management of biochemically recurrent prostate cancer after initial prostate cancer treatment and negative or equivocal findings on standard-of-care imaging. The LOCATE trial is a prospective, multi-center, open-label study (NCT02680041) conducted at 15 sites in the United States. Its primary endpoint measured the percentage of men with suspected biochemical recurrence of prostate cancer following initial prior therapy whose treatment plan was changed following an 18F fluciclovine PET/CT scan.

Axumin (fluciclovine F 18 injection) is a U.S. Food and Drug Administration (FDA)-approved molecular imaging agent for use in PET imaging in men with suspected prostate cancer recurrence; suspicion of prostate cancer recurrence is based on elevated blood levels of prostate specific antigen (PSA) following prior treatment.

The LOCATE trial recorded a patient’s intended treatment plan prior to 18F fluciclovine PET/CT and then recorded how it was altered after patients and their physicians had reviewed the results of the scan. Results of the trial indicated that 59 percent (126/213) of patients had their clinical management changed when results of the 18F fluciclovine PET/CT imaging were added to the diagnostic work-up. Of those changes, 78 percent (98/126) were classified as “major” (i.e., a change in treatment modality).

The topline results were presented in a Moderated Poster Session at the American Urological Association (AUA) 2018 annual meeting, May 18-21 in San Francisco. Results were presented by Gerald L. Andriole, M.D., Robert K. Royce Distinguished Professor and chief of urologic surgery at Washington University School of Medicine, St. Louis, on behalf of the LOCATE study group.

The LOCATE trial prospectively enrolled men with suspected biochemical recurrence of prostate cancer based on rising PSA levels following previous curative-intent treatment, and with negative or equivocal findings on standard-of-care imaging. The primary endpoint was to measure the percentage of patients with suspected biochemical recurrence of prostate cancer after therapy for primary disease whose planned treatment was altered following imaging with 18F fluciclovine PET/CT. Of the 128 patients whose original treatment plan was salvage radiation therapy (with or without androgen deprivation therapy [ADT]), 51 percent (65/128) had their treatment changed after 18F fluciclovine PET/CT. Of the 60 patients originally planned to be treated with ADT, 45/60 (75 percent) had their treatment changed to a non-systemic salvage treatment after 18F fluciclovine PET/CT; thirty of these were changed to a non-systemic salvage treatment and 11 to watchful waiting. The safety profile of 18F fluciclovine in the LOCATE trial is consistent with that described in the approved U.S. Prescribing Information.

“The results showed that management plans were revised for the majority of patients, and that 78 percent of such revisions involved a change in treatment modality. While investigation of the long-term clinical outcomes of these changes in management is warranted, these results indicate that decisions based on 18F fluciclovine PET/CT findings may facilitate appropriate management in men with suspected biochemical recurrence of prostate cancer,” said Andriole.

“Up to 30 percent of patients with prostate cancer will develop local or distant recurrences within 10 years of radical prostatectomy or radiation therapy, and determining the extent and location of recurrent disease optimizes the selection of appropriate treatment,” said Lale Kostakoglu, M.D., MPH, professor of radiology and chief of nuclear medicine, Icahn School of Medicine at Mount Sinai, New York, and member of one of the LOCATE study group’s leading enrollment sites. “The LOCATE study demonstrated that imaging with 18F fluciclovine PET/CT revealed one or more sites of disease recurrence in men with biochemically recurrent prostate cancer who were scanned, and based on the pattern of recurrence, resulted in a change in management after the scan in 59 percent of the patients.”

For more information: www.blueearthdiagnostics.com

Related Content

Noninvasive Radioablation Offers Long-term Benefits to High-risk Heart Arrhythmia Patients
News | Radiation Therapy | September 17, 2019
September 17, 2019 — Treating high-risk heart patients with a single, high dose of...
Long-term Hormone Therapy Increases Mortality Risk for Low-PSA Men After Prostate Surgery
News | Prostate Cancer | September 16, 2019
Secondary analysis of a recent clinical trial that changed the standard of care for men with recurring prostate cancer...
Isoray to Spotlight Cesium-131 Advances at ASTRO Annual Meeting
News | Brachytherapy Systems | September 13, 2019
Isoray Inc. announced it will spotlight the growing cancer treatment applications of Cesium-131 brachytherapy at the...
RefleXion Highlights Novel Approach to Radiotherapy at ASTRO 2019

The RefleXion X1 Machine without the Gantry Cover. The patented technology incorporates PET imaging data, which enables tumors to continuously signal their location. Image courtesy of Reflexion Medical.

News | Radiation Therapy | September 12, 2019
Therapeutic oncology company RefleXion Medical announced it will showcase the RefleXion X1 Machine at the American...
ASNC Announces Multisocietal Cardiac Amyloidosis Imaging Consensus
News | Cardiac Imaging | September 09, 2019
September 9, 2019 — The American Society of Nuclear Cardiology (ASNC) published a new expert consensus document along
The irregularly marginated left tumor mass that bulges the lateral capsule appears three times the volume on the multiplanar 3-D/4-D image reconstruction and shows complete extraprostatic extension

Figure 1. 2-D (top) vs 3-D (bottom). The irregularly marginated left tumor mass that bulges the lateral capsule appears three times the volume on the multiplanar 3-D/4-D image reconstruction and shows complete extraprostatic extension. Note: This anterolateral lesion is not clinically palpable.

Feature | Prostate Cancer | September 05, 2019 | By Robert Bard, M.D., DABR, FASLM
Extracapsular extension (ECE) is a major clinical indicator for brachytherapy or external beam treatment of prostate
A 3-D printed tungsten pre-clinical X-ray system collimator. 3D printed, additive manufacturing for medical imaging.

A 3-D printed tungsten pre-clinical X-ray system collimator. The tungsten alloy powder is printed into the form desired and is laser fused so it can be machined and finished. Previously, making collimators from Tungsten was labor intensive because it required working with sheets of the metal to create the collimator matrix. 

Feature | Medical 3-D Printing | September 04, 2019 | By Steve Jeffery
In ...
News | Contrast Media | September 03, 2019
Researchers in South Korea have found that patients with family and personal history of allergic reactions to contrast...
A SPECT nuclear scan of the heart to show perfusion defects in the myocardium due to coronary artery blockages or heart attack. The imaging uses the Mo-99 based medical imaging isotope Tc-99m. The U.S. government has created policy to move away from use of highly enriched uranium (HEU) to low-enriched uranium (LEU) for Mo-99 isotope production, but there is one hold out who has not yet converted before a 2020 deadline. Photo courtesy of Philips Healthcare.

A SPECT nuclear scan of the heart to show perfusion defects in the myocardium due to coronary artery blockages or heart attack. The imaging uses the Mo-99 based medical imaging isotope Tc-99m. The U.S. government has created policy to move away from use of highly enriched uranium (HEU) to low-enriched uranium (LEU) for Mo-99 isotope production, but there is one holdout who has not yet converted before a 2020 deadline. Photo courtesy of Philips Healthcare.

Feature | Nuclear Imaging | August 30, 2019 | Dave Fornell, Editor
In a surprising move, the National Institute for Radioelements (IRE) has applied for a new license to export highly e
An example of a treatment plan for radio-ablation of the heart to noninvasively treat cardiac arrhythmias. This concept is one of the key presentations at the 2019 ASTRO meeting. Image courtesy of Cyberheart. #ASTRO19 #ASTRO2019 #ASTRO

An example of a treatment plan for radio-ablation of the heart to noninvasively treat cardiac arrhythmias. This concept is one of the key presentations at the 2019 ASTRO meeting. Image courtesy of Cyberheart.

Feature | ASTRO | August 29, 2019