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CompletedNCT03264456Updated Mar 9, 2020Results posted

Pretreatment Staging of High-Risk Prostate Cancer With 18F-Fluciclovine PET/MRI

A Phase 1/2 interventional study of [18F] Fluciclovine PET/MRI and [18F] fluciclovine in Prostate Cancer, sponsored by University of Alabama at Birmingham. Completed at 1 site in United States. Open to male participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2020-03-09.

Sponsored by University of Alabama at Birmingham · Phase 1/2, Interventional, and Diagnostic

Phase
Phase 1/2
Study type
Interventional
Enrollment
18
Allocation
Not applicable
Ages
18 Years and older
Sex
Male
01

Study summary

There is great need for improved preoperative imaging in men with high-risk prostate cancer. Investigators propose to develop and validate an optimized simultaneous PET/MRI protocol for local, regional and whole body preoperative staging in a single imaging session using the amino acid PET tracer, F-18 fluciclovine. Despite advances in the diagnosis and treatment of prostate cancer, the preoperative staging of men with prostate carcinoma (PCa) is currently problematic. Conventional imaging is falsely negative for regional lymph node metastases in a substantial fraction of men. In particular, approximately 35% of men with high-risk prostate cancer will have biochemical recurrence even after optimal surgical resection. A major benefit of simultaneous acquisition of a multiparametric prostate MRI (mpMRI) and F-18 fluciclovine PET includes having the patient undergo a single imaging study which provides both anatomic and molecular characterization of the tumor, including metastases which would potentially be missed by conventional anatomic imaging and size criteria. Additionally, simultaneous acquisition will improve co-registration of the PET and MR data which is valuable for small lesions and in anatomically complex regions. Although the use of fluciclovine in the characterization of the primary PCa remains to be established, the anatomic detail provided by conventional mpMRI will complement the detection of small volume metastatic disease by fluciclovine PET. Additionally, the use of hybrid PET/MRI technology allows for the assessment of dynamic tracer uptake and washout during the whole body and regional PET/MRI scan, which may demonstrate the ability to increase detection of the primary PCa on fluciclovine PET. If F-18 fluciclovine PET/MRI can reliably and accurately detect nodal metastases in high-risk prostate cancer patients, surgeons may use this new technology to develop new treatment algorithms for the optimal management of these patients.

02

Conditions studied

  • Prostate Cancer

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03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
Male
Accepts healthy volunteers
No

Inclusion criteria

  • High-risk biopsy-proven treatment-naïve prostate adenocarcinoma (Gleason score ≥ 8 and/or serum PSA > 20)

Exclusion criteria

Exclusion Criteria:

  • Inability to tolerate or undergo PET/MRI
  • Previous or current hematologic or lymphatic disorder (including leukemia, lymphoma, Castleman's disease, etc.)
  • Recurrent prostate adenocarcinoma
  • Known visceral, osseous, or extrapelvic metastases prior to fluciclovine-PET/MRI
  • Known allergy to glucagon or gadolinium-based contrast
04

Study design

Phase
Phase 1 / Phase 2
Primary purpose
Diagnostic
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
18 participants (actual)

Study arms

  • Experimental
    [18F] Fluciclovine PET/MRI

    \[18F\] Fluciclovine PET/MRI for pretreatment staging of high-risk prostate cancer

    Diagnostic Test: [18F] Fluciclovine PET/MRI · Drug: [18F] fluciclovine

Interventions

  • Diagnostic test[18F] Fluciclovine PET/MRI

    \[18F\] fluciclovine PET/MRI

  • Drug[18F] fluciclovine

    \[18F\] fluciclovine

05

What researchers measure

Primary outcomes

  1. Number of Patients With Primary Lesions Detected

    Number of patients with primary lesions detected on 18-F fluciclovine PET/MRI

    Time frame: Baseline through 24 hr

  2. Number of Patients With Nodal Metastases Detected on Fluciclovine-PET/MRI

    Number of patients with nodal metastases detected on \[18F\]fluciclovine PET/MRI

    Time frame: Baseline through 24 hours

Secondary outcomes

  1. Number of Patients With Nodal Metastases Detected on PET/MRI vs. MRI

    Compare number of patients with nodal metastases detected on \[18F\]fluciclovine PET/MRI to number of patients with metastases detected on prostate MRI alone.

    Time frame: Baseline through 24 hours

  2. Follow-up

    Changes in primary lesion maximum SUV between pretreatment PET/MRI and followup PET/MRI following 8 weeks of androgen deprivation therapy (ADT)

    Time frame: Baseline through 8 weeks

06

Results

Posted Jan 22, 2020

Participant flow

Participant flow — Overall Study
Milestone[18F] Fluciclovine PET/MRI
Started18
Completed14
Not completed4
Withdrew: Withdrawal by subject3
Withdrew: Lost to follow-up1

Outcome measures

PrimaryNumber of Patients With Primary Lesions Detected

Number of patients with primary lesions detected on 18-F fluciclovine PET/MRI

Time frame:
Baseline through 24 hr
Reported as:
Count of participants · Participants
Number of Patients With Primary Lesions Detected
Participants[18F] Fluciclovine PET/MRI
Number of Patients With Primary Lesions Detected14
PrimaryNumber of Patients With Nodal Metastases Detected on Fluciclovine-PET/MRI

Number of patients with nodal metastases detected on \[18F\]fluciclovine PET/MRI

Time frame:
Baseline through 24 hours
Reported as:
Count of participants · Participants
Number of Patients With Nodal Metastases Detected on Fluciclovine-PET/MRI
Participants[18F] Fluciclovine PET/MRI
Number of Patients With Nodal Metastases Detected on Fluciclovine-PET/MRI7
SecondaryNumber of Patients With Nodal Metastases Detected on PET/MRI vs. MRI

Compare number of patients with nodal metastases detected on \[18F\]fluciclovine PET/MRI to number of patients with metastases detected on prostate MRI alone.

Time frame:
Baseline through 24 hours
Reported as:
Count of participants · Participants
Number of Patients With Nodal Metastases Detected on PET/MRI vs. MRI
Participants[18F] Fluciclovine PET/MRI
MR alone3
PET/MRI7
SecondaryFollow-up

Changes in primary lesion maximum SUV between pretreatment PET/MRI and followup PET/MRI following 8 weeks of androgen deprivation therapy (ADT)

Time frame:
Baseline through 8 weeks
Reported as:
Mean · standardized uptake values
Follow-up
standardized uptake values[18F] Fluciclovine PET/MRI
Pretreatment maximum SUV7.1 ± 1.7
Maximum SUV after 8 weeks of ADT3.5 ± 2.0

Adverse events

Collected over Baseline through 8 week follow-up scan. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
[18F] Fluciclovine PET/MRI0/14 (0%)0/14 (0%)0/14 (0%)

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)[18F] Fluciclovine PET/MRI
<=18 years0
Between 18 and 65 years8
>=65 years6
Age, Continuous
Age, Continuous(years)[18F] Fluciclovine PET/MRI
Mean65.6 (50 to 81)
Sex: Female, Male
Sex: Female, Male(Participants)[18F] Fluciclovine PET/MRI
Female0
Male14
Race (NIH/OMB)
Race (NIH/OMB)(Participants)[18F] Fluciclovine PET/MRI
American Indian or Alaska Native0
Asian0
Native Hawaiian or Other Pacific Islander0
Black or African American7
White7
More than one race0
Unknown or Not Reported0
Region of Enrollment
Region of Enrollment(participants)[18F] Fluciclovine PET/MRI
United States14
07

Study locations

1 site
  • University of Alabama at Birmingham Medical Center
    Birmingham, Alabama 35249, United States
08

References and documents

Publications

  • Galgano SJ, McDonald AM, Rais-Bahrami S, Porter KK, Choudhary G, Burgan C, Bhambhvani P, Nix JW, Morgan DE, Li Y, Thomas JV, McConathy J. Utility of 18F-Fluciclovine PET/MRI for Staging Newly Diagnosed High-Risk Prostate Cancer and Evaluating Response to Initial Androgen Deprivation Therapy: A Prospective Single-Arm Pilot Study. AJR Am J Roentgenol. 2021 Sep;217(3):720-729. doi: 10.2214/AJR.20.24509. Epub 2020 Oct 14. PubMed 33052718 ↗

Study documents

  • Protocol and statistical analysis plan · Sep 11, 2019

Documents are hosted by the registry — open the source record to download them.

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Registry details

Key details

Study ID
NCT03264456
Lead sponsor
University of Alabama at Birmingham
Responsible party
Samuel Joseph Galgano (Principal Investigator, University of Alabama at Birmingham) — Principal investigator
First posted
Aug 29, 2017
Start date
Nov 8, 2017
Primary completion
Jan 30, 2019
Completion
Feb 13, 2020
Results posted
Jan 22, 2020
Last update
Mar 9, 2020

Study contacts

Samuel Galgano, MD
principal investigator · University of Alabama at Birmingham

Oversight

FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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