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The Impact of Positron Emission Tomography with 18F-Fluciclovine on the Treatment of Biochemical Recurrence of Prostate Cancer: Results from the LOCATE Trial.
- Source :
-
The Journal of urology [J Urol] 2019 Feb; Vol. 201 (2), pp. 322-331. - Publication Year :
- 2019
-
Abstract
- Purpose: The prospective, multicenter LOCATE (F Fluciclovine [FACBC] PET/CT in Patients with Rising PSA after Initial Prostate Cancer Treatment) trial assessed the impact of positron emission tomography/computerized tomography with F-fluciclovine on treatment plans in patients with biochemical recurrence of prostate cancer after primary therapy with curative intent.<br />Materials and Methods: Men who had undergone curative intent treatment of histologically confirmed prostate cancer but who were suspected to have recurrence based on rising prostate specific antigen levels were enrolled prospectively. Each man had negative or equivocal findings on standard of care imaging. F-fluciclovine positron emission tomography/computerized tomography was performed according to standardized protocols. Treating physicians completed a questionnaire regarding the patient treatment plan before and after scanning, recording changes to the treatment modality (eg salvage radiotherapy to systemic androgen deprivation therapy) as major and changes in a modality (eg modified radiotherapy fields) as other.<br />Results: Between June 2016 and May 2017, 213 evaluable patients with a median age of 67 years and median prostate specific antigen 1.00 ng/ml were enrolled in study. F-fluciclovine avid lesions were detected in 122 of the 213 patients (57%). Overall 126 of the 213 patients (59%) had a change in management after the scan, which were major in 98 of 126 (78%) and in 88 (70%) were informed by positive positron emission tomography/computerized tomography findings. The most frequent major changes were from salvage or noncurative systemic therapy to watchful waiting (32 of 126 cases or 25%), from noncurative systemic therapy to salvage therapy (30 of 126 or 24%) and from salvage therapy to noncurative systemic therapy (11 of 126 or 9%).<br />Conclusions: F-fluciclovine positron emission tomography/computerized tomography detected 1 or more recurrence sites in the majority of men with biochemical recurrence, frequently resulting in major changes to management plans. Future studies will be planned to determine whether a management change leads to improved outcomes.
- Subjects :
- Aged
Aged, 80 and over
Clinical Decision-Making
Humans
Kallikreins blood
Male
Middle Aged
Neoplasm Recurrence, Local blood
Neoplasm Recurrence, Local pathology
Neoplasm Recurrence, Local therapy
Patient Selection
Prospective Studies
Prostate diagnostic imaging
Prostate pathology
Prostate-Specific Antigen blood
Prostatic Neoplasms blood
Prostatic Neoplasms pathology
Prostatic Neoplasms therapy
Carboxylic Acids administration & dosage
Cyclobutanes administration & dosage
Neoplasm Recurrence, Local diagnostic imaging
Positron Emission Tomography Computed Tomography methods
Prostatic Neoplasms diagnostic imaging
Radiopharmaceuticals administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1527-3792
- Volume :
- 201
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- The Journal of urology
- Publication Type :
- Academic Journal
- Accession number :
- 30179618
- Full Text :
- https://doi.org/10.1016/j.juro.2018.08.050