Prostate Cancer Clinical Trial
Official title:
[F-18]-Fluorodeoxyglucose (FDG) Positron Emission Tomography and Computed Tomography (PET-CT) in Metastatic Prostate Cancer
This is an National Institute of Health (NIH) funded, investigator-initiated, single center
prospective study to investigate the ability of the new dual-modality positron emission
tomography and computed tomography (PET-CT) imaging systems in comparison to conventional
imaging methods in assessing treatment response in men with metastatic prostate cancer. The
investigators will enroll two groups of men with stage IV metastatic prostate cancer, each
group will be comprised of 160 patients.
- Group I: men with newly diagnosed hormone-responsive measurable metastatic disease who
will be treated with androgen-ablation therapy
- Group II: men with newly-developed hormone-refractory measurable metastatic disease who
will be treated with chemotherapy and /or other therapies for hormone refractory
disease
To be eligible, men in either group must have rising serum prostate specific antigen (PSA)
level - defined as at least 2 consecutive rises in PSA documented over a reference value
(1st measure within 28 days prior to recruitment). The first rising PSA (2nd measure) should
be taken at least 14 days after the reference value. A confirmatory PSA measure (3rd
measure) obtained at least 14 days after the 2nd measure is required and must be greater
than the 2nd measure. Additionally, patients must have a serum PSA concentration of at least
2 ng/mL in addition to increasing PSA to be eligible. Patients will be followed with the
PET-CT at 4, 8, and 12 months after the initiation of androgen ablation therapy (Group I) or
chemotherapy (Group II).
Our long-range objective is to obtain pilot data to investigate the ability of the new dual-modality positron emission tomography and computed tomography (PET-CT) imaging systems for assessing treatment response in patients with metastatic prostate cancer in comparison to conventional imaging. PET-CT is not employed here for staging; all men in this study will have stage IV metastatic prostate cancer. We believe that the combined anatomic and in-vivo metabolic imaging information provided by PET-CT allows accurate objective assessment of such critical clinical issues as early prediction and evaluation of response or resistance to various therapeutic interventions, including the novel chemotherapy regimen, as well as the prediction of key clinical outcomes such as time to hormone-refractoriness and survival. Our intermediate-range objective is therefore to investigate the diagnostic and prognostic utility of PET-CT with the most commonly available PET tracer, [F-18]-fluorodeoxyglucose (FDG), in metastatic prostate cancer. We plan to correlate the treatment-induced changes of glucose metabolism in metastatic prostate cancer lesions to the changes in various conventional clinical, laboratory, and diagnostic imaging parameters such as serum prostate-specific antigen level, lesion size, time to androgen independence, and survival. This objective is motivated by our preliminary basic science and clinical data as well as the published reports of other investigators demonstrating the pragmatic potential diagnostic and prognostic utility of FDG PET-CT in men with metastatic prostate cancer. ;
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