Exploratory study of 18F-fluciclovine pet/ct for response assessment to docetaxel in patients with metastatic castration-resistant prostate cancer.

Monitoring therapeutic response in patients with metastatic castration-resistant prostate cancer (mCRPC) can be challenging. We set out to determine if 18F-fluciclovine PET/CT could be a useful imaging biomarker for response to docetaxel chemotherapy in patients with mCRPC. Seven patients with mCRPC had 18F-fluciclovine PET/CT scheduled at baseline and after 1 and 6 cycles of chemotherapy. The sum of SUVmax from the prostate/bed and up to 5 metastatic bone and soft tissue/visceral lesions were recorded. The SUVpeak of the hottest lesion (PERCIST-like) was also recorded. In comparison to the baseline scan, a decrease of ≥30% was considered response; new lesions or >30% increase was progressive disease; change of <30% was stable disease. Bone scintigraphy and CT were acquired at baseline and after the 6th cycle. Response assessment was based on the Prostate Cancer Clinical Trial Working Group 3 recommendations. All (7/7) enrolled patients completed the 1st and 2nd scans, while 4/7 patients completed all 3 scans. PET response correlated with PSA response in 3/7 (42.9%) patients after 1 cycle of docetaxel, and 3/4 (75%) patients after 6 cycles of docetaxel, respectively. Bone scan and CT correlated with PSA response in 1/4 (25%) patients. There was no significant correlation between baseline 18F-fluciclovine PET parameters or changes in PET parameters and time to PSA progression. In conclusion, this exploratory study showed that 18F-fluciclovine PET/CT has better correlation with PSA response than CT or bone scan in patients with mCRPC treated with docetaxel. 18F-fluciclovine PET/CT however did not predict time to PSA progression.

American journal of nuclear medicine and molecular imaging. 2021 Jun 15*** epublish ***

Akinyemi A Akintayo, Mehmet A Bilen, Olayinka A Abiodun-Ojo, Omer Kucuk, Bradley Carthon, Zengjia Chen, Ashesh B Jani, Ephraim E Parent, David M Schuster

Department of Radiology and Imaging Sciences, Emory University Hospital 1364 Clifton Road, Atlanta, GA 30322, USA., Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University Atlanta, GA, USA., Department of Radiation Oncology Emory University School of Medicine Atlanta, GA, USA., Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health Atlanta, Georgia, USA., Department of Radiology, Mayo Clinic Jacksonville, Florida, USA.

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