One in seven men will
develop prostate cancer in his lifetime, suggests the American Cancer Society. In 2017, more than 161,000 new
cases of prostate cancer are expected to be diagnosed in the United States, and
about 26,730 deaths from the disease are anticipated.
The featured clinical investigation article of the March 2017 issue of the Journal of Nuclear Medicine
demonstrates that the PET radiotracer fluciclovine (fluorine-18; F-18)
can help guide and monitor targeted treatment for recurrent prostate
cancer, allowing for individualized, targeted therapy.
‘The PET radiotracer fluciclovine can help guide and monitor targeted treatment for recurrent prostate cancer, allowing for individualized, targeted therapy.’
"This is the first study of its kind demonstrating changes in
post-surgery radiotherapy target design with advanced molecular imaging
in recurrent prostate cancer, with no demonstrated increase in early
radiotherapy side effects," explains Ashesh B. Jani of the Winship
Cancer Institute of Emory University, Atlanta, Georgia.
For the study, 96 patients were enrolled in a clinical trial of
radiotherapy for recurrent prostate cancer after prostatectomy. All
patients underwent initial treatment planning based on results from
conventional abdominopelvic imaging (CT or MRI). 45 of the
patients then underwent treatment-planning modification (better defining
the tumor-targeted area) after additionally undergoing abdominopelvic
F-18-fluciclovine PET/CT. No increase in toxicity was observed with this
The Emory researchers determined that the inclusion of
F-18-fluciclovine PET information in the treatment planning process
leads to significant differences in target volumes (the areas to receive
radiotherapy). It did result in higher radiation dose delivered to the
penile bulb, but no significant differences in bladder or rectal
radiation dose or in acute genitourinary or gastrointestinal toxicity.
These are preliminary results in a three-year study, which
hypothesizes that there will be an increase in disease-free survival for
patients in the F-18-fluciclovine-modified treatment group over those
in the standard treatment group.
This study could have implications beyond prostate cancer, Jani
points out, "Our methodology is readily applicable to other novel
imaging agents, and it may potentially facilitate improvement of cancer