NCT04175431

Brief Summary

This phase II trial studies how well prostate specific membrane antigen (PSMA) or fluciclovine positron emission tomography (PET)/computed tomography (CT) site-directed therapy works for treating patients with prostate cancer. PSMA or fluciclovine PET/CT may detect prostate cancer early and may help to show whether patients benefit from site directed treatment to PET detected abnormalities.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
100

participants targeted

Target at P50-P75 for phase_2

Timeline
87mo left

Started Sep 2020

Longer than P75 for phase_2

Geographic Reach
1 country

2 active sites

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress44%
Sep 2020Jul 2033

First Submitted

Initial submission to the registry

November 7, 2019

Completed
18 days until next milestone

First Posted

Study publicly available on registry

November 25, 2019

Completed
10 months until next milestone

Study Start

First participant enrolled

September 30, 2020

Completed
7.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

July 1, 2028

Expected
5 years until next milestone

Study Completion

Last participant's last visit for all outcomes

July 1, 2033

Last Updated

December 18, 2025

Status Verified

December 1, 2025

Enrollment Period

7.8 years

First QC Date

November 7, 2019

Last Update Submit

December 16, 2025

Conditions

Outcome Measures

Primary Outcomes (1)

  • Undetectable PSA (< 0.2 ng/mL) rate

    At 2 years

Secondary Outcomes (6)

  • Total testosterone

    Up to 7 years

  • Median time to reinitiation of antiandrogen therapy (ADT)

    Up to 7 years

  • Overall survival

    Up to 7 years

  • Number of patients with abnormalities within the prostatic fossa with PSA < 10 ng/mL

    Up to 7 years

  • Number of patients without abnormalities with PSA < 10 ng/mL

    Up to 7 years

  • +1 more secondary outcomes

Study Arms (3)

Group I (fluciclovine PET/CT)

ACTIVE COMPARATOR

Patients for whom initial fluciclovine or PSMA PET/CT does not reveal any abnormalities outside the prostatic fossa undergo PSA rechecks every 3 months, and undergo fluciclovine or PSMA PET/CT once PSA is \> 2 ng/ml. If still no abnormalities are found outside of the prostatic fossa, patients continue to undergo PSA rechecks every 3 months, and undergo fluciclovine or PSMA PET/CT once PSA is \> 5 ng/ml. Patients are off study for treatment plan once PSA reaches 10 ng/ml.

Procedure: Positron Emission TomographyProcedure: Computed TomographyProcedure: PSMA PET Scan

Group II (surgery, radiotherapy, abiraterone, prednisone)

EXPERIMENTAL

Patients undergo fluciclovine or PSMA PET/CT and who have =\< 3 regions of metastatic disease outside of the prostatic fossa that are amenable to metastasis-directed therapy undergo lymphadenectomy or radiation therapy. Six to ten weeks after surgery, patients receive abiraterone acetate 1000 mg PO QD and prednisone PO QD. Treatment repeats every 4 weeks for 6 cycles in the absence of disease progression or unacceptable toxicity. Patients may start radiation therapy after 2 cycles of abiraterone acetate and prednisone.

Procedure: Positron Emission TomographyProcedure: LymphadenectomyRadiation: Radiation TherapyDrug: Abiraterone AcetateDrug: PrednisoneProcedure: Computed TomographyDrug: AbirateroneProcedure: PSMA PET Scan

Group III (abiraterone, prednisone)

EXPERIMENTAL

Patients undergo fluciclovine or PSMA PET/CT and who have \> 3 regions of metastatic disease receive abiraterone acetate and prednisone as in Group II.

Procedure: Positron Emission TomographyDrug: Abiraterone AcetateDrug: PrednisoneProcedure: Computed TomographyDrug: AbirateroneProcedure: PSMA PET Scan

Interventions

Undergo fluciclovine PET/CT

Also known as: Medical Imaging, PET Scan, positron emission tomography scan, proton magnetic resonance spectroscopic imaging, Positron-Emission Tomography
Group I (fluciclovine PET/CT)Group II (surgery, radiotherapy, abiraterone, prednisone)Group III (abiraterone, prednisone)

Undergo lymphadenectomy

Also known as: Lymph Node Dissection, lymph node excision, excision of the lymph node
Group II (surgery, radiotherapy, abiraterone, prednisone)

Undergo radiation therapy

Also known as: Cancer Radiotherapy, Irradiation, Radiotherapeutics, RT, ENERGY_TYPE, Irradiated, Therapy, Radiation, NOS
Group II (surgery, radiotherapy, abiraterone, prednisone)

Given PO

Also known as: 154229-18-2, Yonsa, Zytiga, Androsta-5
Group II (surgery, radiotherapy, abiraterone, prednisone)Group III (abiraterone, prednisone)

Given PO

Also known as: Deltasone, Prednicort, Prednisone Intensol, Rayos, Sterapred, Dehydrocortisone, Prednilonga, Servisone
Group II (surgery, radiotherapy, abiraterone, prednisone)Group III (abiraterone, prednisone)

Undergo fluciclovine PET/CT

Also known as: CAT Scan, CAT, computerized axial tomography, computerized tomography, CT Scan
Group I (fluciclovine PET/CT)Group II (surgery, radiotherapy, abiraterone, prednisone)Group III (abiraterone, prednisone)

Given PO

Also known as: 154229-19-3, 17-(3-Pyridyl)androsta-5, 16-dien-3beta-ol, CB 7598
Group II (surgery, radiotherapy, abiraterone, prednisone)Group III (abiraterone, prednisone)
PSMA PET ScanPROCEDURE

Undergo PSMA PET scan

Also known as: Prostate-specific Membrane Antigen PET, PSMA PET, PSMA-Positron emission tomography
Group I (fluciclovine PET/CT)Group II (surgery, radiotherapy, abiraterone, prednisone)Group III (abiraterone, prednisone)

Eligibility Criteria

Age18 Years+
Sexmale
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Patient must have histologically or cytologically documented evidence of prostate adenocarcinoma
  • Patient must previously have undergone radical prostatectomy
  • Patient must previously have undergone either adjuvant or salvage radiation therapy to the prostatic fossa +/- whole pelvis
  • Patient must have a prostate specific antigen (PSA) \>= 0.2 and \< 10 ng/mL. If there is only one PSA value that has risen to \>= 0.2 with this biochemical recurrence, a second PSA value must be confirmed to be within \>= 0.2 and \< 10 ng/mL at least 2 weeks from the first value and within 28 days of enrollment
  • PSA doubling time must be calculated utilizing either all PSA measurements \> 0.1 ng/mL from most recent biochemically-recurred (BCR) or the most recent 3 PSA measurements \> 0.1 ng/mL (if the latter, all 3 PSA measurements must be \> 2 weeks apart to be used in the calculation). PSA doubling time must be \> 3 months and \< 18 months. The Memorial Sloan Kettering PSA doubling time calculator should be used
  • Patient must have no previous evidence of radiographically detectable metastatic prostate cancer by conventional CT and bone scan imaging
  • Patient must have total testosterone level \> 120 ng/dL demonstrated within 42 days of enrollment
  • Patient must have Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
  • Absolute neutrophil count (ANC) \>= 1.0 X 10\^9/L
  • Platelet count \>= 100 X 10\^9/L
  • Hemoglobin \>= 9 g/dL
  • Potassium \>= 3.5
  • Serum bilirubin =\< 1.5 X upper limit of normal (ULN) or =\< 3 X ULN for patients with documented Gilbert's syndrome
  • Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) =\< 3 X ULN
  • Creatinine clearance (Cr Cl) \>= 30 mL/min as estimated by the Cockcroft-Gault criteria or as determined by 24 hour Cr Cl measurement
  • +2 more criteria

You may not qualify if:

  • Chronic active hepatitis B or C
  • History of a second, non-prostate malignancy that required systemic therapy in the last 2 years except cancer in situ of bladder and non-melanomatous cancers of the skin
  • Patient with a serious underlying medical condition that would otherwise impair the patient's ability to undergo fluciclovine or PSMA PET/CT imaging or receive subsequent treatment
  • Any condition that would alter the patient's mental status, prohibiting understanding and/or authorization of informed consent
  • Expected lifespan of less than 12 weeks
  • Inability to lay still for imaging
  • Weight \> 300 lbs. (due to equipment specifications)
  • Any other underlying medical condition that, in the opinion of the investigator, would impair the ability of the patient to receive or tolerate the planned treatment and/or follow up

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

University of Pittsburgh Cancer Institute (UPCI)

Pittsburgh, Pennsylvania, 15232, United States

RECRUITING

Fred Hutch/University of Washington Cancer Consortium

Seattle, Washington, 98109, United States

RECRUITING

MeSH Terms

Interventions

Magnetic Resonance SpectroscopyX-RaysLymph Node ExcisionRadiotherapyRadiationAbiraterone AcetatePrednisoneabirateroneGlutamate Carboxypeptidase II

Intervention Hierarchy (Ancestors)

Spectrum AnalysisChemistry Techniques, AnalyticalInvestigative TechniquesElectromagnetic RadiationElectromagnetic PhenomenaMagnetic PhenomenaPhysical PhenomenaRadiation, IonizingSurgical Procedures, OperativeTherapeuticsAndrostenesAndrostanesSteroidsFused-Ring CompoundsPolycyclic CompoundsPregnadienediolsPregnadienesPregnanesCarboxypeptidasesExopeptidasesPeptide HydrolasesHydrolasesEnzymesEnzymes and CoenzymesMetalloexopeptidasesMetalloproteases

Study Officials

  • Evan Yu

    Fred Hutch/University of Washington Cancer Consortium

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Study Design

Study Type
interventional
Phase
phase 2
Allocation
NON RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

November 7, 2019

First Posted

November 25, 2019

Study Start

September 30, 2020

Primary Completion (Estimated)

July 1, 2028

Study Completion (Estimated)

July 1, 2033

Last Updated

December 18, 2025

Record last verified: 2025-12

Data Sharing

IPD Sharing
Will not share

Locations