carbon-11 acetate and fludeoxyglucose f 18 pet scan of the bone in patients with metastatic prostate cancer that has spread to the bone

Conditions: Metastatic Cancer; Prostate Cancer

Summary: rationale: imaging procedures, such as pet scan, may help doctors predict a patient's response to treatment and help plan the best treatment. purpose: this clinical trial is studying carbon-11 acetate and fludeoxyglucose f 18 pet scan of the bone in patients with metastatic prostate cancer that has spread to the bone.

objectives: primary * correlate pre-treatment and 3-month post-treatment carbon-11 (\^11c) acetate and fludeoxyglucose f 18 positron emission tomography (\^18f-fdg pet) images with changes in clinical response measures in patients with bone-dominant metastatic prostate cancer. secondary * compare \^11c acetate and \^18f-fdg pet scanning results with bone scintigraphy in these patients to determine which best predicts clinical response. * correlate changes in \^11c acetate and \^18f-fdg pet with changes in prostate-specific antigen level. * correlate changes in \^11c acetate and \^18f-fdg pet with clinical symptom parameters (pain scale scores and analgesic usage scales). * correlate \^11c acetate and \^18f-fdg pet scan response with clinical time to progression. * determine if pet scan response can predict duration of progression-free survival. outline: this is a pilot study. patients are stratified according to hormone response (sensitive \[stratum 1\] vs refractory \[stratum 2\]). patients undergo carbon-11 acetate and fludeoxyglucose f 18 positron emission tomography imaging prior to and 3 months after initiation of either androgen-deprivation therapy (stratum 1) or docetaxel (stratum 2). pain and quality of life are assessed at baseline and at 3 months. patients are followed every 3 months for up to 5 years. projected accrual: a total of 40 patients will be accrued for this study.

Eligibility criteria:
disease characteristics: * diagnosis of prostate cancer, meeting 1 of the following criteria: * metastatic hormone-sensitive disease prior to initiation of first-line androgen-deprivation therapy and meets the following criteria: * histologic confirmation of original diagnosis * hormone-sensitive is defined as progressive disease in the absence of androgen-deprivation therapy * presence of ≥ 3 convincing bone metastases, as defined by bone scintigraphy, ct scan (mri if indicated), or plain x-ray * metastatic hormone-refractory disease prior to initiation of a first-line chemotherapy regimen that includes docetaxel and meets the following criteria: * histologic confirmation of original diagnosis * hormone-refractory is defined as development or advancement of metastatic disease with castrate testosterone levels (total testosterone \< 20 ng/dl) * presence of ≥ 3 convincing bone metastases, as defined by bone scintigraphy, ct scan (mri if indicated), or plain x-ray * must have castrate testosterone levels (\< 20 ng/dl) from orchiectomy or undergoing maintenance with a luteinizing hormone-releasing hormone agonist * outside the window of a potential antiandrogen withdrawal response (either decline in prostate-specific antigen or objective response by imaging) patient characteristics: * life expectancy \> 12 weeks * no serious underlying medical condition that would otherwise impair the patient's ability to receive treatment and undergo imaging studies * no condition that would alter the patient's mental status, prohibiting the basic understanding and/or authorization of informed consent * able to lie still for the imaging * weight ≤ 300 lbs prior concurrent therapy: * see disease characteristics * at least 6 weeks since prior bicalutamide or nilutamide * at least 4 weeks since prior flutamide, ketoconazole, diethylstilbestrol, or estradiol * more than 4 weeks since prior bisphosphonate therapy * more than 4 weeks since prior radiotherapy to the bone * more than 4 weeks since prior radiopharmaceutical treatment to the bone * no concurrent radiotherapy

Keywords: recurrent prostate cancer stage iv prostate cancer bone metastases