Marie & Jim,
It will be interesting to see if the F18-DCFBC tracer can pick up mets that the C-11 Acetate could not. Unlike the C-11 Acetate, which detects a characteristic metabolism, PSMA-linked tracers are highly specific to the cancer itself. The Ga-68 tracer that Low Road used is only available in Germany and Switzerland as far as I know.
A pilot study is like "clinical trial lite." They typically only recruit a small number of patients as a proof of concept. If it works, they expand recruitment to a larger group.
I agree that Lu-177-PSMA sounds promising. In the US, there has been some work on it at Weill Cornell. Unlike Xofigo, which is only useful for bone mets, it can treat all
mets, bone and visceral alike, as Low Road said. The "PSMA" part is a monoclonal antibody that attaches to any prostate cancer cell surface. The other part, Lu-177, is radioactive and emits both beta particles (electrons) and gamma rays. The beta particles are very short range and kill the cells they get attached to. The gamma rays can be seen by a gamma ray camera - so not only does it kill the mets, it tells you where they are.Phase II study of lutetium-177 labeled anti-prostate-specific membrane antigen (PSMA) monoclonal antibody J591 for metastatic castration-resistant prostate cancer
There's only one clinical trial I know of in the US that is still recruiting.177Lu Radiolabeled Monoclonal Antibody HuJ591 (177Lu-J591) and Ketoconazole in Patients With Prostate Cancer
The other part of Low Road's post that I found so exciting is combining PET/MRI rather than PET/CT, which potentially enables detection of much smaller mets and at lower PSA. This offers the potential to find mets even in settings like failed RP, when the PSA is still very low. I've only read about
it being used so far in Germany, Italy, and Canada.
Post Edited (Tall Allen) : 10/2/2014 4:42:56 PM (GMT-6)