Clinical Research Papers:

Early outcome prediction on 18F-fluorocholine PET/CT in metastatic castration-resistant prostate cancer patients treated with abiraterone

Ugo De Giorgi _, Paola Caroli, Salvatore L. Burgio, Cecilia Menna, Vincenza Conteduca, Emanuela Bianchi, Francesca Fabbri, Elisa Carretta, Dino Amadori, Giovanni Paganelli and Federica Matteucci

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Oncotarget. 2014; 5:12448-12458. https://doi.org/10.18632/oncotarget.2558

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Ugo De Giorgi1, Paola Caroli2, Salvatore L. Burgio1, Cecilia Menna1, Vincenza Conteduca1, Emanuela Bianchi1, Francesca Fabbri3, Elisa Carretta3, Dino Amadori1, Giovanni Paganelli2, Federica Matteucci2

1Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.) IRCCS, Meldola, Italy

2Department of Nuclear Medicine, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.) IRCCS, Meldola, Italy

3Biostatistics and Clinical Trials Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.) IRCCS, Meldola, Italy

Correspondence to:

Ugo De Giorgi, e-mail: [email protected]

Keywords: Abiraterone, Castration-resistant prostate cancer, 18F-fluorocholine positron emission tomography, PSA, Bone flare

Received: August 13, 2014     Accepted: October 01, 2014     Published: October 11, 2014


Objective: We investigated the role of 18F-fluorocholine positron emission tomography/computed tomography (FCH-PET/CT) in the early evaluation of abiraterone and outcome prediction in patients with metastatic castration-resistant prostate cancer (CRPC).

Patient and methods: Forty-three patients with metastatic CRPC progressing after docetaxel received abiraterone 1,000 mg daily with prednisone 5 mg twice daily. Patients were evaluated monthly for serological PSA response and safety. FCH-PET/CT was done at baseline and after 3 to 6 weeks. Univariate and multivariate Cox regression models addressed potential predictors of progression-free survival (PFS) and overall survival (OS).

Results: Declines in PSA level of ≥50% were seen in 21 of 43 (49%) patients. Forty-two patients were evaluable for FCH-PET/CT response. FCH-PET/CT bone flare was observed in 4 of 42 (10%) evaluable patients. In univariate analysis, PSA decline and FCH-PET/CT response predicted PFS, while PSA decline and FCH-PET/CT (progression vs non progression) predicted OS. In multivariate analysis, only FCH-PET/CT (progression vs nonprogression) remained significant for PFS and OS (p = 0.022 and p = 0.027, respectively).

Conclusion: Early FCH-PET/CT can predict clinical outcome in CRPC beyond PSA response. These data support further studies on FCH-PET/CT for abiraterone monitoring and outcome prediction in patients with CRPC.

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