"Re the topic of axumin, I was told that for FDA approval axumin was approved for soft tissue, not about bones, and no studies have been done by them relate to bones, even though some anecdotal evidence might mention bones." diller
Does anyone have any comments or thoughts or info on Auximin scan effectiveness for Bone vs tissue metastatsises?
I had the Axumin scan after bone scan showed nothing. Axumin found mets on my coll
He was not given correct info. Axumin was approved for ALL recurrences.
fda.gov/newsevents/newsroom...
It detected mets in bones or soft tissue in all studies using it.
Correct!
Below is comprehensive information regarding the radiotracer/isotope fluciclovine (Axumin) for isolating location of prostate cancer cell activity. After 26 years of usual imaging unable to identify location of my continuing prostate cancer evidenced by PSA elevation whenever I took a break from ADT medications, my recent administration of fluciclovine followed by F18 PET/CT imaging from top of head down to mid-thigh finally determined no bone metastasis anywhere, but a 1cm of prostate cancer cell activity near the area of where my urethra was reattached to my bladder neck “26 years ago!” I will complete five targeted radiation treatments of 600 cGy tomorrow that was administered from a Thursday, to following Tuesday and Thursday, to this week final Tuesday and Thursday for a total of 3000 cGy. Obvious hope is my prostate cancer will finally be totally eradicated and my 26 years of the variety of ADT medications coming to an end!
Will wait a month and check PSA level and about 4 weeks to let the fractured DNA to disburse before having an MRI to see if that activity has disappeared.
Axumin/fluciclovine F18 PET/CT Imaging for recurrent Prostate CancerAxumin PET Agent Added to NCCN Guidelines for Suspected Recurrent Prostate Cancer itnonline.com/content/axumi...
Guidelines state PET/CT or PET/MRI with F-18 fluciclovine should be considered in clinical workup of patients with recurrent or progressing prostate cancer
Note, specifically that Axumin received Transitional Pass-Through Status in the Hospital Outpatient Prospective Payment System 2017 Final Rule from the Centers for Medicare & Medicaid Services (CMS), effective since Jan. 1, 2017. This also provides a product-specific A-code (A9588) for use with Medicare and private insurer patient claims. Axumin is currently available from 18 radiopharmacies throughout the United States, with additional manufacturing sites planned for 2018.
Tall Allen,
Looking at your chart here:
pcnrv.blogspot.com/2017/06/...
It seems that Auximin and psma scan are basically about the same at 2.0 PSA and maybe at lower levels of PSA.
So is there any reason to favor psma scans over Auximin scans.
It depends on the decision one is faced with. Many people who want a PET scan want it to rule out distant mets so that salvage RT is not futile. They would want it at the lowest PSA possible. For men who already know they have disant mets and whose PSA is, say, over 20, and they are tracking progression while on systemic therapy, they don't even need a PET scan, a bone scan will suffice. There is a discussion of "PET Scan Uses" in a subsection of this article:
Where are the F18-DCFPyL psma locations?
Do you mean where can you get such scans?
Yes the F18-DCFPyL scans
Among the places, Germany and Australia. Australia is cheapest.
UCSF has clinical studies, but you need to meet their criteria.
I am there's others. But is it off the top of my head.
Maybe you should start a new message thread on this topic alone so we can start a more complete list.
It is not available in Australia, Germany or at UCSF. The DCFPyL PET scan is only available in open clinical trials in a few places. Whether one qualifies depends on your clinical situation. There are often charges. Here's a complete list:
clinicaltrials.gov/ct2/resu...
It is free at NIH. They have added the restriction that recurrent PSA must be over 0.5 (not just 0.2) post-prostatectomy and the waiting list is over 2 months.
Tall Allen
Was I mistaking another type of psma scan for DCFPyL pmsa scan?
Yes - the Ga-68-PSMA-11 PET scan, which is not quite as accurate at lower PSAs. The F18 PSMA-based scans are more accurate. DCFPyL was developed at Johns Hopkins. There was a large multi-institutional clinical trial (OSPREY) for which we are awaiting results. Hopefully, FDA approval will follow. There is a new F18 PSMA-based scan called F18-PSMA-1007 that may prove to be even better because it is not urine-excreted. It is in clinical trials in Germany and elsewhere.
Tall Allen
F18-PSMA-1007 sounds very interesting. If not excreted by kidney, is it excreted by liver?
Where in Germany is it being trialed?
Yes, the liver mostly. Avoids masking the urinary area.
Here's some more info about it:
pcnrv.blogspot.com/2018/07/...
It was tested at Heidelberg, Technical University Munich and German Cancer Research Center.
Bone scan vs 18F NaF PET
promising against soft tissue and bone metastasis: AMG 509
bone scan following chemo
Percentage of tissue with carsinoma when Gleason 9 and accuracy of normal ct scan
