Lymph Node Metastasis Confirmed by Biopsy

[dac500]

On November 9, I had biopsy of the right perirectal lymph node, which is one of the ten lymph nodes that had abnormal intense uptake in 18F-DCFPyL PET/CT scan. The doctor performing the biopsy could get only two tiny samples. One of the sample tests positive for prostate cancer. Unfortunately, no Gleason scale could be assigned. The other lymph nodes are not easy to reach for biopsy. Abnormal intense uptake indicates that they must also have prostate cancer.

[Tall_Allen]

There are no Gleason scores for metastases, only for prostate tumors.

[dac500 in reply to Tall_Allen]

My mistake. The result confirms the sensitivity 18F-DCFPyL PET/CT scan. I hope this scan would be available very soon for everybody in USA.

[Tall_Allen in reply to dac500]

In fact, an expanded Phase 3 trial was just announced today. They haven't started recruiting yet. They are allowing anyone with recurrences after primary surgery or radiation:

clinicaltrials.gov/ct2/show...

[rv195 in reply to Tall_Allen]

Tall_Allen, does this study exclude you if you have already begun Lupron therapy? I would like to check it out for my partner who had a prostatectomy Jan. 2015 with a Gleason of 4+3 and 4+4 and a PSA of 2.4 three months after surgery with a rising PSA over time up to about 8. He completed 9 months of Lupron in part of 2016 and 2017. Then a Lupron holiday for 18 months. In Oct of 2018 PSA began doubling in 3 months time so he had another 6 month injection. No mets as far as we know on a conventional scan done in late 2014. I thought this study might be helpful until I read the exclusions. What are your thoughts?

[dac500 in reply to rv195]

Here are the exclusion criteria:

Exclusion Criteria:

Subjects administered any high energy (>300 KeV) gamma-emitting radioisotope within five (5) physical half-lives prior to Day 1

Ongoing treatment with any systemic therapy (e.g. ADT, antiandrogen, GnRH, LHRH agonist or antagonist) for prostate cancer

Treatment with ADT in the past 3 months of Day 1

Receipt of investigational therapy for prostate cancer within 60 days of Day 1

Subjects with any medical condition or other circumstances that, in the opinion of the investigator, compromise the safety or compliance of the subject to produce reliable data or completing the study

[Tall_Allen in reply to rv195]

As dac500 pointed out, he would be excluded. What would you do differently with the scan results if it is positive or it is negative?

[tiffingirl in reply to Tall_Allen]

I was under the impression that if a scan were to be positive in a certain area of the bones for example that radiation could be done. Is that an option?

[Tall_Allen in reply to tiffingirl]

It is sometimes an option, if it is safe. But the benefit, if any, is uncertain. Radiation is often done for palliative purposes but that will usually show up on a bone scan, so a PET scan wouldn't be needed.