Carbon-11 Acetate and Fludeoxyglucose F 18 PET Scan of the Bone in Patients With Metastatic Prostate Cancer That Has Spread to the Bone
Carbon-11 Acetate and Fludeoxyglucose F 18 PET Scan of the Bone in Patients With Metastatic Prostate Cancer That Has Spread to the Bone
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.
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