Most imaging tests have not been able to localize recurrent prostate cancer when the PSA is mildly increased.[1][3] Axumin scans were compared to [11C]-tagged
choline PET scans, another FDA approved PET scan that can assist in this situation, and to
biopsy results.[3][5] Fluciclovine tagged PET scans appear to more sensitive than CT scans[6] and to [11C]-tagged
choline PET scans.[7][8]
Mechanism
Fluciclovine is a [18F]-tagged synthetic analog of the
amino acid L-
leucine.[9][10] FACBC uptake by the tumor is related to functional activity of two
amino acid transporters,[11] specifically sodium-dependent system ASC, with a lesser contribution by sodium-independent system L.[10] Although it is handled by the amino acid transporter system, it does not undergo terminally incorporative metabolism within the body.[10] The distribution of the tracer in the body differs from
choline and
FDG, as kidney uptake of FACBC is negligible, and no activity is found in the urinary tract.[10][11] There is low native brain uptake compared to FDG, which may enhance detection of brain metastases[2][10] or primary brain tumors.[10] The more intense native liver and pancreatic uptake seen with this agent would be expected to limit disease detection in those organs.[10] FACBC has a short synthesis time and a long half-life, which eliminate the need for an onsite cyclotron.[11]
Marketing
Axumin is marketed by Blue Earth Diagnostics, Ltd., United Kingdom.[4]
References
^
abSchiavina R, Ceci F, Borghesi M, et al. (2013). "The dilemma of localizing disease relapse after radical treatment for prostate cancer: which is the value of the actual imaging techniques?". Curr Radiopharm. 6 (2): 92–5.
doi:
10.2174/1874471011306020005.
PMID23597246.
^
abForrest W. "Start-up develops prostate PET agent." AuntMinnie.com 9 May 2014
[1]Archived 1 December 2017 at the
Wayback Machine
^
abcFDA Press Release. "FDA approves new diagnostic imaging agent to detect recurrent prostate cancer" 27 May 2016
[2]
^
abDrugs.com "FDA Approves Axumin (fluciclovine F 18) Diagnostic Imaging Agent to Detect Recurrent Prostate Cancer" 27 May 2016
[3]
^Berberabe T. "FDA Approves Radioactive Imaging Agent Axumin in Recurrent Prostate Cancer." OncLive 27 May 2016
[4]
^Evangelista L, Briganti A, Fanti S, et al. (2016). "New Clinical Indications for (18)F/(11)C-choline, New Tracers for Positron Emission Tomography and a Promising Hybrid Device for Prostate Cancer Staging: A Systematic Review of the Literature". Eur. Urol. 70 (1): 161–75.
doi:
10.1016/j.eururo.2016.01.029.
PMID26850970.
^Nanni C, Schiavina R, Brunocilla E, et al. (2015). "18F-Fluciclovine PET/CT for the Detection of Prostate Cancer Relapse: A Comparison to 11C-Choline PET/CT". Clin Nucl Med. 40 (8): e386–91.
doi:
10.1097/RLU.0000000000000849.
PMID26053708.
S2CID31082439.
^Bankhead C. "Prostate Scan Agent Approved by FDA." MedPage Today 27 May 2016
[5]
^
abcSchiavina R, Brunocilla E, Martorana G (2014). "The new promise of FACBC position emission tomography/computed tomography in the localization of disease relapse after radical treatment for prostate cancer: are we turning to the right radiotracer?". Eur. Urol. 65 (1): 255–6.
doi:
10.1016/j.eururo.2013.08.053.
PMID24094575.