Clinical and Molecular Correlates of Positron Emission Tomography (PET) With 89Zr-DFO-huJ591 in Metastatic Prostate Cancer

A Phase I/II Study of Clinical and Molecular Correlates of Positron Emission Tomography (PET) With 89Zr-DFO-huJ591 in Metastatic Prostate Cancer

The purpose of this study is to define the safety and accuracy of 89Zr-DFO-huJ591 PET scans. By improving our ability to find cancer cells, the investigators hope to be able to improve treatment for patients in the future.

The study doctors want to determine whether a new kind of scan, called a 89Zr-DFO-huJ591 PET scan, can specifically see prostate cancer that has spread to other parts of the body, especially the bones. The study doctors will also look at how the 89Zr-DFO-huJ591 reacts with the body and how long it stays in the body. The investigators will also ask the patient to have a biopsy performed. The study doctors will compare the findings the investigators see on the scans with findings on the optional tissue biopsy. Finally, the investigators will compare the pictures from a 89Zr-DFO-huJ591 PET scan with those of a standard PET scan (called FDG PET) and standard CT scans or magnetic resonance (MRI) scans or bone scans, depending on which standard scans the doctor has ordered.

PET scanning uses a small amount of radiation attached to a molecule that is taken up by the cancer. In this trial, the patient will undergo two types of PET scans. One uses FDG. FDG is a standard tracer for PET scans. The patient will also undergo another type of PET scan that is experimental. This experimental PET uses a radioactive protein called J591. The radiation source is a type of metal called zirconium-89 (89Zr). The whole tracer, J591 plus the 89Zr, is abbreviated as 89Zr-DFO-huJ591. This tracer is what is being studied. The tracer used in a scan should find where the cancer is in the body.

Inclusion Criteria:

Metastatic Prostate Cancer Patients:

• Adult male ≥ 18 years of age
• Patients with histologically confirmed prostate cancer at MSKCC
• Progressive disease manifest by either:
• Imaging modalities:
• Bone Scan: New osseous lesions on bone scan and/or
• MRI or CT: An increase in measurable soft tissue disease or the appearance of new sites of disease.

OR

• Biochemical progression:

At least 3 rising PSA values from a baseline that are obtained 1 week or more apart, or 2 measurements obtained 2 or more weeks apart. The increase over the range of values should be at least 25%.

• Visible lesions by CT, bone scan, or MRI that are consistent with disease
• Performance status of 60 or higher (Karnofsky scale) (Appendix B)
• Ability to understand and willingness to sign a written informed consent document

Rising PSA Prostate Cancer Patients:

• Adult male ≥18 years of age
• Patients with histologically confirmed prostate cancer at MSKCC
• Undergone radical prostatectomy
• Detectable PSA (>0.05 ng/mL) that rises on subsequent evaluation
• Radiographic evaluation involving bone imaging and cross sectional imaging of at least the pelvis that is negative or equivocal for metastatic disease
• Performance status of 60 or higher (Karnofsky scale) (Appendix B)
• Ability to understand and willingness to sign a written informed consent document

Exclusion Criteria:

• Patients meeting any of the following criteria will not be eligible for study entry (Metastatic and Rising PSA cohorts):
• Previous anaphylactic reaction to either J591 or FDG
• Hepatic laboratory values
• Bilirubin > 1.5 x ULN (institutional upper limits of normal) Exception: patient's with a history of Gilbert's disease
• AST/ALT > 2.5 x ULN
• Albumin < 2 g/dL