Gallium-68 Citrate PET Used in Prostate Cancer

Inclusion Criteria:

- Male patients with histologically confirmed prostate cancer

- Patients must have castrate levels of testosterone (< 50 ng/dL) on LHRH analogue or
have had prior orchiectomy.

- Presence of one or more metastases by standard radiographic scans including
cross-sectional imaging of the chest/abdomen/pelvis and whole body bone scan that is
safely accessible to tumor biopsy in the judgment of treating clinician and/or
Interventional Radiology

- Evidence of disease progression by PCWG2 criteria during or within 4 weeks following
treatment discontinuation with potent androgen signaling inhibitor, including
abiraterone, enzalutamide, ARN-509, or a combination.

- Patients must be either receiving or within 4 weeks of discontinuation of androgen
signaling inhibitor at the time of PET imaging and tumor biopsy.

- Age 18 years or older at the time of study entry

- Platelets >75,000/μl and PT or INR and a PTT < 1.5 times the institutional ULN within
14 days prior to biopsy.

Exclusion Criteria:

- Intervening systemic therapy between discontinuation of androgen signaling inhibitor
and planned date of gallium citrate PET.

- History of radiation therapy to the target metastatic lesion selected for tumor biopsy

- Contra-indication to biopsy including uncontrolled bleeding diathesis.

- Active infection within 14 days of study enrollment

- Contraindications for MRI (for patients undergoing PET/MR study), including presence
of pacemaker, aneurysm clip, implanted device, or severe claustrophobia