Summary

Advice

The technology described in this briefing is Axumin, a radiopharmaceutical agent. It is intended for use in positron emission tomography (PET) to detect suspected prostate cancer recurrence in people who have elevated prostate-specific antigen levels after primary curative treatment. It is currently the only licensed PET tracer indicated for use in recurrent prostate cancer.
The innovative aspects are that it is a prostate cancer-specific PET tracer with a novel mechanism of action based on amino acid transport. Its longer half-life and shorter uptake period may allow use in more people with suspected prostate cancer recurrence compared with other PET tracers.
The intended place in therapy is in addition to bone scans or MRI to detect suspected prostate cancer recurrence in adults. It may be used as an alternative to choline or prostate-specific membrane antigen PET/CT in centres where these scans are available.
The main points from the evidence summarised in this briefing are from 1 meta-analysis and 5 studies (2 randomised trials and 3 non-randomised observational studies) including more than 1,200 men with suspected prostate cancer recurrence. The evidence reported that Axumin PET/CT detected prostate cancer recurrence with good diagnostic accuracy and frequently led to changes in patients' management plans.
Key uncertainties around the evidence or technology are the lack of comparative studies with other PET tracers. There are no head-to-head studies comparing Axumin with ¹⁸F‑choline. Also, the effects of Axumin PET on earlier diagnosis and on quality of life have not been evaluated.
The per-patient cost for a single dose of Axumin tracer is £950 (excluding VAT), plus transport costs estimated at £50 to £250 per shipment. The resource impact would be a cost increase per scan. The technology has the potential to free up resources if it reduces the number of imaging tests needed to confirm diagnosis or if fewer people are referred for radiotherapy.