# Fluciclovine F-18

Source: https://onco.cc/drugs/fluciclovine-f18/  
OnCo record `fluciclovine-f18` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Fluciclovine F-18 was the first PET tracer approved for finding recurrent prostate cancer after treatment (2016), and has been largely superseded since 2020 by PSMA PET.

## Summary

Approved May 2016 for suspected recurrence with rising PSA; detection ~68% overall, lower at low PSA. EMSPOT/EMPIRE-1 (Lancet 2021) showed fluciclovine-guided salvage radiotherapy improved failure-free survival. PSMA PET (Ga-68 PSMA-11, piflufolastat, flotufolastat) has higher detection and displaced it.

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-09-08
- Tags: gap-fill; diagnostic
- Brand: Axumin
- Modality: PET radiotracer (synthetic amino acid)
- Mechanism: 18F-labelled leucine analogue taken up via LAT1/ASCT2 amino-acid transporters upregulated in prostate cancer; low urinary excretion improves pelvic imaging.
- Approvals: US 2016: PET imaging in men with suspected prostate cancer recurrence based on elevated PSA; EU 2017: Same

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Fluciclovine_(18F)
- Label (DailyMed): https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=Axumin

## Connected records

- cancers: [Glioma & glioblastoma](https://onco.cc/cancers/glioblastoma/), [Multiple myeloma](https://onco.cc/cancers/multiple-myeloma/), [Prostate cancer](https://onco.cc/cancers/prostate/)
- technologies: [PET (positron emission tomography)](https://onco.cc/technologies/pet/), [PET/CT](https://onco.cc/technologies/pet-ct/)
- companies: [Blue Earth Diagnostics (Bracco)](https://onco.cc/companies/blue-earth-diagnostics/)
- terms: [Biochemical recurrence (BCR)](https://onco.cc/terms/biochemical-recurrence/)
- trials: [18F-Fluciclovine PET Imaging for Detecting High Grade Glioma Recurrence After Radiochemotherapy](https://onco.cc/trials/nct05479136/), [Study to Establish the Diagnostic Performance of 18F Fluciclovine PET in Detecting Recurrent Brain Metastases](https://onco.cc/trials/nct04410133/), [Treating Prostate Cancer That Has Come Back After Surgery With Apalutamide and Targeted Radiation Based on PET Imaging](https://onco.cc/trials/nct04423211/)

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