68Ga-prostate-specific membrane antigen (PSMA) PET/CT as a clinical decision-making tool in biochemically recurrent prostate cancer

Davies, A; Foo, M; Gan, CL; Kourambas, J; Redgrave, N; Donnellan, S; Appu, S; Williams, S; Coleman, A; Segelov, E; Bradley, J; Soo, G; Ramdave, S; Kwan, EM; Azad, AA

Author(s): Davies, A; Foo, M; Gan, CL; Kourambas, J; Redgrave, N; Donnellan, S; Appu, S; Williams, S; Coleman, A; Segelov, E; Bradley, J; Soo, G; Ramdave, S; Kwan, EM; Azad, AA;
Details: Publication Year 2022-10,Volume 18,Issue #5,Page e204-e210
Journal Title: Asia-Pacific Journal of Clinical Oncology
Publication Type: Research article
Abstract: OBJECTIVE: PSMA PET/CT has demonstrated superior sensitivity over conventional imaging in the detection of local and distant recurrence in biochemically relapsed (BCR) prostate cancer. We prospectively investigated the management impact of (68) Ga-PSMA PET/CT imaging in men with BCR, with the aim of identifying baseline clinicopathological predictors for management change. PATIENTS AND METHODS: Men with BCR who met eligibility criteria underwent (68) Ga-PSMA-11 PET/CT at Monash Health (Melbourne, Australia). Intended management plans were prospectively documented before and after (68) Ga-PSMA PET/CT imaging. Binary logistic regression analysis was performed to identify potential clinicopathological predictors of management change. Descriptive statistics were used to characterize the nature of these changes. RESULTS: Seventy men underwent (68) Ga-PSMA-11 PET/CT imaging. Median age was 67 years (IQR 63-72) and median PSA was 0.48 ng/ml (IQR 0.21-1.9). PSMA-avid disease was observed in 56% (39/70) of patients. Pre-scan management plan was altered following scanning in 43% (30/70) of patients. Management changes were significantly more common in patients with higher baseline PSA levels (PSA>/=2 ng/ml, p = 0.01). 18/36 (50%) of the patients initially planned for watchful waiting had their management changed, including the use of salvage pelvic radiotherapy (n = 7) and stereotactic ablative body radiotherapy to oligometastatic disease (n = 6). CONCLUSION: Management change after (68) Ga-PSMA PET/CT for BCR is common and typically resulted in treatment intensification strategies in those planned for a watchful waiting approach. This study adds to the growing pool of evidence supporting the clinical utility of PSMA PET/CT imaging in the care of patients with BCR after definitive therapy.
Keywords: Aged; *Antigens, Surface/analysis; Clinical Decision-Making; *Glutamate Carboxypeptidase II/analysis; Humans; Male; Middle Aged; Neoplasm Recurrence, Local/diagnostic imaging; *Positron Emission Tomography Computed Tomography/methods; Prostate/pathology; Prostate-Specific Antigen; Prostatectomy/methods; *Prostatic Neoplasms/diagnostic imaging/pathology/therapy; Psma pet/ct; biochemical relapse; decision making; prostate cancer
Department(s): Radiation Oncology; Medical Oncology
PubMed ID: 34161628
Publisher's Version: https://doi.org/10.1111/ajco.13595
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-10-23 06:31:15

Last Modified: 2024-10-23 06:33:16