EAU-EANM Consensus Statements on the Role of Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography in Patients with Prostate Cancer and with Respect to [177Lu]Lu-PSMA Radioligand Therapy
- Author(s)
- Fanti, S; Briganti, A; Emmett, L; Fizazi, K; Gillessen, S; Goffin, K; Hadaschik, BA; Herrmann, K; Kunikowska, J; Maurer, T; MacLennan, S; Mottet, N; Murphy, DG; Oprea-Lager, DE; O'Sullivan, JM; Oyen, WJG; Rouviere, O; Sartor, O; Stenzl, A; Van Poppel, H; Walz, J; Witjes, W; Bjartell, A;
- Details
- Publication Year 2022-10,Volume 5,Issue #5,Page 530-536
- Journal Title
- European Urology Oncology
- Publication Type
- Guideline
- Abstract
- BACKGROUND: Prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) is useful for selected clinical indications in patients with prostate cancer (PCa) but it may have broader clinical utility owing to the emergence of lutetium-177-PSMA-617 ([(177)Lu]Lu-PSMA) therapy. However, robust data regarding the impact of PSMA PET/CT on patient management and treatment are lacking, and in many areas, the role of next-generation imaging has not been defined. OBJECTIVE: To assess expert opinion on the use of PSMA-based imaging and therapy to develop interim guidance. DESIGN, SETTING, AND PARTICIPANTS: A panel of 21 PCa experts from various disciplines received thematic topics and relevant literature. A questionnaire to assess proposed guidance statements regarding PSMA PET/CT and [(177)Lu]Lu-PSMA therapy was developed for completion remotely in a first e-Delphi round. A subsequent panel discussion was conducted during a 1-d meeting, which included a second Delphi round. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Panellists voted anonymously on statements using a nine-point Likert scale from 1 = strongly disagree to 9 = strongly agree. Median scores were calculated and consensus was assessed using methods proposed by the Research and Development (RAND) corporation. RESULTS AND LIMITATIONS: Statements were developed to cover the following topics: PSMA PET/CT utility, clinical use, and choice of tracer; patient selection; and management of patients receiving [(177)Lu]Lu-PSMA for metastatic PCa. Consensus was reached for 33/36 statements. In-group bias is a potential limitation, as some statements were rephrased during discussions at the 1-d meeting. CONCLUSIONS: Adoption of PSMA PET/CT as an imaging tool to guide [(177)Lu]Lu-PSMA therapy should be supported by indications for appropriate use. PATIENT SUMMARY: A panel of experts in prostate cancer reached a consensus for the majority of statements proposed regarding the role of prostate-specific membrane antigen (PSMA)-based imaging and therapy, particularly the use of PSMA-based imaging in patients suitable for [(177)Lu]Lu-PSMA therapy and the need to perform PSMA-based imaging before considering patients as candidates for this therapy.
- Keywords
- Dipeptides/therapeutic use; Heterocyclic Compounds, 1-Ring/therapeutic use; Humans; Male; *Positron Emission Tomography Computed Tomography/methods; Prostate/pathology; Prostate-Specific Antigen; *Prostatic Neoplasms, Castration-Resistant/diagnostic imaging/drug; therapy/radiotherapy; Radiopharmaceuticals/therapeutic use; Computed tomography; Consensus; Diagnosis; Lutetium; Patient selection; Positron emission tomography; Prostate cancer; Prostate-specific membrane antigen; Radioactive tracer; Therapy
- Department(s)
- Surgical Oncology
- PubMed ID
- 35697600
- Publisher's Version
- https://doi.org/10.1016/j.euo.2022.05.003
- Open Access at Publisher's Site
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Creation Date: 2024-10-24 05:32:22
Last Modified: 2024-10-24 05:33:22