Pd01-12 Psma-Pet Guided Metastases Directed Treatment in Patients With Oligorecurrent Prostate Cancer

You have accessJournal of UrologyProstate Cancer: Advanced (including Drug Therapy) I (PD01)1 May 2024PD01-12 PSMA-PET GUIDED METASTASES DIRECTED TREATMENT IN PATIENTS WITH OLIGORECURRENT PROSTATE CANCER Lorenzo Bianchi, Eleonora Balestrazzi, Daniele Robesti, Giorgio Gandaglia, Francesco Ceci, Pawel Rajwa, Roderick C.N. van den Bergh, Chiara Mignogna, Matteo Droghetti, Pietro Piazza, Alessandro Pissavini, Andrea Farolfi, Alexandre Mottrie, Alberto Briganti, Alessio Giuseppe Morganti, Stefano Fanti, Francesco Montorsi, Riccardo Schiavina, and Eugenio Brunocilla Lorenzo BianchiLorenzo Bianchi , Eleonora BalestrazziEleonora Balestrazzi , Daniele RobestiDaniele Robesti , Giorgio GandagliaGiorgio Gandaglia , Francesco CeciFrancesco Ceci , Pawel RajwaPawel Rajwa , Roderick C.N. van den BerghRoderick C.N. van den Bergh , Chiara MignognaChiara Mignogna , Matteo DroghettiMatteo Droghetti , Pietro PiazzaPietro Piazza , Alessandro PissaviniAlessandro Pissavini , Andrea FarolfiAndrea Farolfi , Alexandre MottrieAlexandre Mottrie , Alberto BrigantiAlberto Briganti , Alessio Giuseppe MorgantiAlessio Giuseppe Morganti , Stefano FantiStefano Fanti , Francesco MontorsiFrancesco Montorsi , Riccardo SchiavinaRiccardo Schiavina , and Eugenio BrunocillaEugenio Brunocilla View All Author Informationhttps://doi.org/10.1097/01.JU.0001009540.33579.43.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: PSMA-PET is considered the imaging of choice in patients with recurrent prostate cancer (PCa) after primary treatments. We performed a multicentric retrospective study aimed to explore the oncologic benefit of salvage PSMA-guided metastases directed treatment (MDT) in oligo-recurrent (≤3 lesions) PCa patients with miN1/M1a-b disease at PSMA-PET. METHODS: We retrospectively analyzed patients that underwent previous radical prostatectomy (RP) for PCa and PSMA-PET (from January 2018 to April 2023) performed for biochemical recurrence (BCR) at high volume European Centers. Oligo-recurrent patients with N1/M1a-b disease at PSMA-PET and eligible for MDT were identified.Two different clinical settings were explored, including 74 patients (58%) with first BCR and 53 (42%) with BCR after previous salvage treatments. Patients underwent various PSMA-targeted salvage therapies: radiotherapy on whole pelvis plus Stereotactic Body Radiation Therapy (SBRT) on lymph node or bone, salvage lymphadenectomy, nodal and bone SBRT.Kaplan Meier curves were used to assess metastases free survival (MFS) and castration-resistant prostate cancer-free survival (CRPC-FS) at 3 years of follow up after stratifying population according to the miTNM stage (miN1 vs. miM1a-b) at PSMA-PET. RESULTS: Overall, 127 patients treated with MDT were enrolled: 54 (42,5%) miN1, 24 (18,9%) miM1a and 49 (38.6%) miM1b. The median (IQR) follow-up after PSMA-PET was 23 (13-36) months. The median (IQR) PSA level at PSMA-PET was 0.9 ng/mL (0,3-2). Biochemical response (PSA≤0.2 ng/ml) after PSMA-PET MDT was reached in 59 patients (55.7%).Metastases after PSMA-PET guided treatment occurred in 45 patients (35.4%).MFS estimates at 3 years were 48.3% in miN1 vs 60.5% in miM1a and 61.5% in miM1b patients (p=0,41) with a median (IQR) time to metastases of 18 (5-29) months. Twenty (15.7%) patients progressed to CRPC status and five patients (3.9%) died due to prostate cancer. The CRPC-FS estimates at 3 years were 95% in miN1, 84.8% in miM1a and 65.2% in miM1b patients (p=0.026) with a median (IQR) time to CRPC of 19 (10-32) months. CONCLUSIONS: In a selected population of oligo-recurrent miN1/M1a-b PCa patients treated with MDT those with N1 localization showed a trend for higher rates of further metastases progression compared to those with M1a-b disease; however, in miN1 men, PSMA-PET targeted MDT appears to significantly delay progression to CRPC status compared to those with miM1a-b. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e68 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Lorenzo Bianchi More articles by this author Eleonora Balestrazzi More articles by this author Daniele Robesti More articles by this author Giorgio Gandaglia More articles by this author Francesco Ceci More articles by this author Pawel Rajwa More articles by this author Roderick C.N. van den Bergh More articles by this author Chiara Mignogna More articles by this author Matteo Droghetti More articles by this author Pietro Piazza More articles by this author Alessandro Pissavini More articles by this author Andrea Farolfi More articles by this author Alexandre Mottrie More articles by this author Alberto Briganti More articles by this author Alessio Giuseppe Morganti More articles by this author Stefano Fanti More articles by this author Francesco Montorsi More articles by this author Riccardo Schiavina More articles by this author Eugenio Brunocilla More articles by this author Expand All Advertisement PDF downloadLoading ...