Mp60-16 Psma-Pet Guided Metastasis Directed Therapy for Oligometastatic Prostate Cancer

You have accessJournal of UrologyProstate Cancer: Advanced (Including Drug Therapy) III (MP60)1 May 2024MP60-16 PSMA-PET GUIDED METASTASIS DIRECTED THERAPY FOR OLIGOMETASTATIC PROSTATE CANCER Umar Ghaffar, Vidit Sharma, Giuseppe Reitano, Spyridon P. Basourakos, Grant M. Henning, Mohamed E. Ahmed, Ekamjit S. Deol, Geoffrey B. Johnson, Jack Andrews, Eugene D. Kwon, and Robert J. Karnes Umar GhaffarUmar Ghaffar , Vidit SharmaVidit Sharma , Giuseppe ReitanoGiuseppe Reitano , Spyridon P. BasourakosSpyridon P. Basourakos , Grant M. HenningGrant M. Henning , Mohamed E. AhmedMohamed E. Ahmed , Ekamjit S. DeolEkamjit S. Deol , Geoffrey B. JohnsonGeoffrey B. Johnson , Jack AndrewsJack Andrews , Eugene D. KwonEugene D. Kwon , and Robert J. KarnesRobert J. Karnes View All Author Informationhttps://doi.org/10.1097/01.JU.0001008804.84010.ec.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Oligometastatic disease (OM) is an intermediate stage of cancer spread between localized and widespread metastasis in which radical treatment of metastasis may potentially be curative. With the advent of PSMA-PET, oligometastatic disease is increasingly being diagnosed in patients with prostate cancer (PC). We aim to assess the utility of PSMA-PET for improving therapeutics and diagnostics of OM PCa. METHODS: PSMA-PET scans performed at our institution between 04/01/2022 and 11/01/2022 were retrospectively reviewed to identify patients with OM disease (5 or fewer sites). Clinicopathological, treatment and follow-up was collected. Cox regression was used to identify factors predicting radiographic (RPFS) and biochemical progression-free survival (BPFS). RESULTS: 141 patients were identified with mean age 71.4 at OM diagnosis. Median PSA at diagnosis was 8.7 ng/ml. Initial definitive treatment for PC included prostatectomy (67%) and radiotherapy (23%). 8.5% patients had De Novo oligometastatic disease. Mean metastatic sites, SUVmax and mean miPSMA were 2.14, 11 and 1.9 respectively. Patterns included osseous (63.8%), nodal (43.3%) and visceral (2.8%). 28.6% had castration resistant disease at time of OM (CRPC). Patients underwent the following modalities : Surgery (2.1%), Stereotactic ablative radiotherapy (SABR) (49.6%), Intensity-modulated radiation therapy (19.1%), cryoablation (7%), ADT (57.4%) and chemotherapy (4.9%). On follow up imaging, 13.4% progressed to diffuse metastasis, 48.5% resolved, 32.38% improved and 10.6% were unchanged or progressed. MDT with ADT was a significant predictor of RPFS and BPFS on multivariable cox regression (Table 1). CONCLUSIONS: PSMA is an excellent modality to diagnose and guide the management of oligometastatic disease. Metastasis directed therapy may be used with adjunctive androgen deprivation therapy to further improve progression-free survival after treatment. Download PPT Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1006 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Umar Ghaffar More articles by this author Vidit Sharma More articles by this author Giuseppe Reitano More articles by this author Spyridon P. Basourakos More articles by this author Grant M. Henning More articles by this author Mohamed E. Ahmed More articles by this author Ekamjit S. Deol More articles by this author Geoffrey B. Johnson More articles by this author Jack Andrews More articles by this author Eugene D. Kwon More articles by this author Robert J. Karnes More articles by this author Expand All Advertisement PDF downloadLoading ...