Pd45-10 Prostate-Specific Membrane Antigen Imaging Findings and Subsequent Clinical Management Among Patients With Biochemical Recurrent Prostate Cancer: A Retrospective Cohort Study

You have accessJournal of UrologyProstate Cancer: Staging II (PD45) 1 May 2024PD45-10 PROSTATE-SPECIFIC MEMBRANE ANTIGEN IMAGING FINDINGS AND SUBSEQUENT CLINICAL MANAGEMENT AMONG PATIENTS WITH BIOCHEMICAL RECURRENT PROSTATE CANCER: A RETROSPECTIVE COHORT STUDY Michael S. Leapman, Maximilian Rabil, Umar Ghaffar, Jessica B. Long, Sarah Westvold, Preston Sprenkle, Isaac Y. Kim, Lawrence Saperstein, Jaleh Fallah, Daniel Suzman, Catherine Lerro, Jianjin Xu, Paul G. Kluetz, Natalia Kunst, Shi-Yi Wang, Xiaomei Ma, Cary P. Gross, and R. Jeffrey Karnes Michael S. LeapmanMichael S. Leapman, Maximilian RabilMaximilian Rabil, Umar GhaffarUmar Ghaffar, Jessica B. LongJessica B. Long, Sarah WestvoldSarah Westvold, Preston SprenklePreston Sprenkle, Isaac Y. KimIsaac Y. Kim, Lawrence SapersteinLawrence Saperstein, Jaleh FallahJaleh Fallah, Daniel SuzmanDaniel Suzman, Catherine LerroCatherine Lerro, Jianjin XuJianjin Xu, Paul G. KluetzPaul G. Kluetz, Natalia KunstNatalia Kunst, Shi-Yi WangShi-Yi Wang, Xiaomei MaXiaomei Ma, Cary P. GrossCary P. Gross, and R. Jeffrey KarnesR. Jeffrey Karnes View All Author Informationhttps: //doi. org/10. 1097/01. JU. 0001008792. 09108. b4. 10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prostate specific membrane antigen positron emission tomography (PSMA-PET) has been shown to improve prostate cancer localization, particularly in the setting of biochemical recurrence (BCR). We assessed patterns of clinical management following PSMA-PET imaging in the setting of BCR in the era following approval of PSMA-PET in the United States (US). METHODS: We conducted a retrospective cohort study of patients undergoing PSMA-PET imaging for the evaluation of BCR from two large US academic referral centers. The primary objective was to evaluate clinical management in the six-month period following first PSMA-PET scan in relation to imaging findings. We classified treatment categories as no treatment, local therapy, systemic therapy, and metastasis directed therapy (MDT). In addition, we evaluated PSMA-PET findings and subsequent therapy by PSA strata at imaging (0-1. 99, 2. 0-4. 99 and ≥5. 0 ng/mL). RESULTS: We identified 583 patients undergoing PSMA-PET imaging from March 2019 through February 2023, including 393 (67%) with prior prostatectomy, 155 (27%) radiation therapy and 35 (6%) other treatments. The median PSA at testing was 1. 8 ng/mL. PET findings were negative in 142 (24%) patients, showed evidence of localized recurrence in 86 (15%), regional pelvic nodal disease in 61 (10%) and evidence of distant metastasis in 294 (50%). Distant metastasis was identified in 105 (35%) of those with PSA 0-1. 99, 67 (60%) with PSA 2. 0-4. 99, and 116 (72%) of those with PSA >5 ng/mL. Subsequent management within six months of imaging differed by PSMA finding (Figure 1). Among 142 patients with negative imaging, 63 (44%) received any kind of treatment. Conversely, 93% of patients with detected metastases were treated, including with systemic therapy in 189 (64%), MDT in 76 (26%), and local therapy alone in 7 (2%). Distributions of treatment differed by PSA level within strata of PSMA findings. For example, among 294 patients with metastases identified, MDT was used more frequently in those with PSA <2. 0 ng/mL (37%) as compared with 2. 0-4. 99 ng/mL (30%) or PSA ≥5. 0 ng/mL (14%), p<0. 001. CONCLUSIONS: Most patients undergoing PSMA-PET for BCR were found to have identifiable areas of disease and initiated therapy within six months. Download PPT Source of Funding: Food and Drug Administration (FDA) of the U. S. Department of Health and Human Services (HHS) as part of a financial assistance award FD005938 totaling 383, 914 with 100 percent funded by FDA/HHS. The contents are those of the author (s) and do not necessarily represent the official views of, nor an endorsement, by FDA/HHS, or the U. S. Government © 2024 by American Urological Association Education and Research, Inc. FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e971 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc. Metrics Author Information Michael S. Leapman More articles by this author Maximilian Rabil More articles by this author Umar Ghaffar More articles by this author Jessica B. Long More articles by this author Sarah Westvold More articles by this author Preston Sprenkle More articles by this author Isaac Y. Kim More articles by this author Lawrence Saperstein More articles by this author Jaleh Fallah More articles by this author Daniel Suzman More articles by this author Catherine Lerro More articles by this author Jianjin Xu More articles by this author Paul G. Kluetz More articles by this author Natalia Kunst More articles by this author Shi-Yi Wang More articles by this author Xiaomei Ma More articles by this author Cary P. Gross More articles by this author R. Jeffrey Karnes More articles by this author Expand All Advertisement PDF downloadLoading. . .