Pd45-08 Psma Pet Findings in Patients With High-Risk Biochemical Recurrence After Local Treatment of Prostate Cancer

You have accessJournal of UrologyProstate Cancer: Staging II (PD45)1 May 2024PD45-08 PSMA PET FINDINGS IN PATIENTS WITH HIGH-RISK BIOCHEMICAL RECURRENCE AFTER LOCAL TREATMENT OF PROSTATE CANCER Nicole Handa, Richard Bennett, Eric V. Li, Austin Ho, Mitchell M. Huang, Sai Kumar, Clayton Neill, Hiten D. Patel, Edward M. Schaeffer, and Ashley E. Ross Nicole HandaNicole Handa , Richard BennettRichard Bennett , Eric V. LiEric V. Li , Austin HoAustin Ho , Mitchell M. HuangMitchell M. Huang , Sai KumarSai Kumar , Clayton NeillClayton Neill , Hiten D. PatelHiten D. Patel , Edward M. SchaefferEdward M. Schaeffer , and Ashley E. RossAshley E. Ross View All Author Informationhttps://doi.org/10.1097/01.JU.0001008792.09108.b4.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The recently reported EMBARK study demonstrated a metastasis free survival benefit with the use of enzalutamide for patients with high-risk biochemical recurrence (BCR) and negative conventional imaging. PSMA PET has emerged as a more sensitive modality to stage patients with BCR. Here, we describe PSMA PET characteristics of patients with high-risk BCR. METHODS: This was a retrospective analysis of 145 patients who underwent radical prostatectomy (RP) and/or radiation therapy (RT) for treatment of prostate cancer with high-risk BCR (defined similarly to EMBARK criteria as PSA≥2 ng/mL above nadir after RT or ≥1 ng/mL after RP+/-RT) who subsequently had Gallium-68 or F-18 piflufolastat (DCFPyL) PSMA PET/CT from July 2021-March 2023. Patients with prior cytotoxic chemotherapy, androgen deprivation therapy (ADT) initiated >3 months prior to PSMA PET except for neoadjuvant/adjuvant ADT completed ≥9 months prior, or positive conventional imaging within 3 months of PSMA PET were excluded. Univariate regression, Pearson's Chi-squared, Wilcoxon rank sum, and Fisher's exact tests were used for analysis. RESULTS: 113/145 (77%) patients in the study had ≥1 lesion on PSMA PET. Median PSA was 3.56. There was no difference in PSMA PET positivity based on age, race, Gleason Grade on initial biopsy, or PSA. 63/77 (82%) of patients treated with RP, 35/42 (83%) treated with RT, and 15/26 (58%) treated with RP and RT were PSMA PET positive. In the study population, 18 (12%) patients had lesions in the prostate only, 11 (8%) had lesions in the prostate bed only, 31 (21%) had lesions concerning for N1M0 disease, and 53 (37%) had lesions concerning for M1 disease. Within the subset of patients with M1 lesions, 6/53 (11%) had 1 lesion, 15/53 (28%) had 2-3 lesions, and 32/53 (60%) had >3 lesions. CONCLUSIONS: Nearly 80% of patients with high-risk BCR after local treatment for prostate cancer with RP and/or RT will have positive findings on PSMA PET. 20% of patients had local recurrence and may benefit from additional curative salvage therapy. 14% of these men had oligometastatic disease and may benefit from stereotactic radiation. These findings highlight the importance of PET PSMA imaging in the high-risk BCR cohort as these results might improve individualized treatment decisions and outcomes. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e970 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Nicole Handa More articles by this author Richard Bennett More articles by this author Eric V. Li More articles by this author Austin Ho More articles by this author Mitchell M. Huang More articles by this author Sai Kumar More articles by this author Clayton Neill More articles by this author Hiten D. Patel More articles by this author Edward M. Schaeffer More articles by this author Ashley E. Ross More articles by this author Expand All Advertisement PDF downloadLoading ...