A Clinician’s Guide to Next Generation Imaging in Patients With Advanced Prostate Cancer (RADAR III)

Crawford, E. David; Koo, Phillip J.; Shore, Neal D.; Slovin, Susan F.; Concepcion, Raoul S.; Freedland, Stephen J.; Gomella, Leonard G.; Karsh, Lawrence I.; Keane, Thomas E.; Maroni, Paul; Penson, David F.; Petrylak, Daniel P.; Ross, Ashley E.; Mouraviev, Vlad; Reiter, Robert E.; Divgi, Chaitanya; Yu, Evan Y.

doi:10.1016/j.juro.2018.05.164

Cited by 73 publications

(43 citation statements)

References 40 publications

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“…Different imaging methods can be used for PCa recurrence. In particular, next‐generation imaging techniques are currently recommended to select PCa patients suspected of disease progression based on PSA serum values . Positron emission tomography using radiolabelled prostate‐specific membrane antigen (PSMA‐PET) is emerging as an important modality for imaging biochemical recurrent PCa …”

Section: Introductionmentioning

confidence: 99%

“…In particular, next-generation imaging techniques are currently recommended to select PCa patients suspected of disease progression based on PSA serum values. 5 Positron emission tomography using radiolabelled prostate-specific membrane antigen (PSMA-PET) is emerging as an important modality for imaging biochemical recurrent PCa. 6,7 PSMA is a transmembrane protein that is located within the apical epithelium of secretory ducts in benign prostatic tissue.…”

Section: Introductionmentioning

confidence: 99%

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Correlation between PSA kinetics and PSMA‐PET in prostate cancer restaging: A meta‐analysis

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Treglia

Ferrari

et al. 2019

Eur J Clin Investigation

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Background Serum prostate‐specific antigen (PSA) may predict the risk of positive positron emission tomography/computed tomography with radiolabelled prostate‐specific membrane antigen (PSMA‐PET/CT) in patients with biochemical recurrent prostate cancer (BRPCa). However, to date, there are no clear data regarding the correlation between PSA kinetics and PSMA‐PET findings. We performed a systematic review and meta‐analysis to provide evidence‐based data in this setting. Methods A comprehensive literature search of studies published through October 2018 in PubMed/MEDLINE, EMBASE and Cochrane library databases was performed. A meta‐analysis to establish the detection rate (DR) of PSMA‐PET using different cut‐off values of PSA doubling time (PSAdt) and a pooled analysis to establish whether shorter PSAdt may predict positive PSMA‐PET results was performed in patients with BRPCa. Results Twelve articles were included in the systematic review, and eight articles (including about 1400 patients) were selected for the meta‐analysis. The pooled DR including 95% confidence intervals (95%CI) of PSMA‐PET in restaging prostate cancer (PCa) patients was 72% (95%CI:60%‐82%), increasing to 83% (95%CI:75%‐90%) when PSAdt was ≤6 months and decreasing to 60% (95%CI:37%‐80%) when PSAdt was >6 months, without a statistical significant difference. PSAdt ≤6 months may predict the positive result of PSMA‐PET (pooled odds ratio: 3.22; 95%CI:1.17‐8.88). Statistical heterogeneity among the included studies was found. Conclusions PSA kinetics, and in particular shorter PSAdt, may be predictor of PSMA‐PET positivity in patients with BRPCa. Further larger studies in this setting are warranted.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Correlation between PSA kinetics and PSMA‐PET in prostate cancer restaging: A meta‐analysis

Mestre

Treglia

Ferrari

et al. 2019

Eur J Clin Investigation

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“…The role of next‐generation imaging (NGI) modalities (eg, Axumin, PSMA‐PET) raises important questions regarding their role in disease staging, treatment choice in the nmCRPC setting, and treatment monitoring and follow up. In general, the panel supported consideration of NGI as per RADAR III guidance (Table 4), for patients with BCR, nmCRPC, and M1 CR patients 54 . There was much discussion regarding the latter patients due to the lack of data and difficulty making comparisons to non‐NGI techniques.…”

Section: Resultsmentioning

confidence: 99%

Optimizing the management of castration‐resistant prostate cancer patients: A practical guide for clinicians

et al. 2020

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Background Advanced prostate cancer (PC) patients, especially those with metastatic prostate cancer (mPC), often require complex management pathways. Despite the publication of clinical practice guidelines by leading urological and oncological organizations that provide a substantial and comprehensive framework, there are numerous clinical scenarios that are not always addressed, especially as new treatments become available, new imaging modalities are developed, and advances in genetic testing continue. Methods A 14‐member expert review panel comprised of urologists and medical oncologists were chosen to provide guidance on addressing specific topics and issues regarding metastatic castration‐resistant prostate cancer (mCRPC) patients. Panel members were chosen based upon their experience and expertise in the management of PC patients. Four academic members (two urologists and two medical oncologists) of the panel served as group leaders; the remaining eight panel members were from Large Urology Group Practice Association (LUGPA) practices with proven experience in leading their advanced PC clinics. The panel members were assigned to four separate working groups, each assigned a specific mCRPC topic to review and discuss with the entire panel. Results This article describes the practical recommendations of an expert panel on the management of mCRPC patients. The target reading audience for this publication is all providers (urologists, medical oncologists, radiation oncologists, or advanced practice providers) who evaluate and manage advanced PC patients, regardless of their practice setting. Conclusion The panel has provided recommendations for managing mCRPC with regard to specific issues: (a) biomarker monitoring and the role of genetic and molecular testing; (b) rationale, current strategies, and optimal sequencing of the various approved therapies, including hormonal therapy, cytotoxic chemotherapy, radiopharmaceuticals and immunotherapy; (c) adverse event management and monitoring; and (d) imaging advanced PC patients. These recommendations seek to complement national guidelines, not replace them, and a discussion of where the panel agreed or disagreed with national guidelines is included.

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“…Moreover, whole-body MRI (WB-MRI), with or without diffusion-weighted imaging, is excluded. Although WB-MRI may have utility in this clinical setting, particularly for the detection of bone metastases, the variability in availability, accessibility, quality, and standardization, as well as the fact that there are no currently established procedural terminology codes for reimbursement, has hindered its clinical adoption (1,2).…”

Section: Executive Summarymentioning

confidence: 99%

Appropriate Use Criteria for Imaging Evaluation of Biochemical Recurrence of Prostate Cancer After Definitive Primary Treatment

et al. 2020

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A Clinician’s Guide to Next Generation Imaging in Patients With Advanced Prostate Cancer (RADAR III)

Cited by 73 publications

References 40 publications

Correlation between PSA kinetics and PSMA‐PET in prostate cancer restaging: A meta‐analysis

Correlation between PSA kinetics and PSMA‐PET in prostate cancer restaging: A meta‐analysis

Optimizing the management of castration‐resistant prostate cancer patients: A practical guide for clinicians

Appropriate Use Criteria for Imaging Evaluation of Biochemical Recurrence of Prostate Cancer After Definitive Primary Treatment

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