A Risk Model for Patients with PSA-Only Recurrence (Biochemical Recurrence) Based on PSA and PSMA PET/CT: An Individual Patient Data Meta-Analysis

Abstract

An individual patient meta-analysis followed 1216 patients with PSA-only recurrence (biochemical recurrence, BCR) restaged with [68Ga]Ga-PSMA-11 PET/CT before the salvage treatment for median 3.5 years and analyzed the overall survival (OS). A new risk model included a good risk group with a prescan PSA < 0.5 ng/mL (26%), an intermediate risk group with a prescan PSA > 0.5 ng/mL and a PSMA PET/CT with 1 to 5 positive sites (65%), and a poor risk group with a prescan PSA > 0.5 ng/mL and a PSA PET/CT with > 5 positive sites (9%) (p < 0.0001, log rank test). The poor risk group had a five-year OS > 60%. Adding a BCR risk score by the European Association of Urology did not significantly improve the prediction of OS (p = 0.64). In conclusion, the restaging PSMA PET/CT markedly predicted the 5-year OS. The new risk model for patients with PSA-only relapse requires a restaging PSMA PET/CT for patients with a prescan PSA > 0.5 ng/mL and has a potential use in new trials aiming to improve the outcome for patients with PSA-only recurrence who have polysites prostate cancer detected on PSMA PET/CT.

Pretest PSA and Restaging PSMA PET/CT Predict Survival in Biochemically Recurrent Prostate Cancer

“…BCR patients were recruited between Dec 2014 and April 2020 at five centers across two continents [ 5 , 7 ]. The University in Ankara, Turkey, reported 94 patients; the Hacettepe University, Ankara, Turkey, reported 102; the University Hospital in Innsbruck, Austria, reported 500; the Johannes Gutenberg University in Mainz, Germany, reported 225; and Sorbonne University, Paris, France, reported 294 patients.…”

“…A multicenter study of 1216 BCR patients showed that the PSA threshold had a significant impact on their overall survival (OS) [ 5 ]. The European Association of Urology (EAU) published a BCR risk classification [ 6 ], and later, the multicenter study made a new BCR risk model that was based on the pretest PSA threshold and groups by number of positive sites on a restaging PSMA PET/CT [ 7 ].…”

Correction: von Eyben et al. A Risk Model for Patients with PSA-Only Recurrence (Biochemical Recurrence) Based on PSA and PSMA PET/CT: An Individual Patient Data Meta-Analysis. Cancers 2022, 14, 5461

“…In the original publication [ 1 ], there was a mistake in Figure 6. The lower line that shows the control group treatment is ADT + SDaRT + MDT; however, it should only include ADT + MDT.…”