Identifying the Best Candidates for Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography as the Primary Staging Approach Among Men with High-risk Prostate Cancer and Negative Conventional Imaging

Abstract

Prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/ computed tomography (CT) is an emerging imaging modality with greater sensitivity and specificity over conventional imaging for prostate cancer (PCa) staging. Using data from two prospective trials (NCT03368547 and NCT04050215), we

Nomograms to predict outcomes after 177Lu-PSMA therapy in men with metastatic castration-resistant prostate cancer: an international, multicentre, retrospective study

“…8 Nomograms using PSMA-PET imaging were developed previously to predict the probability of a positive scan or upstaging in patients with early disease stage, but not for outcome of patients with mCRPC. 28,29 Lastly, our models meet the acceptance criteria of the American Joint Committee on Cancer for inclusion of risk models for individualised prognosis in the practice of precision medicine. 30 This study has important clinical implications.…”

“…Between (29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40). Predictors selected in the overall survival model were time since diagnosis of prostate cancer, chemotherapy status, baseline haemoglobin concentration, bone involvement status, liver involvement status, number of metastatic lesions, and tumour SUV mean (table 2, appendix p 7).…”

Incorporating PSMA-Targeting Theranostics Into Personalized Prostate Cancer Treatment: a Multidisciplinary Perspective

“…Extending the cranial border of the pelvic field from L5/S1 to L4/L5 increased accuracy of covering potentially involved nodes. Another recent study used data from two prospective trials with PSMA PET/CT imaging in high-risk individuals with cN0M0 disease per conventional imaging to develop a nomogram to help identify high-risk patients who might benefit from the addition of a PSMA PET/CT ( 48 ).…”

Performance of a Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography–Derived Risk-Stratification Tool for High-risk and Very High-risk Prostate Cancer

“…Recently, we developed a PSMA nomogram to calculate the probability of finding nonlocalized disease on PSMA PET/CT in patients who appear to have cN0M0 disease on conventional imaging. 8 , 9 In this study, we evaluated the significance of the PSMA nomogram (and, by proxy, PSMA PET/CT itself) on long-term, clinically meaningful end points (including distant metastasis [DM], prostate cancer–specific mortality [PCSM], and overall survival [OS]) using internal validation, external validation, and comparison with existing risk-stratification models. We hypothesized that the PSMA nomogram would provide more accurate prognostication than existing risk-stratification tools in high-risk patients based on the underlying hypothesis that previously occult, PSMA PET/CT–detectable nonlocalized disease may be the primary reason for treatment failures and underlie the heterogeneity in clinical outcomes.…”