Impact of ⁶⁸Ga-PSMA-11 PET on Management in Patients with Biochemically Recurrent Prostate Cancer

Abstract

The purpose of this prospective study was to estimate the effect of Ga-labeled prostate-specific membrane antigen (PSMA)-11 PET on the intended management of patients with biochemically recurrent prostate cancer. Pre- and postimaging surveys were filled out by the referring providers for patients with biochemical recurrence who were imaged using Ga-PSMA-11 PET. The inclusion criterion for this study was a prostate-specific antigen (PSA) doubling time of less than 12 mo after initial treatment (NCT02611882). Of the 150 consecutive patients imaged, 126 surveys were completed (84% response rate). The responses were categorized as major change, minor change, no change, or unknown change. There were 103 patients (82%) with disease detected on Ga-PSMA-11 PET. On the basis of the survey results, there were 67 patients (53.2%) with major changes in management and 8 patients (6.4%) with minor changes. The proportion of cases resulting in a change in management did not significantly differ by baseline PSA level. In patients with PSA levels below 0.2 ng/dL, 7 of 12 patients had disease detected onGa-PSMA-11 PET, 5 of whom had a major change in management. Ga-PSMA-11 PET resulted in a major change in management in 53% of patients with biochemical recurrence. Further studies are warranted to investigate whether PSMA-based management strategies result in improved outcomes for patients.

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

“…After reviewing the full texts, four articles were excluded from the quantitative analysis (meta‐analysis) due to insufficient data to reassess the correlation between PSA kinetics and DR of PSMA‐PET and 8 studies including about 1,400 patients were finally selected for the meta‐analysis (Figure ).…”

Treatment Outcomes from 68Ga-PSMA PET/CT–Informed Salvage Radiation Treatment in Men with Rising PSA After Radical Prostatectomy: Prognostic Value of a Negative PSMA PET

“…In a previous study, we demonstrated that up to 29% of men in this patient cohort have disease outside the prostate fossa at the time of imaging with PSMA PET/CT (5). We know that there is a high management impact with PSMA PET/CT in this patient population (7)(8)(9)12,13). However, what Data in parentheses are percentages unless otherwise noted.…”

“…Recent publications have reported PSMA PET/CT identifying disease outside the prostate fossa in 28%-43% of men with a rising PSA after RP (5-7). These findings have led to significant changes in patient care, with many patients confirmed with metastatic disease on PSMA PET scans not proceeding to salvage fossa radiotherapy (8,9).…”

State‐of‐the‐art imaging techniques in the management of preoperative staging and re‐staging of prostate cancer

“…In other subgroups, they reported a DR of 93.0% for PSA values between 1 and 2 ng/mL, 72.7% for PSA values between 0.5 and 1 ng/mL, and 57.9% for PSA values between 0.2 and 0.5 ng/mL. Other authors substantially confirmed the same results, which represents the base for an increasing application of PSMA in the clinical routine …”