Influence of androgen deprivation therapy on PSMA expression and PSMA-ligand PET imaging of prostate cancer patients

Vaz, Sofia; Hadaschik, Boris; Gabriel, Michael; Herrmann, Ken; Eiber, Matthias; Costa, Durval C.

doi:10.1007/s00259-019-04529-8

Cited by 71 publications

(72 citation statements)

References 22 publications

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“…The duration of ADT is a key point to be considered when interpreting the in uence of ADT and PSMA expression and is the main reason for the diverging results. The studies assembled by Vaz et al (13) suggesting an increased PSMA expression under ADT had in most cases a therapy duration of only one month or shorter, while in our study the median therapy duration was 156 days with only two patients having ADT for less than two months. We a rm the assumption of Afshar-Oromieh et Al.…”

Section: Discussioncontrasting

confidence: 60%

“…Recently, Vaz et al (13) summarized the currently available clinical (n=9) and in vitro and in vivo (n=10) studies investigating the effect of ADT on PSMA expression. They outlined the high heterogeneity of these 19 reports in terms of study design, numbers of patients or cell lines, hormone sensitivity, ADT type and duration of application.…”

Section: Discussionmentioning

confidence: 99%

“…As PSMA-based imaging becomes more and more important for planning local ablative therapy, the in uence of ADT on PSMA-expression is of high relevance (13).…”

Section: Introductionmentioning

confidence: 99%

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PSMA PET Before and After Initial Long Term Androgen Deprivation in Patients With Newly Diagnosed Prostate Cancer

Hoberück¹,

Löck²,

Winzer³

et al. 2020

Preprint

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Purpose: The study aimed to evaluate the effect of androgen deprivation therapy (ADT) on PSMA imaging and its correlation to the PSA concentration comparing qualitative and quantitative parameters: SUVmax, SUVmean, PSMA-derived tumor volume (PSMA-TV), total lesion PSMA (TL-PSMA) and metabolic imaging (mi)PSMA score. Methods: Retrospective analysis of 19 therapy-naïve and oligometastatic prostate cancer patients (median age 73 years) who underwent either 68Ga-PSMA-11-PET/CT or -PET/MRI before initiation (T1) of as well as during ADT (T2). The median duration of ADT was 156 days (range: 61-289 days). All lesions were analyzed using several qualitative and quantitative PET parameters.Results: During long term ADT occurred a relevant decrease of lesion count and PSMA expression. A total of 104 PSMA-positive lesions (21 intraprostatic, 54 lymphonodal, 29 osseous) were visually detected at each of the two points, while at T2 two new bone lesions were detected in one patient. All analyzed PET parameters, which correlated strongly with each other. During ADT, all patients experienced a decrease of their PSA level (median: 29.1 before vs. 0.69 after; p<0.001). The PSA level at T2 correlates modestly with the decrease of PSMA expression and its derived volumes.Conclusion: Post ADT scans detected less PSMA-positive lesions with overall lower PSMA expression, regardless of primary tumor site or metastatic sites. None of the PET parameters has proven to be superior, as they all correlated modestly with the PSA value at T2. Thus, the simply acquirable miPSMA score seems to be the most suitable for evaluating the effect of ADT on PSMA expression.

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Section: Discussioncontrasting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

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PSMA PET Before and After Initial Long Term Androgen Deprivation in Patients With Newly Diagnosed Prostate Cancer

Hoberück¹,

Löck²,

Winzer³

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…As PSMA-based imaging becomes increasingly important for planning local ablative therapy, the influence of ADT on PSMA expression is of high relevance [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

“…In an animal study, Evans et al [ 17 ] reported a decreasing cell count under ADT and a higher PSMA expression per cell. These findings may affect imaging: the effect of increased PSMA expression in surviving cells may be overcompensated for by induced cell death in the vast majority of cells [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

[68Ga]Ga-PSMA-11 PET before and after initial long-term androgen deprivation in patients with newly diagnosed prostate cancer: a retrospective single-center study

et al. 2020

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Purpose The study aimed to evaluate the effect of androgen deprivation therapy (ADT) on PSMA imaging and its correlation to the PSA concentration by comparing qualitative and quantitative parameters: SUVmax, SUVmean, PSMA-derived tumor volume (PSMA-TV), total lesion PSMA (TL-PSMA) and molecular imaging (mi)PSMA score. Methods Retrospective analysis of 21 therapy-naïve patients with oligometastatic prostate cancer (median age 70 years) who underwent either [68Ga]Ga-PSMA-11-PET/CT or -PET/MRI before initiation of (T1) as well as during ADT (T2). The median duration of ADT was 155 days (range 61–289 days). All lesions were analyzed using several qualitative and quantitative PET parameters. Results A total of 109 PSMA-positive lesions (24 intraprostatic, 56 lymphonodal and 29 osseous) were visually detected at any of the examinations, while at T2, two new bone lesions were detected in one patient. During ADT, all patients experienced a decrease in their PSA level (median: 29.1 before vs. 0.71 after; p < 0.001). During long-term ADT, a relevant decrease in lesion count occurred, especially in patients with a T2 PSA value < 1 ng/ml (median: 4 vs. 0.9; p = 0.007) and PSMA expression, which resulted in miN- and/or miM-downstaging in 11 patients (52.7%). All analyzed PET parameters correlated strongly with each other. The PSA level at T2 correlated modestly with the decrease in PSMA expression and its derived volumes. Conclusion Post-ADT scans detected, especially in patients with a residual PSA < 1 ng/ml, fewer PSMA-positive lesions with overall lower PSMA expression, regardless of primary tumor site or metastatic sites. None of the PET parameters has proven to be superior, as they all correlated modestly with the PSA value at T2. Thus, the simply acquirable miPSMA score seems to be the most suitable for evaluating the effect of ADT on PSMA expression.

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Clinical Pharmacology of Radiotheranostics in Oncology

Beek

Burggraaf

Teunissen

et al. 2022

Clin Pharma and Therapeutics

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The combined use of diagnostic and therapeutic radioligands with the same molecular target, also known as theranostics, enables accurate patient selection, targeted therapy, and prediction of treatment response. Radioiodine, bone‐seeking radioligands and norepinephrine analogs have been used for many years for diagnostic imaging and radioligand therapy of thyroid carcinoma, bone metastases, pheochromocytoma, paraganglioma, and neuroblastoma, respectively. In recent years, radiolabeled somatostatin analogs and prostate‐specific membrane antigen ligands have shown clinical efficacy in the treatment of neuroendocrine tumors and prostate cancer, respectively. Several candidate compounds are targeting novel theranostic targets such as fibroblast activation protein, C‐X‐C chemokine receptor 4, and gastrin‐releasing peptide receptor. In addition, several strategies to improve efficacy of radioligand therapy are being evaluated, including dosimetry‐based dose optimization, multireceptor targeting, upregulation of target receptors, radiosensitization, pharmacogenomics, and radiation genomics. Design and evaluation of novel radioligands and optimization of dose and dose schedules, within the complex context of individualized multimodal cancer treatment, requires a multidisciplinary approach that includes clinical pharmacology. Significant increases in the use of these radiopharmaceuticals in routine oncological practice can be expected, which will have major impact on patient care as well as (radio)pharmacy utilization.

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Influence of androgen deprivation therapy on PSMA expression and PSMA-ligand PET imaging of prostate cancer patients

Cited by 71 publications

References 22 publications

PSMA PET Before and After Initial Long Term Androgen Deprivation in Patients With Newly Diagnosed Prostate Cancer

PSMA PET Before and After Initial Long Term Androgen Deprivation in Patients With Newly Diagnosed Prostate Cancer

[68Ga]Ga-PSMA-11 PET before and after initial long-term androgen deprivation in patients with newly diagnosed prostate cancer: a retrospective single-center study

Clinical Pharmacology of Radiotheranostics in Oncology

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