Radiolabeled Monoclonal Antibody Indium 111-Labeled CYT-356 Localizes Extraprostatic Recurrent Carcinoma After Prostatectomy

Clinical utility of indium 111‐capromab pendetide immunoscintigraphy in the detection of early, recurrent prostate carcinoma after radical prostatectomy

“…17,21,22 These conclusions were based on initial studies of patients with biochemical recurrence after prostate extirpation and with high serum PSA levels (average, 28.7 ng/mL; median, 13.8 ng/mL). 15 In a large, multicenter study of 877 patients with a mean serum PSA level of 8.9 ng/mL after undergoing surgical resection of the prostate, a 10-fold increase in serum PSA level was associated with a 1.23-fold higher risk of a positive capromab pendetide uptake in the prostatic fossa. 23 Additional studies have suggested that a low serum PSA level after primary treatment of prostate carcinoma may be associated with a negative capromab pendetide scan.…”

“…27,40,41 The utility of the capromab pendetide scan in differentiating local recurrence from distant recurrence after radical prostatectomy is the better selection of patients for possible salvage radiotherapy to the prostatic bed and avoid unnecessary radiation treatment in patients with metastatic disease. 15,[42][43][44] In an initial report of 7 patients with biochemical failure after undergoing radical prostatectomy in whom no capromab pendetide scan activity was identified beyond the radiation field, only 2 patients (29%) demonstrated evidence of biochemical recurrence within 1 year after salvage external beam radiation. 15 In contrast, radiation treatment failed in 4 of 6 patients (66%) with more distant disease on capromab pendetide scanning.…”

“…15,[42][43][44] In an initial report of 7 patients with biochemical failure after undergoing radical prostatectomy in whom no capromab pendetide scan activity was identified beyond the radiation field, only 2 patients (29%) demonstrated evidence of biochemical recurrence within 1 year after salvage external beam radiation. 15 In contrast, radiation treatment failed in 4 of 6 patients (66%) with more distant disease on capromab pendetide scanning. 15 In a recent study, of 23 patients with postoperative biochemical failure, 16 patients (70%) with a negative capromab pendetide scan achieved a durable complete response after salvage radiation therapy, with a decrease in serum PSA Յ 0.3 ng/mL for at least 6 months.…”

“…9,10 The sensitivity, specificity, and overall accuracy of this radionuclide scan have been reported at 62%, 72%, and 88%, respectively, in early analyses 11 and at 75%, 86%, and 81%, respectively, in more recent studies. [12][13][14] Earlier capromab pendetide studies of patients with biochemical recurrence after prostate extirpation were performed in men with high serum PSA levels (average, 28.7 ng/mL; median, 13.8 ng/mL) 15 and demonstrated that, whereas 3 of 48 patients (6%) had local prostatic fossa uptake of capromab, 35 of 48 patients (73%) had evidence of antibody uptake beyond the prostatic fossa. 15 Generally, distant capromab pendetide scan activity has been reported at higher serum PSA levels.…”

“…[12][13][14] Earlier capromab pendetide studies of patients with biochemical recurrence after prostate extirpation were performed in men with high serum PSA levels (average, 28.7 ng/mL; median, 13.8 ng/mL) 15 and demonstrated that, whereas 3 of 48 patients (6%) had local prostatic fossa uptake of capromab, 35 of 48 patients (73%) had evidence of antibody uptake beyond the prostatic fossa. 15 Generally, distant capromab pendetide scan activity has been reported at higher serum PSA levels. 10,12,13,16 Although anecdotal evidence of uptake of capromab pendetide at serum PSA levels as low as 0.13 ng/mL has been reported, 12,3,16 the utility of the capromab pendetide scan in patients with early biochemical evidence (PSA Ն 4.0 ng/mL) of recurrent prostate carcinoma is not known.…”