Appropriate Use Criteria for Imaging Evaluation of Biochemical Recurrence of Prostate Cancer After Definitive Primary Treatment

Jadvar, Hossein; Ballas, Leslie K.; Choyke, Peter L.; Fanti, Stefano; Gulley, James L.; Herrmann, Ken; Hope, Thomas A.; Klitzke, Alan; Oldan, Jorge; Pomper, Martin G.; Rowe, Steven P.; Subramaniam, Rathan M.; Taneja, Samir S.; Vargas, Herbert Alberto; Ahuja, Sukhjeet

doi:10.2967/jnumed.119.240929

Cited by 12 publications

(9 citation statements)

References 96 publications

(114 reference statements)

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“…There is reduced expression of PSMA molecule in advanced disease with reduced to no uptake/avidity on 68 Ga-PSMA ligand imaging. These patients have been found to have discordance between 68 Ga-PSMA and 18 F-FDG PET/CT imaging and more aggressive phenotype with poor response to PSMA directed therapies [50][51][52][53]. Chen et al found 13/56 (23.2%) of patients with at least one PSMA negative and FDG positive lesion.…”

Section: F-fdg For Imaging Discordancementioning

confidence: 99%

PSMA Theranostics: Science and Practice

Mokoala

Lawal

Lengana³

et al. 2021

Cancers

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Prostate cancer (PCa) causes significant morbidity and mortality in men globally. While localized PCa may be managed with curative intent by surgery and/or radiation therapy, the management of advanced hormone resistant metastatic disease (mCRPC) is more challenging. Theranostics is a principle based on the ability to use an organ specific ligand and label it to both a diagnostic and a therapeutic agent. The overexpression of prostate specific membrane antigen (PSMA) on prostate cancer cells creates a unique opportunity for development of targeted radionuclide therapy. The use of both beta and alpha emitting particles has shown great success. Several clinical trials have been initiated assessing the efficacy and safety profile of these radionuclide agents. The results are encouraging with PSMA directed radioligand therapy performing well in patients who have exhausted all other standard treatment options. Future studies need to assess the timing of introduction of these radionuclide therapies in the management schema of mCRPC. Drugs or therapies are not without side effects and targeted radionuclide therapies presents a new set of toxicities including xerostomia and myelosuppression. New therapeutic strategies are being explored to improve outcomes while keeping toxicities to a minimum. This review aims to look at the various PSMA labelled tracers that form part of the theragnostic approach and subsequently delve into the progress made in the area of radionuclide therapy.

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Section: F-fdg For Imaging Discordancementioning

confidence: 99%

PSMA Theranostics: Science and Practice

Mokoala

Lawal

Lengana³

et al. 2021

Cancers

View full text Add to dashboard Cite

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Section: The Notion and Relevance Of Biochemical Recurrence (Bcr)mentioning

confidence: 99%

“…Its comparative detection sensitivity in the BCR setting has been assessed against a previous-generation tracer, choline, demonstrating the superiority of Ga-PSMA in terms of detection rates at any PSA level, [26][27][28] and has now been included as a recommendation in this setting in international guidelines. 29 At the usually low PSA levels BCR features, even with PSMA-PET and more so with conventional imaging, the eventual identification of macroscopic disease is invariably limited to an oligorecurrence context. Other than enlarging this space as it shrinks the true BCR space, the availability of such imaging has also shifted the treatment paradigm towards metastasis-directed treatment, both in the CSPC and the CRPC setting.…”

Section: Impact Of Novel Imaging Technologiesmentioning

confidence: 99%

Should androgen deprivation therapy and other systemic treatments be used in men with prostate cancer and a rising PSA post-local treatments?

et al. 2021

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Biochemical recurrence is an evolving space in prostate cancer, with increasing multidisciplinary involvement. Androgen deprivation therapy has shown proof of its value in complementing salvage radiotherapy in high-risk biochemical relapsing patients; ongoing trials aim to further refine this treatment combination. As systemic treatments, and notably next-generation androgen receptor targeted agents, have moved towards early hormone-sensitive and non-metastatic stages, the prostate specific antigen (PSA)-relapse disease stage will be undoubtedly challenged by future evidence from such ongoing clinical trials. With the use of modern imaging and newer molecular technologies, including integration of tumoral genomic profiling and liquid biopsies in risk stratification, a path towards a precision oncology-focused approach will become a reality to guide in the future decisions for patients with a diagnosis of biochemical recurrence.

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“…Kim et al (2016), used Multiplexed SRM-MS to assess the effectiveness of biomarkers for the diagnosis of prostate cancer in urine samples. Out of 48 urine samples analysed, the researchers identified ANXA3, IDHC, PEDF, PRDX6, SERA, and TGM4 as potential biomarkers for use in the diagnosis of prostate cancer (Jadvar et al, 2020).…”

Section: Proteome Analysis Enhance Person-alised Treatmentmentioning

confidence: 99%

“…According to the Office for National Statistics (2019) cancer registration report, PCa was the most common cancer in men in the UK with over 40,000 cases diagnosed in 2017 alone. The current methods of determining the correct therapy for a patient diagnosed with PCa depend almost entirely on Prostate-Specific Antigen (PSA) levels, histopathological features, diagnostic imaging, and clinical assessment of the severity of the disease (Jadvar et al, 2020). Recent developments in genomic technology have changed our perception of complex molecular, genetic, metabolomic, epigenetic, and transcriptomic remodelling in PCa.…”

Section: Introductionmentioning

confidence: 99%