Can PSMA-based tumor burden predict response to docetaxel treatment in metastatic castration-resistant prostate cancer?

Şimşek, Duygu Has; Kuyumcu, Serkan; Karadogan, Seyfullah; Oflas, Melis; Işık, Emine Göknur; Özkan, Zeynep Gözde; Paksoy, Nail; Ekmekçioğlu, Özgül; Ekenel, Meltem; Şanlı, Yasemin

doi:10.1007/s12149-021-01610-x

Cited by 16 publications

(20 citation statements)

References 37 publications

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“…Second, it could help speed up the interpretation time, which is important when nuclear medicine physicians/radiologists are scarce. Third, a validated and fast assessment of tumour burden could have several implications, for example, providing prognostic information [ 10 , 11 , 12 ] and evaluating treatment response [ 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

Freely Available, Fully Automated AI-Based Analysis of Primary Tumour and Metastases of Prostate Cancer in Whole-Body [18F]-PSMA-1007 PET-CT

Trägårdh

Enqvist

Ulén³

et al. 2022

Diagnostics

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Here, we aimed to develop and validate a fully automated artificial intelligence (AI)-based method for the detection and quantification of suspected prostate tumour/local recurrence, lymph node metastases, and bone metastases from [18F]PSMA-1007 positron emission tomography-computed tomography (PET-CT) images. Images from 660 patients were included. Segmentations by one expert reader were ground truth. A convolutional neural network (CNN) was developed and trained on a training set, and the performance was tested on a separate test set of 120 patients. The AI method was compared with manual segmentations performed by several nuclear medicine physicians. Assessment of tumour burden (total lesion volume (TLV) and total lesion uptake (TLU)) was performed. The sensitivity of the AI method was, on average, 79% for detecting prostate tumour/recurrence, 79% for lymph node metastases, and 62% for bone metastases. On average, nuclear medicine physicians’ corresponding sensitivities were 78%, 78%, and 59%, respectively. The correlations of TLV and TLU between AI and nuclear medicine physicians were all statistically significant and ranged from R = 0.53 to R = 0.83. In conclusion, the development of an AI-based method for prostate cancer detection with sensitivity on par with nuclear medicine physicians was possible. The developed AI tool is freely available for researchers.

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Section: Discussionmentioning

confidence: 99%

Freely Available, Fully Automated AI-Based Analysis of Primary Tumour and Metastases of Prostate Cancer in Whole-Body [18F]-PSMA-1007 PET-CT

Trägårdh

Enqvist

Ulén³

et al. 2022

Diagnostics

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“…Globally, seven articles related to the role of PET-imaging in the evaluation of response to chemotherapy (all docetaxel; as neoadjuvant therapy in one study [ 33 ]; as first-line therapy in five [ 34 , 35 , 36 , 37 , 38 ] and as a palliative regimen in one study [ 39 ]; Table 1 ) were included in this review. In four out of seven papers, radiolabeled choline PET was used.…”

Section: Resultsmentioning

confidence: 99%

“…In the last few years, some articles were published, using [ 68 Ga]PSMA-11 for the monitoring of response to docetaxel, with the initial results suggesting that [ 68 Ga]PSMA-11 PET/CT might be superior to conventional imaging in the evaluation of response to chemotherapy, either in hormone-sensitive or mCRPCa patients ([ 37 , 38 ]). Finally, the group of Simsek [ 39 ], similarly to Quaquarini et al [ 36 ], showed that the total baseline PSMA-derived tumor volume (TV-PSMA) may be predictive of response to first-line docetaxel, thus delineating the opportunity to use it as a reliable tool for survival assessment in mCRPCa patients.…”

Section: Resultsmentioning

confidence: 99%

PSMA and Choline PET for the Assessment of Response to Therapy and Survival Outcomes in Prostate Cancer Patients: A Systematic Review from the Literature

Alongi

Laudicella

Lanzafame

et al. 2022

Cancers

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The aims of this systematic review were to (1) assess the utility of PSMA-PET and choline-PET in the assessment of response to systemic and local therapy, and to (2) determine the value of both tracers for the prediction of response to therapy and survival outcomes in prostate cancer. We performed a systematic literature search in PubMed/Scopus/Google Scholar/Cochrane/EMBASE databases (between January 2010 and October 2021) accordingly. The quality of the included studies was evaluated following the “Quality Assessment of Prognostic Accuracy Studies” tool (QUAPAS-2). We selected 40 articles: 23 articles discussed the use of PET imaging with [68Ga]PSMA-11 (16 articles/1123 patients) or [11C]/[18F]Choline (7 articles/356 patients) for the prediction of response to radiotherapy (RT) and survival outcomes. Seven articles (three with [68Ga]PSMA-11, three with [11C]Choline, one with [18F]Choline) assessed the role of PET imaging in the evaluation of response to docetaxel (as neoadjuvant therapy in one study, as first-line therapy in five studies, and as a palliative regimen in one study). Seven papers with radiolabeled [18F]Choline PET/CT (n = 121 patients) and three with [68Ga]PSMA-11 PET (n = 87 patients) were selected before and after enzalutamide/abiraterone acetate. Finally, [18F]Choline and [68Ga]PSMA-11 PET/CT as gatekeepers for the treatment of metastatic prostate cancer with Radium-223 were assessed in three papers. In conclusion, in patients undergoing RT, radiolabeled choline and [68Ga]PSMA-11 have an important prognostic role. In the case of systemic therapies, the role of such new-generation imaging techniques is still controversial without sufficient data, thus requiring additional in this scenario.

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“…Tumor burden is also a critical point for therapy of choice since the CHAARTED study showed that low volume M1 disease did not benefit from DTX as much as high volume disease 34 . Our previous study revealed that PSMA-based tumor burden could help select patients who would receive DTx treatment in mCRPC, and high TV-PSMA was significantly related to poor outcome 35 . Seifert et al 36 reported that TV-PSMA was a significant negative predictor of OS for LuPSMA therapy in mCRPC.…”

Section: Discussionmentioning

confidence: 99%

Outcome of 177Lu-PSMA Radionuclide Treatment in Advanced Prostate Cancer and Its Association With Clinical Parameters

et al. 2022

Self Cite

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Purpose: This study was set out to analyze the efficacy and safety of 177 Lu-PSMA-617 (LuPSMA) treatment in metastatic castration-resistant prostate cancer (mCRPC) patients. Patients and Methods: Progressive mCRPC patients who received at least 1 cycle of LuPSMA therapy were evaluated retrospectively. Demographic, clinic, and histopathological data were documented. Treatment efficacy was determined based on biochemical response criteria (Prostate Cancer Clinical Trial Working Group 3), and toxicity rates were defined based on CTCAE v4.03. The prognostic significance of laboratory/clinical data and 68 Ga-PSMA PET/CT quantitative results were analyzed using SPSS Version 24.0. Results: One hundred patients (median prostate-specific antigen [PSA] level, 75.7 ng/mL) who met the eligibility criteria were identified. The median number of cycles received per patient was 3 (range, 1-9). After the first cycles of LuPSMA, biochemical partial response, biochemical stable disease, and biochemical progressive disease were observed in 31%, 36%, and 33% of patients, respectively. Any PSA decline was determined in 60% of patients. After the fourth cycle of treatment, biochemical partial response, biochemical stable disease, and biochemical progressive disease were defined in 48%, 26%, and 26% of patients, respectively. The median overall survival (OS) from the first cycle of LuPSMA was 14 months. Patients who had any PSA response after the first cycle had significantly longer OS than nonresponders (median OS: 17 vs 9 months; P ≤ 0.001). Total PSMA-derived tumor volume ( P = 0.004), total PSMA activity per lesion ( P = 0.01), PSA ( P = 0.007), alkaline phosphatase ( P = 0.002), lactate dehydrogenase ( P < 0.001), and hemoglobin ( P < 0.001) were significant prognostic factors for OS in univariate Cox regression analysis. Conclusions: LuPSMA therapy is a favorable treatment for mCRPC with remarkable therapeutic efficacy and low toxicity rates, even in progressive disease under standard therapies. Baseline PSMA-based tumor burden, PSA, alkaline phosphatase, lactate dehydrogenase, and hemoglobin were significant predictors of OS and can be useful for selection of the best candidate for LuPSMA therapy.

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Can PSMA-based tumor burden predict response to docetaxel treatment in metastatic castration-resistant prostate cancer?

Cited by 16 publications

References 37 publications

Freely Available, Fully Automated AI-Based Analysis of Primary Tumour and Metastases of Prostate Cancer in Whole-Body [18F]-PSMA-1007 PET-CT

Freely Available, Fully Automated AI-Based Analysis of Primary Tumour and Metastases of Prostate Cancer in Whole-Body [18F]-PSMA-1007 PET-CT

PSMA and Choline PET for the Assessment of Response to Therapy and Survival Outcomes in Prostate Cancer Patients: A Systematic Review from the Literature

Outcome of 177Lu-PSMA Radionuclide Treatment in Advanced Prostate Cancer and Its Association With Clinical Parameters

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