Prospective study on the effect of short-term androgen deprivation therapy on PSMA uptake evaluated with 68Ga-PSMA-11 PET/MRI in men with treatment-naïve prostate cancer

Ettala, Otto; Malaspina, Simona; Tuokkola, Terhi; Luoto, Pauliina; Löyttyniemi, Eliisa; Boström, Peter J.; Kemppainen, Jukka

doi:10.1007/s00259-019-04635-7

Cited by 50 publications

(52 citation statements)

References 21 publications

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“… Ferraro et al [ 47 ] 2019 Switzerland Retrospective 65 (51–79) 60 13 ± 13.6 ng/mL Staging None 68Ga-PSMA-11 46 Detection of disease Data from PET are able to select patients who benefit from ePLND. Ettala et al [ 48 ] 2019 Finland Prospective 71 (64–78) 9 52 ng/mL (7–280) Staging ADT 68Ga-PSMA-11 9 Acquisition protocol 68Ga-PSMA is associated with an increase uptake due to ADT administration. The optimal time to acquisition is after 3–4 weeks post-ADT.…”

Section: Resultsmentioning

confidence: 99%

PET/MRI in prostate cancer: a systematic review and meta-analysis

Evangelista

Zattoni

Cassarino

et al. 2020

Eur J Nucl Med Mol Imaging

105

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Aim In recent years, the clinical availability of scanners for integrated positron emission tomography (PET) and magnetic resonance imaging (MRI) has enabled the practical potential of multimodal, combined metabolic-receptor, anatomical, and functional imaging to be explored. The present systematic review and meta-analysis summarize the diagnostic information provided by PET/MRI in patients with prostate cancer (PCa). Materials and methods A literature search was conducted in three different databases. The terms used were “choline” or “prostate-specific membrane antigen - PSMA” AND “prostate cancer” or “prostate” AND “PET/MRI” or “PET MRI” or “PET-MRI” or “positron emission tomography/magnetic resonance imaging.” All relevant records identified were combined, and the full texts were retrieved. Reports were excluded if (1) they did not consider hybrid PET/MRI; or (2) the sample size was < 10 patients; or (3) the raw data were not enough to enable the completion of a 2 × 2 contingency table. Results Fifty articles were eligible for systematic review, and 23 for meta-analysis. The pooled data concerned 2104 patients. Initial disease staging was the main indication for PET/MRI in 24 studies. Radiolabeled PSMA was the tracer most frequently used. In primary tumors, the pooled sensitivity for the patient-based analysis was 94.9%. At restaging, the pooled detection rate was 80.9% and was higher for radiolabeled PSMA than for choline (81.8% and 77.3%, respectively). Conclusions PET/MRI proved highly sensitive in detecting primary PCa, with a high detection rate for recurrent disease, particularly when radiolabeled PSMA was used.

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Section: Resultsmentioning

confidence: 99%

PET/MRI in prostate cancer: a systematic review and meta-analysis

Evangelista

Zattoni

Cassarino

et al. 2020

Eur J Nucl Med Mol Imaging

105

View full text Add to dashboard Cite

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“…(91 %) Ettala et al . [ 17 ] 9 pts., prospectively enrolled, start of degarelix (Firmagon®) in HSPC [ 68 Ga]-PSMA-11 (baseline and 3 times post-ADT) Heterogeneous increase in PSMA uptake 3 to 4 weeks post-ADT Start of enzalutamide or abiraterone in CRPC Emmett et al . [ 10 ] Cohort 1 (8 pts.…”

Section: Discussionmentioning

confidence: 99%

[18F]-JK-PSMA-7 PET/CT Under Androgen Deprivation Therapy in Advanced Prostate Cancer

et al. 2020

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Purpose PSMA imaging is frequently used for monitoring of androgen deprivation therapy (ADT) in prostate cancer. In a previous study, [18F]-JK-PSMA-7 exhibited favorable properties for tumor localization after biochemical recurrence. In this retrospective study, we evaluated the performance of [18F]-JK-PSMA-7 under ADT. Procedures We examined the performance of [18F]-JK-PSMA-7 in 70 patients (first cohort) with increasing or detectable PSA values under ADT (PSA < 2 ng/ml for 21/70 patients). We further analyzed 58 independent patients with PSA levels < 2 ng/ml under ADT, who were imaged with [68Ga]PSMA-11 or [18F]DCFPyL (second cohort). Finally, we compared detection rates between [18F]-JK-PSMA-7, [68Ga]PSMA-11, and [18F]DCFPyL. Results In the first cohort, we detected [18F]-JK-PSMA-7-positive lesions in 63/70 patients. In patients with PSA levels ≥ 2 ng/ml, the detection rate was 100 % (49/49). In patients with PSA < 2 ng/ml, the detection rate was significantly lower (66.7 %, 14/21, p = 9.7 × 10−5) and dropped from 85.7 % (12/14, PSA levels between 0.3 and 2.0 ng/ml) to 28.6 % (2/7) for PSA levels < 0.3 ng/ml (p = 1.73 × 10−2). In the second cohort (PSA < 2 ng/ml), the detection rate was 79.3 % (46/58) for [68Ga]PSMA-11 or [18F]DCFPyL. Again, the detection rate was significantly higher (p = 1.1 × 10−2) for patients with PSA levels between 0.3 and 2.0 ng/ml (87.0 %, 40/46) relative to those with PSA levels < 0.3 ng/ml (50 %, 6/12). No significant difference was found between [18F]-JK-PSMA-7 and [68Ga]PSMA-11 or [18F]DCFPyL in patients with PSA levels < 2 ng/ml (p = 0.4295). Conclusion [18F]-JK-PSMA-7 PET showed a high detection rate in patients with PSA levels ≥ 0.3 ng/ml under ADT. The lower PSA threshold of 0.3 ng/ml for high detection rates was consistent across the three PSMA ligands. Thus, PSMA imaging is suitable for clinical follow-up of patients with increasing PSA levels under ADT.

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“…To date, functional and in vitro studies have shown that ADT can result in a rise of PSMA expression. 64 There are few data in the literature describing the flare phenomenon associated with PSMA PET/CT for the evaluation of treatment response, and future works are warranted.…”

Section: Conclusion and Future Perspectivesmentioning

confidence: 99%

Flare phenomenon in prostate cancer: recent evidence on new drugs and next generation imaging

et al. 2021

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Over the years, an increasing proportion of metastatic prostate cancer patients has been found to experience an initial bone flare phenomenon under both standard therapies (androgen deprivation therapy, chemotherapy, radiotherapy, abiraterone, enzalutamide) and novel agents (immunotherapy, bone-targeting radioisotopes). The underlying biological mechanisms of the flare phenomenon are still elusive and need further clarification, particularly in relation to different types of treatment and their treatment response assessment. Flare phenomenon is often underestimated and, in some cases, can negatively affect clinical outcome. In cases with suspected bone flare, the treatment should be continued for a minimum of 12 more weeks before further decisions about efficacy can be taken. Physicians and patients should be aware of this effect to avoid unwarranted anxiety and inadequate early discontinuation of treatment. This review aims at highlighting new evidence on flare phenomenon arising after the introduction of new drugs extending across the biochemical, radiographic and clinical spectrum of the disease.

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Prospective study on the effect of short-term androgen deprivation therapy on PSMA uptake evaluated with 68Ga-PSMA-11 PET/MRI in men with treatment-naïve prostate cancer

Cited by 50 publications

References 21 publications

PET/MRI in prostate cancer: a systematic review and meta-analysis

PET/MRI in prostate cancer: a systematic review and meta-analysis

[18F]-JK-PSMA-7 PET/CT Under Androgen Deprivation Therapy in Advanced Prostate Cancer

Flare phenomenon in prostate cancer: recent evidence on new drugs and next generation imaging

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