Role of volumetric parameters obtained from 68 Ga-PSMA PET/CT and 18F-FDG PET/CT in predicting overall survival in patients with mCRPC receiving taxane therapy

Güzel, Yunus; Kömek, Halil; Can, Canan; Kaplan, İhsan; Akdeniz, Nadiye; Kepenek, Ferat; Gündoğan, Cihan

doi:10.1007/s12149-023-01854-9

Cited by 10 publications

(2 citation statements)

References 46 publications

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“…Due to its heterogeneity, CRPC may present a mosaic of neoplastic clones, some of which could be PSMA−/FDG+. Therefore, to have a reliable assessment of the whole burden of disease, dual-tracer imaging could be considered in mCRPC, particularly in those already subjected to multiple lines of treatment, or if neuroendocrine dedifferentiation is suspected [42,49].…”

Section: Discussionmentioning

confidence: 99%

“…[ 68 Ga]Ga-PSMA-11 showed a higher detection rate than [ 18 F]FDG (75% vs. 51.8%; p = 0.004), although 23.2% of patients showed at least 1 mismatched PSMA−/FDG+ lesion. In the study by Güzel et al [49], the authors recommend dual-tracer PET imaging in mCRPC undergoing taxane chemotherapy, as 78.9% of vis-ceral metastases were PSMA−/FDG+, representing a strong negative prognostic factor in multivariate Cox regression analysis. Similarly, semiquantitative parameters, such as the sum of total lesion glycolysis (TLG) and total lesion PSMA (TLP), were also predictors of shorter OS at multivariate analysis.…”

Section: Dual-tracer Psma/18f-fdg: Is It a Must?mentioning

confidence: 99%

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PSMA PET/CT in Castration-Resistant Prostate Cancer: Myth or Reality?

Urso,

Filippi,

Castello

et al. 2023

JCM

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Background: prostate-specific membrane antigen (PSMA) ligand PET has been recently incorporated into international guidelines for several different indications in prostate cancer (PCa) patients. However, there are still some open questions regarding the role of PSMA ligand PET in castration-resistant prostate cancer (CRPC). The aim of this work is to assess the clinical value of PSMA ligand PET/CT in patients with CRPC. Results: PSMA ligand PET has demonstrated higher detection rates in comparison to conventional imaging and allows for a significant reduction in the number of M0 CRPC patients. However, its real impact on patients’ prognosis is still an open question. Moreover, in CRPC patients, PSMA ligand PET presents some sensitivity and specificity limitations. Due to its heterogeneity, CRPC may present a mosaic of neoplastic clones, some of which could be PSMA−/FDG+, or vice versa. Likewise, unspecific bone uptake (UBU) and second primary neoplasms (SNPs) overexpressing PSMA in the neoangiogenic vessels represent potential specificity issues. Integrated multi-tracer imaging (PSMA ligand and [18F]FDG PET) together with a multidisciplinary discussion could allow for reaching the most accurate evaluation of each patient from a precision medicine point of view.

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Section: Discussionmentioning

confidence: 99%

Section: Dual-tracer Psma/18f-fdg: Is It a Must?mentioning

confidence: 99%

PSMA PET/CT in Castration-Resistant Prostate Cancer: Myth or Reality?

Urso,

Filippi,

Castello

et al. 2023

JCM

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Deep learning–based whole-body characterization of prostate cancer lesions on [68Ga]Ga-PSMA-11 PET/CT in patients with post-prostatectomy recurrence

Huang,

Yang,

et al. 2023

Eur J Nucl Med Mol Imaging

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Correlation of [68Ga]Ga-PSMA PET/CT response and PSA decline in first-line enzalutamide for metastatic castration-resistant prostate cancer patients

Giunta,

Caroli,

Scarpi

et al. 2024

Eur J Nucl Med Mol Imaging

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Purpose to assess the utility of response monitoring to enzalutamide by using [ 68 Ga]Ga-PSMA PET in mCRPC patients treated with enzalutamide as first-line therapy. Methods patients underwent [ 68 Ga]Ga-PSMA PET less than 8 weeks before and 3 months after starting enzalutamide. On the basis of EAU/EANM criteria, patients were categorized as PSMA responders (PET-R) or PSMA non-responders (PET-NR), whilst, based on PSA, they were classified as biochemical responders (PSA-R) or non-responders (PSA-NR). Survival analysis was performed using the Cox regression hazard model and the Kaplan-Meier method. Results 69 patients were considered fully evaluable. We observed 47.8% of concordance between [68Ga]Ga-PSMA PET and PSA monitoring at 3 months after starting enzalutamide. For discordant cases, the PSA reduction has a weak impact on PFS and a significant impact on OS in PET-NR patients, whilst this change has no impact either for PFS and OS in PET-R ones. Conclusions [ 68 Ga]Ga-PSMA PET could be a useful imaging tool for monitoring response to enzalutamide in mCRPC patients, being more informative than PSA in this setting, and possibly better guiding clinicians in therapeutic decisions. Supplementary Information The online version contains supplementary material available at 10.1007/s00259-024-06887-4.

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Role of volumetric parameters obtained from 68 Ga-PSMA PET/CT and 18F-FDG PET/CT in predicting overall survival in patients with mCRPC receiving taxane therapy

Cited by 10 publications

References 46 publications

PSMA PET/CT in Castration-Resistant Prostate Cancer: Myth or Reality?

PSMA PET/CT in Castration-Resistant Prostate Cancer: Myth or Reality?

Deep learning–based whole-body characterization of prostate cancer lesions on [68Ga]Ga-PSMA-11 PET/CT in patients with post-prostatectomy recurrence

Correlation of [68Ga]Ga-PSMA PET/CT response and PSA decline in first-line enzalutamide for metastatic castration-resistant prostate cancer patients

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