Can Findings on PSMA PET/CT Alter Management in Recurrent Prostate Cancer?
Posted: Tuesday, July 14, 2020
High detection rates for additional disease sites were discovered in patients with prostate cancer who underwent 18-F–DCFPyL prostate-specific membrane antigen positron-emission tomography/computed tomography (PSMA PET/CT). Ur Metser, MD, FRCPC, of the University of Toronto, Ontario, Canada, and colleagues found the PET results resulted in a change in treatment management for 66% of patients with prostate cancer. These preliminary data were during the Society of Nuclear Medicine and Molecular Imaging (SNMMI) 2020 Virtual Annual Meeting (Abstract 40) and published in The Journal of Nuclear Medicine.
“The identification of extent of recurrence and specific sites of recurrence is crucial in determining the most appropriate mode of therapy for these men,” commented Dr. Metser in a SNMMI press release.
A total of 410 men who had biochemical failure after primary therapy, no or limited disease on CT or bone scintigraphy scans, as well as a history of prostate cancer treatment were enrolled in this prospective study. Of the 410 men, 261 had PET-detected lesions. There was also a 56% (174 of 310 patients) increase in PET detection rates for lesions in men who had underwent negative conventional imaging. In addition, PSMA PET/CT scan was 63% more effective in detecting new lesions, whereas these patients initially tested negative in prior CT and bone scan scintigraphs.
Based on the PET scan results, the authors reported a 66% change in prostate cancer management. “The most common change was conversion from observation or systemic therapy to surgery or radiation for locoregional (n = 74) or oligometastatic disease (n = 30) or alternatively the addition of nodal-directed therapy to salvage surgery or radiation (n = 37).”
