Posted: Friday, September 1, 2023
A molecular imaging tool developed by California researchers may help to improve treatment decisions for patients with prostate cancer before surgery, according to the findings of a post hoc analysis published in European Urology. Imaging with prostate-specific membrane antigen (PSMA) PET, used alone or with current tools before surgery, accurately predicted biochemical recurrence in patients with prostate cancer. Moreover, the researchers found that PSMA PET may prove to be a strong predictive biomarker when histologic data from surgery are unavailable.
“The imaging tool improves personalized treatments by helping the urologist decide whether or not to perform surgery, and to guide the surgical plan and the follow-up management after surgery,” said the study’s lead author Loïc Djaïleb, MD, PhD, of the David Geffen School of Medicine at the University of California Los Angeles (UCLA), in a press release.
To assess the diagnostic accuracy of gallium Ga-68–PSMA-11 PET before radical prostatectomy, the investigators analyzed follow-up data on 244 patients at a median 32.4 months after surgery from the original surgical cohort (n = 277) of a multicenter, prospective phase III imaging trial. Each scan was evaluated by three blinded, independent readers, and investigators determined risk by comparing biochemical recurrence rates with presurgery and postsurgery PSMA PET data defining prostate uptake and extraprostatic disease status as well as CAPRA (Cancer of the Prostate Risk Assessment) scores. (The CAPRA score combines prostate-specific antigen, MRI, and biopsy information.)
The PSMA PET and presurgical CAPRA scores significantly improved the risk assessment for cancer in comparison with the presurgical CAPRA score alone (C-statistic 0.70 [0.64–0.75] vs. 0.63 [0.57–0.69]; P < .001). Moreover, researchers found the risk assessment of the combined presurgical CAPRA score and PSMA-PET analysis similar to that obtained with the postsurgical CAPRA-S (CAPRA-Surgery) score that relied on tissue retrieved during surgery (P = .19).
Disclosure: For full disclosures of the study authors, visit sciencedirect.com.