Ricardo Pereira Mestre1, Giorgio Treglia2,3,4,5, Matteo Ferrari6, Mariarosa Pascale4, Calogero Mazzara1, Ngwa Che Azinwi7, Anna Llado'1, Anastasios Stathis1, Luca Giovanella2, Enrico Roggero1. 1. Clinic of Medical Oncology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland. 2. Clinic of Nuclear Medicine and PET/CT Center, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland. 3. Health Technology Assessment Unit, Ente Ospedaliero Cantonale, Bellinzona, Switzerland. 4. Clinical Trial Unit, Ente Ospedaliero Cantonale, Bellinzona, Switzerland. 5. Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland. 6. Clinic of Urology, San Giovanni Hospital, Ente Ospedaliero Cantonale, Bellinzona, Switzerland. 7. Clinic of Radiation Oncology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland.
Abstract
BACKGROUND: Serum prostate-specific antigen (PSA) may predict the risk of positive positron emission tomography/computed tomography with radiolabelled prostate-specific membrane antigen (PSMA-PET/CT) in patients with biochemical recurrent prostate cancer (BRPCa). However, to date, there are no clear data regarding the correlation between PSA kinetics and PSMA-PET findings. We performed a systematic review and meta-analysis to provide evidence-based data in this setting. METHODS: A comprehensive literature search of studies published through October 2018 in PubMed/MEDLINE, EMBASE and Cochrane library databases was performed. A meta-analysis to establish the detection rate (DR) of PSMA-PET using different cut-off values of PSA doubling time (PSAdt) and a pooled analysis to establish whether shorter PSAdt may predict positive PSMA-PET results was performed in patients with BRPCa. RESULTS: Twelve articles were included in the systematic review, and eight articles (including about 1400 patients) were selected for the meta-analysis. The pooled DR including 95% confidence intervals (95%CI) of PSMA-PET in restaging prostate cancer (PCa) patients was 72% (95%CI:60%-82%), increasing to 83% (95%CI:75%-90%) when PSAdt was ≤6 months and decreasing to 60% (95%CI:37%-80%) when PSAdt was >6 months, without a statistical significant difference. PSAdt ≤6 months may predict the positive result of PSMA-PET (pooled odds ratio: 3.22; 95%CI:1.17-8.88). Statistical heterogeneity among the included studies was found. CONCLUSIONS: PSA kinetics, and in particular shorter PSAdt, may be predictor of PSMA-PET positivity in patients with BRPCa. Further larger studies in this setting are warranted.
BACKGROUND: Serum prostate-specific antigen (PSA) may predict the risk of positive positron emission tomography/computed tomography with radiolabelled prostate-specific membrane antigen (PSMA-PET/CT) in patients with biochemical recurrent prostate cancer (BRPCa). However, to date, there are no clear data regarding the correlation between PSA kinetics and PSMA-PET findings. We performed a systematic review and meta-analysis to provide evidence-based data in this setting. METHODS: A comprehensive literature search of studies published through October 2018 in PubMed/MEDLINE, EMBASE and Cochrane library databases was performed. A meta-analysis to establish the detection rate (DR) of PSMA-PET using different cut-off values of PSA doubling time (PSAdt) and a pooled analysis to establish whether shorter PSAdt may predict positive PSMA-PET results was performed in patients with BRPCa. RESULTS: Twelve articles were included in the systematic review, and eight articles (including about 1400 patients) were selected for the meta-analysis. The pooled DR including 95% confidence intervals (95%CI) of PSMA-PET in restaging prostate cancer (PCa) patients was 72% (95%CI:60%-82%), increasing to 83% (95%CI:75%-90%) when PSAdt was ≤6 months and decreasing to 60% (95%CI:37%-80%) when PSAdt was >6 months, without a statistical significant difference. PSAdt ≤6 months may predict the positive result of PSMA-PET (pooled odds ratio: 3.22; 95%CI:1.17-8.88). Statistical heterogeneity among the included studies was found. CONCLUSIONS:PSA kinetics, and in particular shorter PSAdt, may be predictor of PSMA-PET positivity in patients with BRPCa. Further larger studies in this setting are warranted.
Authors: Channing J Paller; Danilo Piana; James R Eshleman; Stacy Riel; Samuel R Denmeade; Pedro Isaacsson Velho; Steven P Rowe; Martin G Pomper; Emmanuel S Antonarakis; Jun Luo; Mario A Eisenberger Journal: Prostate Date: 2019-07-30 Impact factor: 4.104
Authors: Michael A Gorin; Steven P Rowe; Mark C Markowski; Ramy Sedhom; Wei Fu; Javaughn Corey R Gray; Mario A Eisenberger; Martin G Pomper; Kenneth J Pienta Journal: J Urol Date: 2020-04-06 Impact factor: 7.450
Authors: Francesco Ceci; Lorenzo Bianchi; Marco Borghesi; Giulia Polverari; Andrea Farolfi; Alberto Briganti; Riccardo Schiavina; Eugenio Brunocilla; Paolo Castellucci; Stefano Fanti Journal: Eur J Nucl Med Mol Imaging Date: 2019-09-06 Impact factor: 9.236