Ida Sonni1, Matthias Eiber2,3, Wolfgang P Fendler2,4, Rejah M Alano2, Sitaram S Vangala5, Amar U Kishan6,7,8, Nicholas Nickols6,7,8, Matthew B Rettig7,8,9, Robert E Reiter7,8,9, Johannes Czernin2,8,9, Jeremie Calais2,8,9. 1. Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, UCLA, Los Angeles, California isonni@mednet.ucla.edu. 2. Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, UCLA, Los Angeles, California. 3. Department of Nuclear Medicine, Technical University of Munich, Klinikum rechts der Isar, Munich, Germany. 4. Department of Nuclear Medicine, University Hospital Essen, Essen, Germany. 5. Department of Medicine Statistics Core, UCLA, Los Angeles, California. 6. Department of Radiation Oncology, David Geffen School of Medicine, UCLA, Los Angeles, California. 7. Department of Urology, UCLA, Los Angeles, California. 8. Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, California; and. 9. Institute of Urologic Oncology, David Geffen School of Medicine, UCLA, Los Angeles, California.
Abstract
The impact of prostate-specific membrane antigen (PSMA) PET/CT on management of prostate cancer (PCa) patients with biochemical recurrence (BCR) is well established. However, whether and how PSMA PET/CT affects the management of patients undergoing scans for other clinical indications remains unknown. The goal of this study was to determine the impact of 68Ga-PSMA-11 PET/CT on initial and subsequent management decisions in a cohort of PCa patients referred for various indications (i.e., a basket trial) excluding the 2 main classic indications: BCR and presurgical staging. Methods: This was a prospective study of 197 patients that aimed to determine the impact of 68Ga-PSMA-11 PET/CT on PCa stage and management. The indications for PSMA PET/CT were initial staging of nonsurgical candidates (30 patients) and restaging after definitive treatment (167 patients). The restaging cohort comprised patients restaged with known advanced metastatic disease (n = 103), after androgen deprivation therapy only (n = 16), after surgery and with serum prostate-specific antigen levels lower than 0.2 ng/mL (n = 13), after radiation therapy and not meeting the Phoenix criteria (n = 22), and after other primary local treatments (i.e., high-intensity focused ultrasound, focal laser ablation, cryoablation, hyperthermia, or irreversible electroporation) (n = 13). Patients with BCR and candidates for curative surgery were excluded. Impact on management was assessed using pre- and post-PET questionnaires completed by referring physicians, electronic chart review, or patient telephone calls. Results: PSMA PET/CT changed the disease stage in 135 of 197 (69%) patients (upstaging in 38%, downstaging in 30%, and no change in stage in 32%). Management was affected in 104 of 182 (57%) patients. Specifically, PSMA PET/CT impacted the management of patients who were restaged after radiation therapy without meeting the Phoenix criteria for BCR, after other definitive local treatments, and with advanced metastatic disease in 13 of 18 (72%), 8 of 12 (67%), and 59 of 96 (61%), respectively. Conclusion: PSMA PET/CT has a profound impact on stage and management of PCa patients outside the 2 main classic indications (BCR and presurgical staging) across all examined clinical scenarios.
The impact of prostate-specific membrane antigen (PSMA) PET/CT on management of prostate cancer (PCa) patients with biochemical recurrence (BCR) is well established. However, whether and how PSMA PET/CT affects the management of patients undergoing scans for other clinical indications remains unknown. The goal of this study was to determine the impact of 68Ga-PSMA-11 PET/CT on initial and subsequent management decisions in a cohort of PCa patients referred for various indications (i.e., a basket trial) excluding the 2 main classic indications: BCR and presurgical staging. Methods: This was a prospective study of 197 patients that aimed to determine the impact of 68Ga-PSMA-11 PET/CT on PCa stage and management. The indications for PSMA PET/CT were initial staging of nonsurgical candidates (30 patients) and restaging after definitive treatment (167 patients). The restaging cohort comprised patients restaged with known advanced metastatic disease (n = 103), after androgen deprivation therapy only (n = 16), after surgery and with serum prostate-specific antigen levels lower than 0.2 ng/mL (n = 13), after radiation therapy and not meeting the Phoenix criteria (n = 22), and after other primary local treatments (i.e., high-intensity focused ultrasound, focal laser ablation, cryoablation, hyperthermia, or irreversible electroporation) (n = 13). Patients with BCR and candidates for curative surgery were excluded. Impact on management was assessed using pre- and post-PET questionnaires completed by referring physicians, electronic chart review, or patient telephone calls. Results: PSMA PET/CT changed the disease stage in 135 of 197 (69%) patients (upstaging in 38%, downstaging in 30%, and no change in stage in 32%). Management was affected in 104 of 182 (57%) patients. Specifically, PSMA PET/CT impacted the management of patients who were restaged after radiation therapy without meeting the Phoenix criteria for BCR, after other definitive local treatments, and with advanced metastatic disease in 13 of 18 (72%), 8 of 12 (67%), and 59 of 96 (61%), respectively. Conclusion: PSMA PET/CT has a profound impact on stage and management of PCa patients outside the 2 main classic indications (BCR and presurgical staging) across all examined clinical scenarios.
Authors: Michael S Cookson; Gunnar Aus; Arthur L Burnett; Edith D Canby-Hagino; Anthony V D'Amico; Roger R Dmochowski; David T Eton; Jeffrey D Forman; S Larry Goldenberg; Javier Hernandez; Celestia S Higano; Stephen R Kraus; Judd W Moul; Catherine Tangen; J Brantley Thrasher; Ian Thompson Journal: J Urol Date: 2007-02 Impact factor: 7.450
Authors: Mack Roach; Gerald Hanks; Howard Thames; Paul Schellhammer; William U Shipley; Gerald H Sokol; Howard Sandler Journal: Int J Radiat Oncol Biol Phys Date: 2006-07-15 Impact factor: 7.038
Authors: Bernhard Grubmüller; Pascal Baltzer; Sabrina Hartenbach; David D'Andrea; Thomas H Helbich; Alexander R Haug; Gregor M Goldner; Wolfgang Wadsak; Sarah Pfaff; Markus Mitterhauser; Theresa Balber; Neydher Berroteran-Infante; Marko Grahovac; John Babich; Christian Seitz; Gero Kramer; Martin Susani; Peter Mazal; Lukas Kenner; Shahrokh F Shariat; Marcus Hacker; Markus Hartenbach Journal: Clin Cancer Res Date: 2018-08-23 Impact factor: 12.531
Authors: Paul J Roach; Roslyn Francis; Louise Emmett; Edward Hsiao; Andrew Kneebone; George Hruby; Thomas Eade; Quoc A Nguyen; Benjamin D Thompson; Thomas Cusick; Michael McCarthy; Colin Tang; Bao Ho; Philip D Stricker; Andrew M Scott Journal: J Nucl Med Date: 2017-06-23 Impact factor: 10.057
Authors: Julian Müller; Daniela A Ferraro; Urs J Muehlematter; Helena I Garcia Schüler; Sarah Kedzia; Daniel Eberli; Matthias Guckenberger; Stephanie G C Kroeze; Tullio Sulser; Daniel M Schmid; Aurelius Omlin; Alexander Müller; Thomas Zilli; Hubert John; Helmut Kranzbuehler; Philipp A Kaufmann; Gustav K von Schulthess; Irene A Burger Journal: Eur J Nucl Med Mol Imaging Date: 2018-11-28 Impact factor: 9.236
Authors: Jeremie Calais; Wolfgang P Fendler; Matthias Eiber; Jeannine Gartmann; Fang-I Chu; Nicholas G Nickols; Robert E Reiter; Matthew B Rettig; Leonard S Marks; Thomas E Ahlering; Linda M Huynh; Roger Slavik; Pawan Gupta; Andrew Quon; Martin S Allen-Auerbach; Johannes Czernin; Ken Herrmann Journal: J Nucl Med Date: 2017-12-14 Impact factor: 10.057
Authors: Annika Herlemann; Vera Wenter; Alexander Kretschmer; Kolja M Thierfelder; Peter Bartenstein; Claudius Faber; Franz-Josef Gildehaus; Christian G Stief; Christian Gratzke; Wolfgang P Fendler Journal: Eur Urol Date: 2016-01-19 Impact factor: 20.096
Authors: Ali Afshar-Oromieh; Tim Holland-Letz; Frederik L Giesel; Clemens Kratochwil; Walter Mier; Sabine Haufe; Nils Debus; Matthias Eder; Michael Eisenhut; Martin Schäfer; Oliver Neels; Markus Hohenfellner; Klaus Kopka; Hans-Ulrich Kauczor; Jürgen Debus; Uwe Haberkorn Journal: Eur J Nucl Med Mol Imaging Date: 2017-05-12 Impact factor: 9.236
Authors: Simon K B Spohn; Viktoria Birkenmaier; Juri Ruf; Michael Mix; August Sigle; Erik Haehl; Sonja Adebahr; Tanja Sprave; Eleni Gkika; Alexander Rühle; Nils H Nicolay; Simon Kirste; Anca L Grosu; Constantinos Zamboglou Journal: Front Oncol Date: 2022-06-07 Impact factor: 5.738
Authors: Dennie Meijer; Pim J van Leeuwen; Pepijn M J Oosterholt; Yves J L Bodar; Henk G van der Poel; N Harry Hendrikse; Maarten L Donswijk; Maurits Wondergem; Annelies E Vellekoop; R Jeroen A van Moorselaar; Jakko A Nieuwenhuijzen; Daniela E Oprea-Lager; André N Vis Journal: Eur J Nucl Med Mol Imaging Date: 2021-02-05 Impact factor: 9.236
Authors: Asim Afaq; Heather Payne; Reena Davda; John Hines; Gary J R Cook; Marie Meagher; Dimitrios Priftakis; Victoria S Warbey; Anand Kelkar; Clement Orczyk; Anita Mitra; Sarah Needleman; Michael Ferris; Greg Mullen; Jamshed Bomanji Journal: J Nucl Med Date: 2021-03-19 Impact factor: 11.082
Authors: Joaquin Mateo; Rana McKay; Wassim Abida; Rahul Aggarwal; Joshi Alumkal; Ajjai Alva; Felix Feng; Xin Gao; Julie Graff; Maha Hussain; Fatima Karzai; Bruce Montgomery; William Oh; Vaibhav Patel; Dana Rathkopf; Matthew Rettig; Nikolaus Schultz; Matthew Smith; David Solit; Cora Sternberg; Eliezer Van Allen; David VanderWeele; Jake Vinson; Howard R Soule; Arul Chinnaiyan; Eric Small; Jonathan W Simons; William Dahut; Andrea K Miyahira; Himisha Beltran Journal: Nat Cancer Date: 2020-11-17
Authors: Lena M Mittlmeier; Matthias Brendel; Leonie Beyer; Nathalie L Albert; Andrei Todica; Mathias J Zacherl; Vera Wenter; Annika Herlemann; Alexander Kretschmer; Stephan T Ledderose; Nina-Sophie Schmidt-Hegemann; Wolfgang G Kunz; Jens Ricke; Peter Bartenstein; Harun Ilhan; Marcus Unterrainer Journal: Front Oncol Date: 2021-05-21 Impact factor: 6.244
Authors: Samuel J Galgano; Andrew M McDonald; Soroush Rais-Bahrami; Kristin K Porter; Gagandeep Choudhary; Constantine Burgan; Pradeep Bhambhvani; Jeffrey W Nix; Desiree E Morgan; Yufeng Li; John V Thomas; Jonathan McConathy Journal: AJR Am J Roentgenol Date: 2020-10-14 Impact factor: 6.582