Mark C Markowski1, Pedro Isaacsson Velho2,3, Mario A Eisenberger2, Martin G Pomper2,4, Kenneth J Pienta5, Michael A Gorin5, Emmanuel S Antonarakis2, Samuel R Denmeade2, Steven P Rowe2,4. 1. Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland; mmarko12@jhmi.edu. 2. Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland. 3. Department of Medical Oncology, Hospital Moinhos de Vento, Porto Alegre, Brazil. 4. Russel H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland; and. 5. James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Abstract
Bipolar androgen therapy (BAT) is an emerging treatment for metastatic castration-resistant prostate cancer (mCRPC). 18F-DCFPyL is a small-molecule PET radiotracer targeting prostate-specific membrane antigen (PSMA). We analyzed the utility of 18F-DCFPyL PET/CT in determining clinical response to BAT. Methods: Six men with mCRPC receiving BAT were imaged with 18F-DCFPyL PET/CT at baseline and after 3 mo of treatment. Progression by PSMA-targeted PET/CT was defined as the appearance of any new 18F-DCFPyL-avid lesion. Results: Three of 6 (50%) patients had progression on 18F-DCFPyL PET/CT. All 3 had stable disease or better on contemporaneous conventional imaging. Radiographic progression on CT or bone scanning was observed within 3 mo of progression on 18F-DCFPyL PET/CT. For the 3 patients who did not have progression on 18F-DCFPyL PET/CT, radiographic progression was not observed for at least 6 mo. Conclusion: New radiotracer-avid lesions on 18F-DCFPyL PET/CT in men with mCRPC undergoing BAT can indicate early progression.
Bipolar androgen therapy (BAT) is an emerging treatment for metastatic castration-resistant prostate cancer (mCRPC). 18F-DCFPyL is a small-molecule PET radiotracer targeting prostate-specific membrane antigen (PSMA). We analyzed the utility of 18F-DCFPyL PET/CT in determining clinical response to BAT. Methods: Six men with mCRPC receiving BAT were imaged with 18F-DCFPyL PET/CT at baseline and after 3 mo of treatment. Progression by PSMA-targeted PET/CT was defined as the appearance of any new 18F-DCFPyL-avid lesion. Results: Three of 6 (50%) patients had progression on 18F-DCFPyL PET/CT. All 3 had stable disease or better on contemporaneous conventional imaging. Radiographic progression on CT or bone scanning was observed within 3 mo of progression on 18F-DCFPyL PET/CT. For the 3 patients who did not have progression on 18F-DCFPyL PET/CT, radiographic progression was not observed for at least 6 mo. Conclusion: New radiotracer-avid lesions on 18F-DCFPyL PET/CT in men with mCRPC undergoing BAT can indicate early progression.
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