.png){kind=icon}
.png){kind=icon}
Return
Clinical Impact of Changes in Tumor Uptake and Volume on PSMA PET/CT During [177Lu]Lu-PSMA Therapy in Metastatic Castration-Resistant Prostate Cancer
.png){kind=icon}
PRE
AI
DOI：10.2967/jnumed.125.270239.png)
.png){kind=icon}
Original request for help.png){kind=icon}
Share.png){kind=icon}
Save
Abstract
En 中文
Although tumor volume and new lesions (NLs) have been investigated previously as measures of response, the clinical impact of changes in tumor uptake on prostate-specific membrane antigen (PSMA) PET remains largely unknown. Methods: This multicenter retrospective study investigated the clinical impact of changes in tumor uptake and volume on PSMA PET during [Lu-177]Lu-PSMA in metastatic castration-resistant prostate cancer (mCRPC). The primary outcomes were the associations of changes in SUVmax (Delta SUVmax) and SUVmean (Delta SUVmean), changes in total tumor volume (Delta TTV), and occurrence of NLs with prostate-specific antigen (PSA) progression-free survival (PSA-PFS) and overall survival (OS). The study included patients with mCRPC who received [Lu-177]Lu-PSMA between 2014 and 2019. PSMA PET/CT was performed at baseline and after 2 cycles of therapy. Whole-body analyses (SUVmax, SUVmean, TTV, and NLs) were performed and calculated using qPSMA software. Results: In total, 124 patients with mCRPC (median age, 73 y; interquartile range, 67-76 y) were included in the study. Whole-body Delta TTV and the occurrence of NLs were significantly associated with shorter PSA-PFS (hazard ratio [HR], 5.7; 95% CI, 3.59-9.06; and HR, 1.6; 95% CI, 1.4-1.8; P < 0.0001) and with OS (HR, 2.3; 95% CI, 1.61-3.43; and HR, 1.3; 95% CI, 1.1-1.4; P < 0.001). Patient-based analysis showed that Delta SUVmax and Delta SUVmean were not associated with outcome (HR, 1.00; 95% CI, 0.99-1.00; P = 0.30; and HR, 0.90; 95% CI, 0.99-1.00; P = 0.11). Region-based analysis found that only Delta SUVmax in visceral lesions was significantly associated with PSA-PFS (P = 0.007) but not with OS. Conclusion: Only Delta TTV and the occurrence of NLs provided significant prognostic value and should be considered when evaluating treatment response to [Lu-177]Lu-PSMA therapy.
Keywords:
metastatic castration-resistant prostate cancer
PSMA PET
response evaluation
RECIP
LuPSMA
radiopharmaceutical therapy
Journal
IF:
9.1
Papers:
6.2K
Citations:
3.0W
Organization
View more organizations