68Ga-PSMA-11 PET-CT study in prostate cancer patients with biochemical recurrence and non-contributive 18F-Choline PET-CT: Impact on therapeutic decision-making and biomarker changes.

Abstract

BACKGROUND:

In this retrospective study, we investigated the impact of 68 Ga-PSMA-11 PET-CT (PSMA PET-CT) upon the treatment plan and therapeutic response obtained for Prostate Cancer (PCa) patients presenting an occult biochemical recurrence.

METHODS:

Forty-two patients with previously negative or doubtful 18F-Choline (FCH) were enrolled. PET images were recorded 1 h after injection of tracer. Only a few months after treatment ended, a PSA assay was requested to evaluate the therapeutic efficacy of the treatment based on PSMA results.

RESULTS:

PSMA-positive lesions were detected in 34/42 (80.9%) patients. Detection rates were 85.7% and 89.3% for serum PSA levels lower than 2 ng/mL, and >2 ng/mL, respectively. One hundred seventy-three lesions were detected: 132/173 in lymph nodes (76.3%), 22/173 as metastatic sites (bone or lung) (12.7%), and 19/173 in the prostate bed (10.9%). As a result of the PSMA PET-CT, therapeutic management changed in 31/42 patients (73.8%). With a follow-up of 4.9 ± 2.27 months, 32/42 (76.2%) PSA assays after treatment guided by PSMA PET-CT were collected. For 37.5% (12/32) of patients, the serum PSA level was lower than 0.2 ng/mL and a PSA decrease of over 50% in 8 (25.0%) other patients were obtained.

CONCLUSION:

Performing a PSMA PET-CT when FCH PET-CT was doubtful or negative allows the recurrence localization in more 80% of patients and this had a major clinical impact, as it resulted in treatment change in more than 70% of patients as well as a significant decrease in PSA levels in more than 60% of them.

• Authors: Matthieu Barbaud, Mathieu Frindel, Ludovic Ferrer, Maelle Le Thiec, Daniela Rusu, Aurore Rauscher, Bruno Maucherat, Pierre Baumgartner, Vincent Fleury, Mathilde Colombié, Agnes Thierry-Morel, Françoise Kraeber-Bodéré, Loïc Campion, Caroline Rousseau
• Journal: The Prostate (Prostate) Vol. 79 Issue 5 Pg. 454-461 (04 2019) ISSN: 1097-0045 [Electronic] United States
• PMID: 30549066 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2018 Wiley Periodicals, Inc.

Chemical References

• Gallium Isotopes
• Gallium Radioisotopes
• Oligopeptides
• Radiopharmaceuticals
• gallium 68 PSMA-11
• fluorocholine
• Edetic Acid
• KLK3 protein, human
• Kallikreins
• Prostate-Specific Antigen
• Choline

Topics

• Aged
• Aged, 80 and over
• Choline (analogs & derivatives)
• Decision Making
• Edetic Acid (analogs & derivatives)
• Gallium Isotopes
• Gallium Radioisotopes
• Humans
• Kallikreins (blood)
• Male
• Middle Aged
• Neoplasm Recurrence, Local (blood, diagnostic imaging)
• Oligopeptides
• Positron Emission Tomography Computed Tomography (methods)
• Prostate-Specific Antigen (blood)
• Prostatic Neoplasms (blood, diagnostic imaging, therapy)
• Radiopharmaceuticals
• Retrospective Studies