TY - JOUR
T1 - Utilization of Salvage and Systemic Therapies for Recurrent Prostate Cancer as a Result of 18F-DCFPyL PET/CT Restaging
AU - Liu, Wei
AU - Zukotynski, Katherine
AU - Emmett, Louise
AU - Chung, Hans T.
AU - Chung, Peter
AU - Wolfson, Robert
AU - Rachinsky, Irina
AU - Kapoor, Anil
AU - Metser, Ur
AU - Loblaw, Andrew
AU - Morton, Gerard
AU - Sexton, Tracy
AU - Lock, Michael
AU - Helou, Joelle
AU - Berlin, Alejandro
AU - Boylan, Colm
AU - Archer, Susan
AU - Pond, Gregory R.
AU - Bauman, Glenn
N1 - Funding Information:
Sources of support: This study was funded by the Ontario Institute for Cancer Research, Canada. OICR #CTI-PICs-LHRI
Funding Information:
Sources of support: This study was funded by the Ontario Institute for Cancer Research, Canada. OICR #CTI-PICs-LHRI. Disclosures: Dr Peter Chung reports grants from Lawson Research Institute during the conduct of the study, personal fees from AbbVie, and personal fees from AstraZeneca outside the submitted work. Dr Gregory Pond reports grants from Ontario Institute for Cancer Research during the conduct of the study, personal fees from Takeda, personal fees from Astra-Zeneca, other from Roche Canada outside the submitted work, and a close family member (spouse) who works for Roche Canada. Dr Glenn Bauman reports grants from Ontario Institute for Cancer Research during the conduct of the study.
Publisher Copyright:
© 2020 The Author(s)
PY - 2021/1/1
Y1 - 2021/1/1
N2 - Purpose: Our purpose was to investigate the effect of the addition of prostate-specific membrane antigen (PSMA)-targeted positron emission tomography/computed tomography (PET/CT) in patients with recurrent prostate cancer post-primary radiation therapy. Methods and Materials: A prospective, multi-institutional clinical trial evaluated 2-(3-{1-carboxy-5-[(6-[18F]fluoro-pyridine-3-carbonyl)-amino]-pentyl}-ureido)-pentanedioic acid (18F-DCFPyL) PET/CT restaging in 79 men with recurrent prostate cancer post-primary radiation therapy. We report actual patient management and compare this with proposed management both before and after PSMA-targeted PET/CT. Results: Most patients (59%) had a major change in actual management compared with pre-PET/CT proposed management. The rate of major change was underestimated by immediately post-PET/CT surveys (32%). Eighteen patients with PSMA avidity in the prostate gland suspicious for malignancy had a prostate biopsy. Sensitivity, specificity, and positive predictive values of PSMA uptake in the prostate were 86%, 67%, and 92%, respectively. Thirty percent of patients had directed salvage therapy and 41% underwent systemic therapy. Eleven out of 79 patients (14%) had high-dose-rate brachytherapy alone for local recurrence, and 91% were free of recurrence at a median follow-up of 20 months. Conclusions: Most patients had a major change in actual management compared with pre–PSMA-targeted PET/CT planned management, and this was underestimated by post-PET/CT questionnaires.
AB - Purpose: Our purpose was to investigate the effect of the addition of prostate-specific membrane antigen (PSMA)-targeted positron emission tomography/computed tomography (PET/CT) in patients with recurrent prostate cancer post-primary radiation therapy. Methods and Materials: A prospective, multi-institutional clinical trial evaluated 2-(3-{1-carboxy-5-[(6-[18F]fluoro-pyridine-3-carbonyl)-amino]-pentyl}-ureido)-pentanedioic acid (18F-DCFPyL) PET/CT restaging in 79 men with recurrent prostate cancer post-primary radiation therapy. We report actual patient management and compare this with proposed management both before and after PSMA-targeted PET/CT. Results: Most patients (59%) had a major change in actual management compared with pre-PET/CT proposed management. The rate of major change was underestimated by immediately post-PET/CT surveys (32%). Eighteen patients with PSMA avidity in the prostate gland suspicious for malignancy had a prostate biopsy. Sensitivity, specificity, and positive predictive values of PSMA uptake in the prostate were 86%, 67%, and 92%, respectively. Thirty percent of patients had directed salvage therapy and 41% underwent systemic therapy. Eleven out of 79 patients (14%) had high-dose-rate brachytherapy alone for local recurrence, and 91% were free of recurrence at a median follow-up of 20 months. Conclusions: Most patients had a major change in actual management compared with pre–PSMA-targeted PET/CT planned management, and this was underestimated by post-PET/CT questionnaires.
UR - http://www.scopus.com/inward/record.url?scp=85092740454&partnerID=8YFLogxK
U2 - 10.1016/j.adro.2020.08.010
DO - 10.1016/j.adro.2020.08.010
M3 - Article
C2 - 33521396
AN - SCOPUS:85092740454
SN - 2452-1094
VL - 6
JO - Advances in Radiation Oncology
JF - Advances in Radiation Oncology
IS - 1
M1 - 100553
ER -
