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 - 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 - https://www.scopus.com/pages/publications/85092740454
U2 - 10.1016/j.adro.2020.08.010
DO - 10.1016/j.adro.2020.08.010
M3 - Article
AN - SCOPUS:85092740454
SN - 2452-1094
VL - 6
JO - Advances in Radiation Oncology
JF - Advances in Radiation Oncology
IS - 1
M1 - 100553
ER -
