PSMA-PET/CT IDs Oligometastatic Disease in Hormone-Sensitive Prostate Cancer

By HealthDay News - Last Updated: November 2, 2021

Prostate-specific membrane antigen (PSMA)-positron emission tomography/computed tomography (PET/CT) performed in hormone-sensitive prostate cancer (HSPC) patients at biochemical recurrence can detect oligometastatic disease (OMD), according to a study published online in Cancers.

Carlos Artigas, MD, from the Université Libre de Bruxelles in Belgium, and colleagues examined the efficacy of PSMA-PET/CT in detecting OMD in a retrospective analysis of a homogenous population of 196 HSPC patients who were considered potential candidates for metastasis-directed therapy (MDT). PSMA PET/CT was performed after radical prostatectomy at biochemical recurrence.

The researchers found that PSMA-PET/CT detected at least one lesion suspicious for recurrent prostate cancer in 117 patients, for an overall positivity rate of 60 percent. The OMD detection rate was 44 percent (74 percent of all positive scans). There was an independent correlation observed for PSMA-PET/CT positivity with prostate-specific antigen (PSA; odds ratio [OR], 1.7) and PSA doubling time (OR, 0.4). The researchers also observed an independent correlation for OMD detection with PSA (OR, 1.6) and no previous salvage therapy (OR, 0.3). In 58 percent of patients, there was a treatment change, mainly to perform MDT after detection of OMD (60 percent of changes).

“Our study found that PSA at the moment of PET and previous salvage treatment were inversely associated with the presence of OMD on a positive scan,” the authors write. “This is an important finding underlying the need of performing PSMA-PET/CT at early biochemical recurrence stages where the probability of finding limited disease spread (OMD) is higher, leading to increased treatment efficacy and better outcomes.”

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