To do so, the authors performed a multi-center prospective registry study among six Ontario centers. Re-staging PSMA-PET/CT was performed in seven different clinical scenarios (NCT03718260): following radical prostatectomy with node-positive disease or a persistently detectable PSA; with biochemical recurrence following radical prostatectomy; biochemical recurrence following radical prostatectomy and post-operative radiotherapy; biochemical recurrence following local therapy (radical prostatectomy or radiotherapy) while on androgen deprivation therapy; biochemical recurrence following radical prostatectomy following metastasis-directed therapy; biochemical recurrence following primary radiotherapy; and a separate PET access cohort with independent adjudication for eligibility.
To be eligible, patients’ treating physicians must attest whether PSMA-PET/CT results would change the planned management strategy.
In this presentation, Dr. Uy provided initial results from a since center. At this center, 253 patients were included and underwent PSMA-PET/CT. At baseline, the median patient age was 71 years (range 50-102 years) and median PSA was 2.7 ng/mL (range 0.04-134.0 ng/mL). Most included patients (n=59; 23.3%) had evidence of biochemical recurrence following radical prostatectomy (cohort 2). In patients with negative conventional imaging (CT and bone scan), PSMA-PET/CT detected disease sites in 68.5% of patients (170/248), which resulted in changes in treatment approach for 67.8% of patients (137/202). Management changes occurred in 72.1% of patients who had previously received radiotherapy and 64.3% of patients who had previously received radical prostatectomy.
The authors conclude that the use of PSMA-PET/CT detected evidence of disease that was not apparent on conventional imaging, resulting in management changes in the majority of patients.
Presented by: Michael Uy, MD, McMaster University Hamilton, Hamilton, ON, Canada
Written by: Christopher J.D. Wallis, Urologic Oncology Fellow, Vanderbilt University Medical Center Contact: @WallisCJD on Twitter at the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting, Virtual Annual Meeting #ASCO21, June, 4-8, 2021