To investigate the impact of 68 Gallium prostate-specific membrane antigen (68 Ga-PSMA) tracers on the management of prostate cancer patients with biochemical recurrence (BCR) by systematical review and meta-analysis.
We performed a literature search on PubMed, Embase, and Web of Science databases up to October 29, 2019. We included studies that reported the proportion of management change after 68 Ga-PSMA tracers in patients with BCR. We used the Quality Assessment of Diagnostic Accuracy Studies-2 tool to evaluate the quality of the included studies. The proportion of management changes were pooled using a random-effects model. Subgroup analyses and meta-regression analyses were performed to explore the source of heterogeneity. Sankey diagram was used for displaying the treatment change from the before to after 68 Ga-PSMA tracers.
We included 20 eligible studies (2,026 patients). The pooled of management change occurred in 53% (95% confidence interval (CI), 46-60%) of patients with BCR and 51% (95% CI, 34%-67%) in early BCR group (prostate-specific antigen (PSA) < 0.5 ng/mL). The pooled PET-positive in patients with BCR was 68% (95%CI, 59%-78%). Fourteen studies reported the management change, with most changes being intermodality (42% vs 17% in intramodality).
The 68 Ga-PSMA tracers can alter the management of more than half of prostate cancer patients with BCR, as well as in the early BCR patients. The 68 Ga-PSMA tracers might be used to guide the individualised treatment in patients with BCR, particularly in the early recurrence patients.
BJU international. 2020 Sep 26 [Epub ahead of print]
Wei Diao, Yuan Cao, Dunyan Su, Zhiyun Jia
Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, PR China., Huaxi MR Research Center, Department of Radiology, West China Hospital of Sichuan University, Chengdu, PR China.