Imaging Biomarkers in Prostate Stereotactic Body Radiotherapy: A Review and Clinical Trial Protocol.

Advances in imaging have changed prostate radiotherapy through improved biochemical control from focal boost and improved detection of recurrence. These advances are reviewed in the context of prostate stereotactic body radiation therapy (SBRT) and the ARGOS/CLIMBER trial protocol. ARGOS/CLIMBER will evaluate 1) the safety and feasibility of SBRT with focal boost guided by multiparametric MRI (mpMRI) and 18F-PSMA-1007 PET and 2) imaging and laboratory biomarkers for response to SBRT. To date, response to prostate SBRT is most commonly evaluated using the Phoenix Criteria for biochemical failure. The drawbacks of this approach include lack of lesion identification, a high false-positive rate, and delay in identifying treatment failure. Patients in ARGOS/CLIMBER will receive dynamic 18F-PSMA-1007 PET and mpMRI prior to SBRT for treatment planning and at 6 and 24 months after SBRT to assess response. Imaging findings will be correlated with prostate-specific antigen (PSA) and biopsy results, with the goal of early, non-invasive, and accurate identification of treatment failure.

Frontiers in oncology. 2022 Apr 13*** epublish ***

Wei Liu, Andrew Loblaw, David Laidley, Hatim Fakir, Lucas Mendez, Melanie Davidson, Zahra Kassam, Ting-Yim Lee, Aaron Ward, Jonathan Thiessen, Jane Bayani, John Conyngham, Laura Bailey, Joseph D Andrews, Glenn Bauman

Department of Oncology, Division of Radiation Oncology, London Health Sciences Centre and Western University, London, ON, Canada., Department of Radiation Oncology, Odette Cancer Center, Sunnybrook Health Sciences Centre and Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada., Division of Nuclear Medicine, St. Joseph's Health Centre and Western University, London, ON, Canada., Department of Oncology and Department of Medical Biophysics, London Health Sciences Centre and Western University, London, ON, Canada., Department of Medical Imaging, St. Joseph's Health Care and Western University, London, ON, Canada., Department of Medical Biophysics, Western University and Lawson Health Research Institute, London, ON, Canada., Ontario Institute for Cancer Research and Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada., Patient Partner, London, ON, Canada., Clinical Research Unit, London Regional Cancer Program, London, ON, Canada.

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