Association Between the PRIMARY Score at Staging Prostate-specific Membrane Antigen Positron Emission Tomography and Overall Survival Among Patients with Newly Diagnosed Prostate Cancer - Beyond the Abstract

PRIMARY score, which is used for the assessment of primary tumor using intraprostatic pattern site and PSMA activity on prostate-specific membrane antigen-directed positron emission tomography (PSMA-PET), was implemented in Prostate Cancer Molecular Imaging Standardized Evaluation (PROMISE) v2.1,2

In a recent publication by our group, the prognostic value of PROMISE has been established in 1889 patients from a large multicenter cohort who underwent PSMA PET for initial staging of prostate cancer at investigator sites across Europe and Australia.3 We found that a PRIMARY score of 5 on initial PSMA PET, which was defined by PSMA intensity (SUVmax ≥12), was associated with shorter overall survival in this cohort. Beyond that, combining the PRIMARY score with PI-RADS scores or clinical T stage enhances its predictive value.

We will continue to enroll patients, including PRIMARY score data, in our international multicentric PROMISE-PET Registry Study (promise-pet.org, NCT06320223) for further analysis.

Written by: Caner Civan, MD, Madeleine J. Karpinski, MSc & Wolfgang P. Fendler, MD

  • Department of Nuclear Medicine, University Hospital Essen, Essen, Germany
References:

  1. Seifert, R., et al., Second Version of the Prostate Cancer Molecular Imaging Standardized Evaluation Framework Including Response Evaluation for Clinical Trials (PROMISE V2). Eur Urol, 2023. 83(5): p. 405–412.
  2. Emmett, L., et al., The PRIMARY Score: Using Intraprostatic (68)Ga-PSMA PET/CT Patterns to Optimize Prostate Cancer Diagnosis. J Nucl Med, 2022. 63(11): p. 1644–1650.
  3. Karpinski, M.J., et al., Association Between the PRIMARY Score at Staging Prostate-specific Membrane Antigen Positron Emission Tomography and Overall Survival Among Patients with Newly Diagnosed Prostate Cancer: Findings from the International, Multicenter PROMISE Registry. Eur Urol, 2025.
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