Impact of Ga-68 PSMA-11 PET on Management in Patients with Biochemically Recurrent Prostate Cancer

Purpose: The purpose of this prospective study was to estimate the effect of (68)Ga-prostate specific membrane antigen (PSMA)-11 PET on intended management of patients with biochemically recurrent prostate cancer. Methods: Pre- and post-imaging surveys were filled out by referring providers in patients with biochemical recurrence who were imaged using (68)Ga-PSMA-11 PET. Inclusion criteria for this study required a PSA doubling time of less than 12 months after initial treatment (NCT02611882). Of the 150 consecutive patients imaged, 126 surveys were completed (84% response rate). Responses were categorized as major, minor, no change or unknown change. Results: 103 (82%) of patients had disease detected on (68)Ga-PSMA-11 PET. Based on survey results, there were 67 (53.2%) patients with major changes, and 8 (6.4%) patients with minor changes in management. The proportion of cases resulting in a change in management did not significantly differ by baseline PSA level. In patients with PSA levels below 0.2 ng/dL, 7 of 12 patients had disease detected on PSMA PET scan, five of whom had a major change in management. Conclusion:(68)Ga-PSMA-11 PET resulted in a major change in management in 53% of patients with biochemical recurrence. Further studies are warranted to investigate whether PSMA-based management strategies result in improved outcomes for patients.

Journal of nuclear medicine : official publication, Society of Nuclear Medicine. 2017 May 18 [Epub ahead of print]

Thomas A Hope, Rahul Aggarwal, Bryant Chee, Dora Tao, Kirsten L Greene, Matthew Cooperberg, Felix Feng, Albert Chang, Charles J Ryan, Eric J Small, Peter R Carroll

University of California, San Francisco, United States.