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

J Nucl Med. 2017 Dec;58(12):1956-1961. doi: 10.2967/jnumed.117.192476. Epub 2017 May 18.

Abstract

The purpose of this prospective study was to estimate the effect of 68Ga-labeled prostate-specific membrane antigen (PSMA)-11 PET on the intended management of patients with biochemically recurrent prostate cancer. Methods: Pre- and postimaging surveys were filled out by the referring providers for patients with biochemical recurrence who were imaged using 68Ga-PSMA-11 PET. The inclusion criterion for this study was a prostate-specific antigen (PSA) doubling time of less than 12 mo after initial treatment (NCT02611882). Of the 150 consecutive patients imaged, 126 surveys were completed (84% response rate). The responses were categorized as major change, minor change, no change, or unknown change. Results: There were 103 patients (82%) with disease detected on 68Ga-PSMA-11 PET. On the basis of the survey results, there were 67 patients (53.2%) with major changes in management and 8 patients (6.4%) with minor changes. 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 68Ga-PSMA-11 PET, 5 of whom had a major change in management. Conclusion:68Ga-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.

Keywords: PET; biochemical recurrence; management; molecular imaging; prostate cancer; prostate-specific membrane antigen.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Edetic Acid / analogs & derivatives
  • Female
  • Humans
  • Image-Guided Biopsy
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / diagnostic imaging
  • Neoplasm Recurrence, Local / drug therapy*
  • Oligopeptides
  • Organometallic Compounds
  • Patient Care Management / methods*
  • Positron Emission Tomography Computed Tomography / methods*
  • Prospective Studies
  • Prostate-Specific Antigen
  • Prostatectomy
  • Prostatic Neoplasms / diagnostic imaging*
  • Prostatic Neoplasms / therapy*
  • Radiopharmaceuticals
  • Reproducibility of Results
  • Treatment Outcome

Substances

  • Oligopeptides
  • Organometallic Compounds
  • Radiopharmaceuticals
  • Edetic Acid
  • Prostate-Specific Antigen
  • Glu-NH-CO-NH-Lys-(Ahx)-((68)Ga(HBED-CC))

Associated data

  • ClinicalTrials.gov/NCT02611882