Value of Whole-body Magnetic Resonance Imaging Using the MET-RADS-P Criteria for Assessing the Response to Intensified Androgen Deprivation Therapy in Metastatic Hormone-naïve and Castration-resistant Prostate Cancer.

IF 8.3 1区 医学 Q1 ONCOLOGY European urology oncology Pub Date : 2024-11-05 DOI:10.1016/j.euo.2024.10.009
Julien Van Damme, Bertrand Tombal, Nicolas Michoux, Sandy Van Nieuwenhove, Vassiliki Pasoglou, Perrine Triqueneaux, Anwar R Padhani, Frederic E Lecouvet
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Abstract

Background and objectives: We assessed the agreement between prostate-specific antigen (PSA) and imaging responses using whole-body magnetic resonance imaging (wbMRI). Our aim was to explore the potential prognostic value of PSA and wbMRI responses in metastatic hormone-naïve prostate cancer (mHNPC) and castration-resistant PC (mCRPC).

Methods: wbMRI was prospectively performed in 37 patients with mHNPC and 51 with mCRPC before and after 6-12 mo of androgen deprivation therapy and an androgen receptor pathway inhibitor (ARPI). Imaging responses were defined according to the Metastasis Reporting and Data System for PC (MET-RADS-P) criteria. A PSA response was defined as PSA ≤0.2 ng/ml in mHNPC and a ≥50% decrease from the pretreatment level in mCRPC. Agreement between PSA and wbMRI responses was assessed using Cohen's κ. The association between time to subsequent treatment and overall survival (OS) was analyzed using Cox regression analysis.

Key findings and limitations: Agreement between PSA and wbMRI responses was fair in mHNPC (κ = 0.30) but none to slight in mCRPC (κ = 0.15). In mHNPC, patients with a PSA or wbMRI response were less likely to receive subsequent treatments; wbMRI progression was associated with a significantly higher risk of death (hazard ratio 8.59; p = 0.002). In mCRPC, two-thirds of patients with a PSA response showed progression on wbMRI; neither PSA nor wbMRI progression changed the likelihood of starting a subsequent treatment or the risk of death.

Conclusions and clinical implications: In mHNPC, wbMRI progression was associated with a higher risk of needing subsequent treatment and shorter OS.

Patient summary: We evaluated the agreement between routine PSA (prostate-specific antigen) test results and whole-body MRI (magnetic resonance imaging) scans for assessing the response of metastatic prostate cancer to treatment. There was disagreement between the PSA and MRI results, mainly for patients with cancer that was resistant to hormone-based treatment. Combining PSA with whole-body MRI might provide a more accurate picture of the response of advanced prostate cancer to treatment.

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使用 MET-RADS-P 标准评估转移性激素无效和阉割耐药前列腺癌患者对强化雄激素剥夺疗法反应的全身磁共振成像价值
背景和目的:我们评估了前列腺特异性抗原(PSA)与全身磁共振成像(wbMRI)成像反应之间的一致性。方法:在雄激素剥夺疗法和雄激素受体通路抑制剂(ARPI)治疗 6-12 个月之前和之后,对 37 名 mHNPC 患者和 51 名 mCRPC 患者进行了前瞻性的全身磁共振成像(wbMRI)检查。成像反应根据PC转移报告和数据系统(MET-RADS-P)标准进行定义。mHNPC的PSA≤0.2 ng/ml和mCRPC的PSA较治疗前水平下降≥50%即为PSA反应。PSA 和 wbMRI 反应之间的一致性采用 Cohen's κ 进行评估。采用Cox回归分析法分析了后续治疗时间与总生存期(OS)之间的关系:在mHNPC(κ = 0.30)中,PSA和wbMRI反应之间的一致性尚可,但在mCRPC(κ = 0.15)中,两者之间的一致性仅为微弱。在mHNPC中,PSA或wbMRI有反应的患者接受后续治疗的可能性较低;wbMRI进展与显著较高的死亡风险相关(危险比为8.59;p = 0.002)。在mCRPC中,三分之二的PSA反应患者在wbMRI上出现进展;PSA或wbMRI进展均未改变开始后续治疗的可能性或死亡风险:患者摘要:我们评估了常规PSA(前列腺特异性抗原)检测结果与全身MRI(磁共振成像)扫描结果在评估转移性前列腺癌治疗反应方面的一致性。前列腺特异性抗原检测结果与核磁共振成像结果之间存在分歧,主要是对激素治疗产生抗药性的癌症患者。将前列腺特异性抗原(PSA)与全身核磁共振成像(MRI)相结合,可能会更准确地反映晚期前列腺癌患者对治疗的反应。
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来源期刊
CiteScore
15.50
自引率
2.40%
发文量
128
审稿时长
20 days
期刊介绍: Journal Name: European Urology Oncology Affiliation: Official Journal of the European Association of Urology Focus: First official publication of the EAU fully devoted to the study of genitourinary malignancies Aims to deliver high-quality research Content: Includes original articles, opinion piece editorials, and invited reviews Covers clinical, basic, and translational research Publication Frequency: Six times a year in electronic format
期刊最新文献
Value of Whole-body Magnetic Resonance Imaging Using the MET-RADS-P Criteria for Assessing the Response to Intensified Androgen Deprivation Therapy in Metastatic Hormone-naïve and Castration-resistant Prostate Cancer. Management of Small Testicular Masses: A Delphi Consensus Study. Reply to Alireza Ghoreifi and Hooman Djaladat's Letter to the Editor re: Yiling Chen, Chenyang Xu, Zezhong Mou, et al. Endoscopic Cryoablation Versus Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma. Eur Urol Oncol. In press. https://doi.org/10.1016/j.euo.2024.04.012. Oncological Outcomes of Active Surveillance versus Surgery or Ablation for Patients with Small Renal Masses: A Systematic Review and Quantitative Analysis. Re: Yiling Chen, Chenyang Xu, Zezhong Mou, et al. Endoscopic Cryoablation Versus Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma. Eur Urol Oncol. In press. https://doi.org/10.1016/j.euo.2024.04.012.
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