Interval Changes in PSMA PET/CT During Radium-223 Therapy for Metastatic Bone Disease from Castration-Resistant Prostate Cancer.

IF 1.3 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Nuclear Medicine and Molecular Imaging Pub Date : 2022-08-01 DOI:10.1007/s13139-022-00754-6

Stephan Probst, Anders Bjartell, Aseem Anand, Tayna Skamene, Cristiano Ferrario

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Abstract

Background: Radium-223, an alpha-emitting therapeutic radiopharmaceutical, prolongs overall survival (OS) in patients with symptomatic bone-predominant metastatic castration-resistant prostate cancer (mCRPC). PSMA PET/CT is a molecular imaging tool for whole-body imaging of prostate cancer and may inform on the mechanisms of radium-223 activity and treatment resistance in mCRPC patients.

Methods: In an open-label, single-arm, prospective trial, we enrolled patients with bone-predominant mCRPC to undergo baseline PSMA PET/CT, 6 cycles of radium-223, and post-therapy PSMA PET/CT. We assessed the relationship between multiple parameters of interval change on PSMA PET/CT on aPROMISE PSMA automated analysis and a human reader, and laboratory measurements.

Results: Fourteen patients were enrolled and 9 patients completed both protocol-defined PSMA PET/CT. Of the 9 evaluable patients, 1 (11%) had a complete response and 8 (89%) had PSMA PET progressive disease. All patients showed decreases in PSMA uptake in some disease sites evident on the baseline scan. The change in overall burden of disease on PSMA PET was more strongly correlated with changes in PSA (ρ = 0.95) than ALP (ρ = 0.62). Progression in bone was a common finding on post-treatment PSMA PET/CT.

Conclusion: PSMA PET was able to assess response in individual lesions during radium-223 therapy in mCRPC patients. PSMA PET responses in previously established disease sites were universal, but most patients also showed overall PSMA PET progression during 6 cycles of radium-223. Given high correlation with changes in PSA, PSMA PET may be of limited value in follow-up during or after radium-223 in bone-predominant mCRPC.

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放射-223治疗去势抵抗性前列腺癌转移性骨病期间PSMA PET/CT间期变化

背景:镭-223是一种释放α的治疗性放射性药物，可延长症状性骨为主转移性去势抵抗性前列腺癌(mCRPC)患者的总生存期(OS)。PSMA PET/CT是一种用于前列腺癌全身成像的分子成像工具，可能为mCRPC患者镭-223活性和治疗耐药的机制提供信息。方法:在一项开放标签、单臂、前瞻性试验中，我们招募了以骨为主的mCRPC患者，接受基线PSMA PET/CT、6周期镭-223和治疗后PSMA PET/CT。我们评估了PSMA PET/CT上间隔变化的多个参数在promise PSMA自动分析和人类阅读器上的关系，以及实验室测量。结果:14名患者入组，9名患者完成了协议定义的PSMA PET/CT。在9名可评估的患者中，1名(11%)完全缓解，8名(89%)患有PSMA PET进行性疾病。基线扫描显示，所有患者在某些疾病部位的PSMA摄取明显减少。PSMA PET总体疾病负担的变化与PSA (ρ = 0.95)的相关性强于ALP (ρ = 0.62)。骨进展是治疗后PSMA PET/CT的常见发现。结论:PSMA PET能够评估mCRPC患者在镭-223治疗期间个体病变的反应。PSMA PET反应在先前确定的疾病部位是普遍的，但大多数患者在6个周期的镭-223治疗期间也表现出PSMA PET的总体进展。鉴于PSMA PET与PSA变化的高度相关性，在以骨为主的mCRPC中，在镭-223治疗期间或之后的随访中，PSMA PET的价值可能有限。图形化的简介:

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来源期刊

Nuclear Medicine and Molecular Imaging RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

2.20

自引率

7.70%

发文量

期刊介绍： Nuclear Medicine and Molecular Imaging (Nucl Med Mol Imaging) is an official journal of the Korean Society of Nuclear Medicine, which bimonthly publishes papers on February, April, June, August, October, and December about nuclear medicine and related sciences such as radiochemistry, radiopharmacy, dosimetry and pharmacokinetics / pharmacodynamics of radiopharmaceuticals, nuclear and molecular imaging analysis, nuclear and molecular imaging instrumentation, radiation biology and radionuclide therapy. The journal specially welcomes works of artificial intelligence applied to nuclear medicine. The journal will also welcome original works relating to molecular imaging research such as the development of molecular imaging probes, reporter imaging assays, imaging cell trafficking, imaging endo(exo)genous gene expression, and imaging signal transduction. Nucl Med Mol Imaging publishes the following types of papers: original articles, reviews, case reports, editorials, interesting images, and letters to the editor. The Korean Society of Nuclear Medicine (KSNM) KSNM is a scientific and professional organization founded in 1961 and a member of the Korean Academy of Medical Sciences of the Korean Medical Association which was established by The Medical Services Law. The aims of KSNM are the promotion of nuclear medicine and cooperation of each member. The business of KSNM includes holding academic meetings and symposia, the publication of journals and books, planning and research of promoting science and health, and training and qualification of nuclear medicine specialists.