Prostate-specific Membrane Antigen Positron Emission Tomography-guided Radiotherapy.

Published on Mar 1, 2021in European urology focus4.827
· DOI :10.1016/J.EUF.2020.09.020
Amar U. Kishan19
Estimated H-index: 19
(UCLA: University of California, Los Angeles),
Nicholas G. Nickols23
Estimated H-index: 23
(UCLA: University of California, Los Angeles),
Daniel E. Spratt50
Estimated H-index: 50
(UM: University of Michigan)
Sources
Abstract
Radiotherapy has curative potential for patients with newly diagnosed localized prostate cancer and biochemical recurrence after radical prostatectomy, and can offer durable treatment responses for patients with oligometastatic disease. The success of radiotherapy in these settings relies on an accurate understanding of the extent of disease that is present and the precise anatomic localization of sites of disease. In this mini review, we provide an overview of recent data evaluating the role of positron emission tomography for assessing prostate-specific membrane antigen distribution in guiding radiotherapy in these settings. PATIENT SUMMARY: This mini review examines current evidence for the use of prostate-specific membrane antigen positron emission tomography/computed tomography to guide radiotherapy for patients with newly diagnosed localized prostate cancer, those with recurrences after radical prostatectomy, and those with oligometastatic disease.
References9
Newest
Importance Complete metastatic ablation of oligometastatic prostate cancer may provide an alternative to early initiation of androgen deprivation therapy (ADT). Objective To determine if stereotactic ablative radiotherapy (SABR) improves oncologic outcomes in men with oligometastatic prostate cancer. Design, Setting, and Participants The Observation vs Stereotactic Ablative Radiation for Oligometastatic Prostate Cancer (ORIOLE) phase 2 randomized study accrued participants from 3 US radiation tr...
210 CitationsSource
#1Michael S. Hofman (University of Melbourne)H-Index: 44
#2Nathan Lawrentschuk (University of Melbourne)H-Index: 58
Last. Declan G. Murphy (University of Melbourne)H-Index: 107
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Summary Background Conventional imaging using CT and bone scan has insufficient sensitivity when staging men with high-risk localised prostate cancer. We aimed to investigate whether novel imaging using prostate-specific membrane antigen (PSMA) PET-CT might improve accuracy and affect management. Methods In this multicentre, two-arm, randomised study, we recruited men with biopsy-proven prostate cancer and high-risk features at ten hospitals in Australia. Patients were randomly assigned to conve...
298 CitationsSource
#1Marlon Perera (UQ: University of Queensland)H-Index: 21
#2Nathan Papa (University of Melbourne)H-Index: 13
Last. Declan G. Murphy (University of Melbourne)H-Index: 107
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Abstract Context Accurate staging of high-risk localised, advanced, and metastatic prostate cancer is becoming increasingly more important in guiding local and systemic treatment. Gallium-68 prostate-specific membrane antigen (PSMA) positron emission tomography (PET) has increasingly been utilised globally to assess the local and metastatic burden of prostate cancer, typically in biochemically recurrent or advanced disease. Following our previous meta-analysis, a high-volume series has been repo...
279 CitationsSource
#1Wolfgang P. Fendler (University of Duisburg-Essen)H-Index: 30
#2Jeremie Calais (UCLA: University of California, Los Angeles)H-Index: 20
Last. Thomas A. Hope (UCSF: University of California, San Francisco)H-Index: 39
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Importance: In retrospective studies, 68Ga-PSMA-11 positron emission tomographic (PET) imaging improves detection of biochemically recurrent prostate cancer compared with conventional imaging. Objective: To assess 68Ga-PSMA-11 PET accuracy in a prospective multicenter trial. Design, Setting, and Participants: In this single-arm prospective trial conducted at University of California, San Francisco and University of California, Los Angeles, 635 patients with biochemically recurrent prostate cance...
206 CitationsSource
#1Michael Fraser (OICR: Ontario Institute for Cancer Research)H-Index: 31
#2Bridget F. Koontz (Duke University)H-Index: 22
Last. Paul C. Boutros (UCLA: University of California, Los Angeles)H-Index: 70
view all 11 authors...
Abstract Advanced prostate cancer patients can present with both widely metastatic or oligometastatic disease. Accumulating clinical evidence suggests that patients with oligometastatic disease have improved clinical responses from metastasis-directed therapy. This suggests that tumours that give rise to the oligometastatic state are distinct biologically and genetically from those that induce widely metastatic lesions. Detailed genomic analysis of the oligometastatic state will identify the mol...
15 CitationsSource
#1Jeremie Calais (UCLA: University of California, Los Angeles)H-Index: 20
#2Johannes Czernin (UCLA: University of California, Los Angeles)H-Index: 94
Last. Nicholas G. Nickols (UCLA: University of California, Los Angeles)H-Index: 23
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Background Salvage radiotherapy (SRT) for prostate cancer (PCa) recurrence after prostatectomy offers long-term biochemical control in about 50–60% of patients. SRT is commonly initiated in patients with serum PSA levels < 1 ng/mL, a threshold at which standard-of-care imaging is insensitive for detecting recurrence. As such, SRT target volumes are usually drawn in the absence of radiographically visible disease. 68Ga-PSMA-11 (PSMA) PET/CT molecular imaging is highly sensitive and may offer anat...
54 CitationsSource
#1Jeremie Calais (UCLA: University of California, Los Angeles)H-Index: 20
#2Amar U. Kishan (UCLA: University of California, Los Angeles)H-Index: 19
Last. Nicholas G. Nickols (UCLA: University of California, Los Angeles)H-Index: 23
view all 15 authors...
: Standard-of-care imaging for initial staging of prostate cancer (PCa) underestimates disease burden. Prostate-specific membrane antigen (PSMA) PET/CT detects PCa metastasis with superior accuracy, having a potential impact on the planning of definitive radiation therapy (RT) for nonmetastatic PCa. Our objectives were to determine how often definitive RT planning based on standard target volumes covers 68Ga-PSMA-11 PET/CT-defined disease and to assess the potential impact of 68Ga-PSMA-11 PET/CT...
61 CitationsSource
#1Jeremie Calais (UCLA: University of California, Los Angeles)H-Index: 20
#2Johannes Czernin (UCLA: University of California, Los Angeles)H-Index: 94
Last. Nicholas G. Nickols (UCLA: University of California, Los Angeles)H-Index: 23
view all 19 authors...
Target volume delineations for prostate cancer (PCa) salvage radiotherapy (SRT) after radical prostatectomy are usually drawn in the absence of visibly recurrent disease. Ga-68-labeled prostate-specific membrane antigen (PSMA-11) PET/CT detects recurrent PCa with sensitivity superior to standard-of-care imaging at serum prostate-specific antigen (PSA) values low enough to affect target volume delineations for routine SRT. Our objective was to map the recurrence pattern of PCa early biochemical r...
145 CitationsSource
#1Peter C. Albertsen (University of Connecticut Health Center)H-Index: 75
#2James A. HanleyH-Index: 89
Last. Judith FineH-Index: 21
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Background: Information on tumor stage and grade are used to assess cancer prognosis and to produce standardized comparisons of end results over time. Changes in the interpretation of classifi cation schemes can alter the apparent distribution of cancer stage or grade in the absence of a true biologic change. Since the introduction of prostate-specifi c antigen testing, the reported incidence of low-grade prostate cancer has declined. To determine whether this decline is in part a result of Glea...
347 CitationsSource
Cited By3
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#1Giulia Marvaso (IEO: European Institute of Oncology)H-Index: 14
#2Stefania Volpe (IEO: European Institute of Oncology)H-Index: 9
Last. Barbara Alicja Jereczek-Fossa (IEO: European Institute of Oncology)H-Index: 36
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Abstract Context The optimal management of oligometastatic prostate cancer (PCa) is still debated. Objective The purpose of the present systematic review and meta-analysis is to collect the available evidence to date to better define the role of stereotactic body radiotherapy (SBRT) in selected patients with oligorecurrent PCa. Evidence acquisition Study methodology complied with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). All prospective studies including PC...
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#2Giulia MarvasoH-Index: 14
Last. Piet OstH-Index: 41
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Abstract Background and purpose Between 30% and 47% of patients treated with definitive radiotherapy (RT) for prostate cancer are at risk of intraprostatic recurrence during follow-up. Re-irradiation with stereotactic body RT (SBRT) is emerging as a feasible and safe therapeutic option. However, no consensus or guidelines exist on this topic. The purpose of this ESTRO ACROP project is to investigate expert opinion on salvage SBRT for intraprostatic relapse after RT. Materials and Methods A 40-it...
3 CitationsSource
#1Jamie Michael (UNC: University of North Carolina at Chapel Hill)H-Index: 1
#2Amir H. Khandani (UNC: University of North Carolina at Chapel Hill)H-Index: 16
Last. Marc A. Bjurlin (UNC: University of North Carolina at Chapel Hill)H-Index: 5
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ABSTRACT Objectives To evaluate the characteristics of FACBC PET/CT in detecting recurrent prostate cancer after radiation or prostatectomy. The secondary aim was to determine the impact of FACBC PET/CT on radiation treatment recommendations in men with biochemical recurrence post-prostatectomy. Methods This is a single center retrospective study of men who underwent an FACBC PET/CT for rising PSA after definitive prostate cancer therapy. Detection rates in men with recurrence following any defi...
1 CitationsSource