PSMA PET accurate for detecting prostate cancer recurrence

  • Fendler WP & al.
  • JAMA Oncol
  • 28 Mar 2019

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • 68Ga-prostate-specific membrane antigen (PSMA)-11 positron emission tomographic (PET) imaging showed high positive predictive value (PPV), detection rate, and interreader agreement in patients with biochemically recurrent prostate cancer.
  • No grade ≥2 adverse events were reported.

Why this matters

  • This study confirms utility of 68Ga-PSMA-11 PET screening in early detection of metastases observed in prior retrospective studies.

Study design

  • Prospective, multicenter study.
  • 635 patients with recurrent prostate cancer received 68Ga-PSMA-11 PET imaging.
  • Funding: None disclosed.

Key results

  • PPV was 0.84 for tumor on a per patient and per region basis (95% CI, 0.75-0.90 and 0.76-0.91, respectively).
  • Overall PET detection rate was 75%.
  • Detection rate was significantly high across predefined PSA ranges:
  • Interreader agreement was substantial for all 4 regions: κ: prostate bed, 0.65; pelvic nodes, 0.73; extrapelvic soft tissue, 0.70; bone, 0.78.
  • No grade ≥2 adverse events were reported; 2% patients experienced grade 1 toxicities.
  • After PET-directed focal therapy, 80% of 39 patients experienced PSA decline of ≥50%.

Limitations

  • Single-group study.

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