PSMA-PET Provides Additional Risk Stratification in High-Risk Prostate Cancer

THURSDAY, Jan. 9, 2025 (HealthDay News) — Among patients with high-risk prostate cancer and no evidence of metastatic disease on conventional imaging, prostate-specific membrane antigen-positron emission tomography (PSMA-PET) results were positive in 84 percent of patients and detected distant metastatic disease in 46 percent, according to a study published online Jan. 3 in JAMA Network Open.

Adrien Holzgreve, M.D., from the University of California, Los Angeles, and colleagues conducted a post-hoc, retrospective cross-sectional study involving 182 patients with high-risk nonmetastatic hormone-sensitive prostate cancer after radical prostatectomy (RP), definitive radiotherapy (dRT), or salvage radiotherapy (SRT) from four prospective studies conducted from Sept. 15, 2016, to Sept. 27, 2021, to describe the staging information obtained by PSMA-PET/computed tomography.

The researchers found that the median prescan prostate-specific antigen levels were 2.4, 6.9, 2.6, and 2.8 ng/mL after RP, dRT, RP and SRT, and overall, respectively. The results of PSMA/PET were positive in 80, 92, 85, and 84 percent of patients after RP, dRT, RP and SRT, and overall, respectively. PSMA-PET detected any distant metastatic disease in 34, 56, 60, and 46 percent of patients after RP, dRT, RP and SRT, and overall, respectively. Polymetastatic disease was detected in 19, 36, 23, and 24 percent of patients after RP, dRT, RP and SRT, and overall, respectively.

“PSMA-PET provides novel additional risk stratification for patients with high-risk nmHSPC [nonmetastatic hormone-sensitive prostate cancer] without distant metastasis based on conventional imaging,” the authors write. “Integration of PSMA-PET in major industry-sponsored clinical trials for secondary end points analyses is warranted.”

Several authors disclosed ties to the biopharmaceutical industry.

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