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Titel: Early molecular imaging response assessment based on determination of total viable tumor burden in [68Ga]Ga-PSMA-11 PET/CT independently predicts overall survival in [177Lu]Lu-PSMA-617 radioligand therapy
VerfasserIn: Rosar, Florian
Wenner, Felix
Khreish, Fadi
Dewes, Sebastian
Wagenpfeil, Gudrun
Hoffmann, Manuela A.
Schreckenberger, Mathias
Bartholomä, Mark
Ezziddin, Samer
Sprache: Englisch
Titel: European Journal of Nuclear Medicine and Molecular Imaging
Bandnummer: 49
Heft: 5
Seiten: 1584–1594
Verlag/Plattform: Springer
Erscheinungsjahr: 2021
Freie Schlagwörter: Metastatic castration-resistant prostate cancer
Radioligand therapy
PSMA PET/CT
Molecular imaging
Response assessment
DDC-Sachgruppe: 610 Medizin, Gesundheit
Dokumenttyp: Journalartikel / Zeitschriftenartikel
Abstract: Purpose In patients with metastatic castration-resistant prostate cancer (mCRPC) treated with prostate-specific membrane antigen-targeted radioligand therapy (PSMA-RLT), the predictive value of PSMA PET/CT-derived response is still under investigation. Early molecular imaging response based on total viable tumor burden and its association with overall survival (OS) was explored in this study. Methods Sixty-six mCRPC patients who received [177Lu]Lu-PSMA-617 RLT within a prospective patient registry (REALITY Study, NCT04833517) were analyzed. Patients received a [68Ga]Ga-PSMA-11 PET/CT scan before the first and after the second cycle of PSMA-RLT. Total lesion PSMA (TLP) was determined by semiautomatic whole-body tumor segmentation. Molecular imaging response was assessed by change in TLP and modified PERCIST criteria. Biochemical response was assessed using standard serum PSA and PCWG3 criteria. Both response assessment methods and additional baseline parameters were analyzed regarding their association with OS by univariate and multivariable analysis. Results By molecular imaging, 40/66 (60.6%) patients showed partial remission (PR), 19/66 (28.7%) stable disease (SD), and 7/66 (10.6%) progressive disease (PD). Biochemical response assessment revealed PR in 34/66 (51.5%) patients, SD in 20/66 (30.3%), and PD in 12/66 (18.2%). Response assessments were concordant in 49/66 (74.3%) cases. On univariate analysis, both molecular and biochemical response (p = 0.001 and 0.008, respectively) as well as two baseline characteristics (ALP and ECOG) were each significantly associated with OS. The median OS of patients showing molecular PR was 24.6 versus 10.7 months in the remaining patients (with SD or PD). On multivariable analysis molecular imaging response remained an independent predictor of OS (p = 0.002), eliminating biochemical response as insignificant (p = 0.515). Conclusion The new whole-body molecular imaging–derived biomarker, early change of total lesion PSMA (TLP), independently predicts overall survival in [177Lu]Lu-PSMA-617 RLT in mCRPC, outperforming conventional PSA-based response assessment. TLP might be considered a more distinguished and advanced biomarker for monitoring PSMA-RLT over commonly used serum PSA.
DOI der Erstveröffentlichung: 10.1007/s00259-021-05594-8
URL der Erstveröffentlichung: https://link.springer.com/article/10.1007/s00259-021-05594-8
Link zu diesem Datensatz: urn:nbn:de:bsz:291--ds-372520
hdl:20.500.11880/33768
http://dx.doi.org/10.22028/D291-37252
ISSN: 1619-7089
1619-7070
Datum des Eintrags: 16-Sep-2022
Fakultät: M - Medizinische Fakultät
Fachrichtung: M - Medizinische Biometrie, Epidemiologie und medizinische Informatik
M - Radiologie
Professur: M - Prof. Dr. Samer Ezziddin
M - Prof. Dr. Stefan Wagenpfeil
Sammlung:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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