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Titel: New insights in the paradigm of upregulation of tumoral PSMA expression by androgen receptor blockade : Enzalutamide induces PSMA upregulation in castration-resistant prostate cancer even in patients having previously progressed on enzalutamide
VerfasserIn: Rosar, Florian
Dewes, Sebastian
Ries, Martin
Schaefer, Andrea
Khreish, Fadi
Maus, Stephan
Bohnenberger, Hendrik
Linxweiler, Johannes
Bartholomä, Mark
Ohlmann, Carsten
Ezziddin, Samer
Sprache: Englisch
Titel: European Journal of Nuclear Medicine and Molecular Imaging
Bandnummer: 47
Heft: 3
Seiten: 687-694
Verlag/Plattform: Springer Nature
Erscheinungsjahr: 2020
Freie Schlagwörter: Metastatic castration-resistant prostate cancer
PSMA radioligand therapy
Androgen deprivation therapy
Enzalutamide
Upregulation of PSMA expression
DDC-Sachgruppe: 610 Medizin, Gesundheit
Dokumenttyp: Journalartikel / Zeitschriftenartikel
Abstract: Purpose There is preliminary evidence for prostate-specific membrane antigen (PSMA) upregulation effects of androgen receptor blockade in prostate cancer. In an attempt to find the best condition for PSMA radioligand therapy in metastatic castration-resistant prostate cancer (mCRPC) patients, we evaluated the effect of oral enzalutamide in patients, predominantly having previously progressed on enzalutamide treatment. Methods Ten patients with advanced mCRPC scheduled for PSMA radioligand therapy were examined with 68Ga-PSMA-11 PET/CT before and after a mean of 11.8 days of enzalutamide 160 mg/day. Imaging results were compared using total PSMA tumor burden quantification. We assessed whole-body total lesion PSMA (TLP), defined as SUVmean × tumor volume and calculated TLP-to-liver ratio (TLP-LR), TLP-to-parotid gland ratio (TLP-PR), and TLP-to-kidney ratio (TLP-KR). Results The mean (median) increase of TLP-LR, TLP-PR, and TLP-KR in the cohort was 49.3% (38.8%), 45.1% (23.5%), and 54.9% (37.6%), respectively. These increases were statistically significant (p = 0.002, p = 0.014, and p = 0.014), while PSA values did not change significantly (p = 0.846). Seven of the 10 patients had previously undergone enzalutamide treatment with eventual progression, formally classified as treatment failure. No side effects were noted in the short term. Conclusions Our results suggest that enzalutamide could be considered as a PSMA radioligand treatment enhancing primer medication, which may increase PSMA expression by a dimension of 50% in mCRPC. The effect was shown even in patients having previously failed enzalutamide treatment for arrest of progression in the mCRPC setting. Our observation deserves evaluation in a prospective setting.
DOI der Erstveröffentlichung: 10.1007/s00259-019-04674-0
URL der Erstveröffentlichung: https://link.springer.com/article/10.1007/s00259-019-04674-0
Link zu diesem Datensatz: urn:nbn:de:bsz:291--ds-377326
hdl:20.500.11880/34122
http://dx.doi.org/10.22028/D291-37732
ISSN: 1619-7089
1619-7070
Datum des Eintrags: 26-Okt-2022
Fakultät: M - Medizinische Fakultät
Fachrichtung: M - Radiologie
M - Urologie und Kinderurologie
Professur: M - Prof. Dr. Samer Ezziddin
M - Prof. Dr. Michael Stöckle
Sammlung:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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