816P - 68Ga-PSMA-PET/CT as a changing practice tool in biochemically recurrent prostate cancer

Date 10 September 2017
Event ESMO 2017 Congress
Session Poster display session
Topics Prostate Cancer
Genitourinary Cancers
Imaging, Diagnosis and Staging
Presenter Pedro Domingues
Citation Annals of Oncology (2017) 28 (suppl_5): v269-v294. 10.1093/annonc/mdx370
Authors P.M. Domingues1, T. Abreu2, M.B. Siqueira3, G. Marinho1, D. Rosa1, H. Cottas1, L.H. Araujo1, D. Herchenhorn2, F.A. Peixoto1
  • 1Medical Oncology, INSTITUTO COI- CLINICAS ONCOLOGICAS INTEGRADAS, 22793-080 - RIO DE JANEIRO/BR
  • 2Medical Oncology, oncologia DOR, 011 - rio de janeiro/BR
  • 3Medical Oncology, oncoclinica, 22640000 - RIO DE JANEIRO/BR

Abstract

Background

PSMA-PET/CT have demonstrated interesting results in the detection of loco-regional and distant disease in prostate cancer patients with biochemical relapse. Even with low levels of PSA, PSMA imaging is able to identify metastatic lesions, being a possible tool for tailoring treatment decisions. This study aims to describe the use of PSMA-PET/CT in the daily practice and its clinical impact in the management of prostate cancer patients who have rising PSA after curative treatment.

Methods

We performed a retrospective analysis in 29 localized prostate cancer patients of three private Brazilian cancer institutions who underwent PSMA-PET/CT for rising PSA after treatment with curative intent. The clinical impact of PSMA-PET/CT was evaluated by whether the assistant physician changed or not the treatment strategy based solely on PSMA results. In addition, modifications related to local (salvage radiotherapy [SRT], salvage lymphadenectomy [SL]) and systemic (antiandrogen deprivation therapy [ADT], chemotherapy [chemo]) treatment were described.

Results

In total, 29 patients were enrolled. Twenty-seven (93%) had undergone radical prostatectomy, and 2 (7%) radiotherapy as the local curative treatment. Sixteen cases (55%) had not received any radiotherapy previously. The mean Gleason score, PSA level and PSADT at time of the examination were 8, 4.2 (0,05-41) ng/ml and 4.4 (0.4-27) months, respectively. PSMA-PET/CT detected at least one suspicious lesion for prostate cancer in 21/29 (58%) patients. Overall, 15/29 (51%) patients had their treatment strategy changed due to results in PSMA imaging. In only 3/29 (10%) the modifications were related exclusively to systemic protocols (1 avoided ADT, 1 added ADT and, 1 added chemo). Whereas in the 12/29 (41%) remaining cases, treatment strategy change involved local treatment. Of these 12 with a local treatment change, 7 added (6 SL, 1 SRT) and 5 avoided (5 SRT) local therapies.

Conclusions

Half of the patients with biochemical relapse that underwent PSMA-PET/CT had their treatment protocol changed, most changes related to local treatment. Although the role of PSMA imaging is not clearly defined, PSMA-PET/CT has been used as a practice changing tool in the daily practice.

Clinical trial identification

Legal entity responsible for the study

Instituto COI

Funding

None

Disclosure

All authors have declared no conflicts of interest.