Utilization of Salvage and Systemic Therapies for Recurrent Prostate Cancer as a Result of 18F-DCFPyL PET/CT Restaging
Purpose: Our purpose was to investigate the effect of the addition of prostate-specific membrane antigen (PSMA)-targeted positron emission tomography/computed tomography (PET/CT) in patients with recurrent prostate cancer post-primary radiation therapy. Methods and Materials: A prospective, multi-in...
| Main Authors: | , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2021-01-01
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| Series: | Advances in Radiation Oncology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2452109420302219 |
| _version_ | 1818870161728339968 |
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| author | Wei Liu, MD Katherine Zukotynski, MD, PhD, FRCPC Louise Emmett, MD, FRACP Hans T. Chung, MD, FRCPC Peter Chung, MD, FRCPC Robert Wolfson, MD, FRCPC Irina Rachinsky, MD, MSc, FRCPC Anil Kapoor, MD, FRCSC Ur Metser, MD, FRCPC Andrew Loblaw, MD, MSc, FRCPC Gerard Morton, MB, FRCPC Tracy Sexton, MD, PhD, FRCPC Michael Lock, MD, FRCPC Joelle Helou, MD, MSc Alejandro Berlin, MD, MSc Colm Boylan, MB, FRCPC Susan Archer, BSc Gregory R. Pond, PhD, PStat Glenn Bauman, MD, FRCPC |
| author_facet | Wei Liu, MD Katherine Zukotynski, MD, PhD, FRCPC Louise Emmett, MD, FRACP Hans T. Chung, MD, FRCPC Peter Chung, MD, FRCPC Robert Wolfson, MD, FRCPC Irina Rachinsky, MD, MSc, FRCPC Anil Kapoor, MD, FRCSC Ur Metser, MD, FRCPC Andrew Loblaw, MD, MSc, FRCPC Gerard Morton, MB, FRCPC Tracy Sexton, MD, PhD, FRCPC Michael Lock, MD, FRCPC Joelle Helou, MD, MSc Alejandro Berlin, MD, MSc Colm Boylan, MB, FRCPC Susan Archer, BSc Gregory R. Pond, PhD, PStat Glenn Bauman, MD, FRCPC |
| author_sort | Wei Liu, MD |
| collection | DOAJ |
| description | Purpose: Our purpose was to investigate the effect of the addition of prostate-specific membrane antigen (PSMA)-targeted positron emission tomography/computed tomography (PET/CT) in patients with recurrent prostate cancer post-primary radiation therapy. Methods and Materials: A prospective, multi-institutional clinical trial evaluated 2-(3-{1-carboxy-5-[(6-[18F]fluoro-pyridine-3-carbonyl)-amino]-pentyl}-ureido)-pentanedioic acid (18F-DCFPyL) PET/CT restaging in 79 men with recurrent prostate cancer post-primary radiation therapy. We report actual patient management and compare this with proposed management both before and after PSMA-targeted PET/CT. Results: Most patients (59%) had a major change in actual management compared with pre-PET/CT proposed management. The rate of major change was underestimated by immediately post-PET/CT surveys (32%). Eighteen patients with PSMA avidity in the prostate gland suspicious for malignancy had a prostate biopsy. Sensitivity, specificity, and positive predictive values of PSMA uptake in the prostate were 86%, 67%, and 92%, respectively. Thirty percent of patients had directed salvage therapy and 41% underwent systemic therapy. Eleven out of 79 patients (14%) had high-dose-rate brachytherapy alone for local recurrence, and 91% were free of recurrence at a median follow-up of 20 months. Conclusions: Most patients had a major change in actual management compared with pre–PSMA-targeted PET/CT planned management, and this was underestimated by post-PET/CT questionnaires. |
| first_indexed | 2024-12-19T12:02:38Z |
| format | Article |
| id | doaj.art-25489d44ab854ea895ee08cf664a57f7 |
| institution | Directory Open Access Journal |
| issn | 2452-1094 |
| language | English |
| last_indexed | 2024-12-19T12:02:38Z |
| publishDate | 2021-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Advances in Radiation Oncology |
| spelling | doaj.art-25489d44ab854ea895ee08cf664a57f72022-12-21T20:22:26ZengElsevierAdvances in Radiation Oncology2452-10942021-01-0161100553Utilization of Salvage and Systemic Therapies for Recurrent Prostate Cancer as a Result of 18F-DCFPyL PET/CT RestagingWei Liu, MD0Katherine Zukotynski, MD, PhD, FRCPC1Louise Emmett, MD, FRACP2Hans T. Chung, MD, FRCPC3Peter Chung, MD, FRCPC4Robert Wolfson, MD, FRCPC5Irina Rachinsky, MD, MSc, FRCPC6Anil Kapoor, MD, FRCSC7Ur Metser, MD, FRCPC8Andrew Loblaw, MD, MSc, FRCPC9Gerard Morton, MB, FRCPC10Tracy Sexton, MD, PhD, FRCPC11Michael Lock, MD, FRCPC12Joelle Helou, MD, MSc13Alejandro Berlin, MD, MSc14Colm Boylan, MB, FRCPC15Susan Archer, BSc16Gregory R. Pond, PhD, PStat17Glenn Bauman, MD, FRCPC18Department of Oncology, Division of Radiation Oncology, London Health Sciences Centre and Western University, London, CanadaDepartments of Medicine and Radiology, McMaster University, Hamilton, CanadaDepartment of Nuclear Medicine and Theranostics, St. Vincent’s Hospital and University of New South Wales, Sydney, AustraliaDepartment of Radiation Oncology, Odette Cancer Center, Sunnybrook Health Sciences Centre, Toronto, Canada; Department of Radiation Oncology, University of Toronto, Toronto, CanadaDepartment of Radiation Oncology, University of Toronto, Toronto, Canada; Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, CanadaDepartment of Medical Imaging, Sunnybrook Health Sciences Centre and University of Toronto, Toronto, CanadaDivision of Nuclear Medicine, London Health Sciences Centre and Western University, London, CanadaUrologic Cancer Centre for Research & Innovation and McMaster University, Hamilton, CanadaDepartment of Medical Imaging, Princess Margaret Cancer Centre and University of Toronto, Toronto, CanadaDepartment of Radiation Oncology, Odette Cancer Center, Sunnybrook Health Sciences Centre, Toronto, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Canada; Institute of Health Care Policy and Evaluation, University of Toronto, CanadaDepartment of Radiation Oncology, Odette Cancer Center, Sunnybrook Health Sciences Centre, Toronto, Canada; Department of Radiation Oncology, University of Toronto, Toronto, CanadaDepartment of Oncology, Division of Radiation Oncology, London Health Sciences Centre and Western University, London, CanadaDepartment of Oncology, Division of Radiation Oncology, London Health Sciences Centre and Western University, London, CanadaDepartment of Radiation Oncology, University of Toronto, Toronto, Canada; Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, CanadaDepartment of Radiation Oncology, University of Toronto, Toronto, Canada; Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Canada; Techna Institute, University Health Network, Toronto, CanadaDepartment of Diagnostic Imaging, St. Joseph’s Healthcare and McMaster University, Hamilton, CanadaDepartment of Oncology, Division of Radiation Oncology, London Health Sciences Centre and Western University, London, CanadaDepartment of Oncology, McMaster University, Hamilton, CanadaDepartment of Oncology, Division of Radiation Oncology, London Health Sciences Centre and Western University, London, Canada; Corresponding author: Glenn Bauman, MD, FRCPCPurpose: Our purpose was to investigate the effect of the addition of prostate-specific membrane antigen (PSMA)-targeted positron emission tomography/computed tomography (PET/CT) in patients with recurrent prostate cancer post-primary radiation therapy. Methods and Materials: A prospective, multi-institutional clinical trial evaluated 2-(3-{1-carboxy-5-[(6-[18F]fluoro-pyridine-3-carbonyl)-amino]-pentyl}-ureido)-pentanedioic acid (18F-DCFPyL) PET/CT restaging in 79 men with recurrent prostate cancer post-primary radiation therapy. We report actual patient management and compare this with proposed management both before and after PSMA-targeted PET/CT. Results: Most patients (59%) had a major change in actual management compared with pre-PET/CT proposed management. The rate of major change was underestimated by immediately post-PET/CT surveys (32%). Eighteen patients with PSMA avidity in the prostate gland suspicious for malignancy had a prostate biopsy. Sensitivity, specificity, and positive predictive values of PSMA uptake in the prostate were 86%, 67%, and 92%, respectively. Thirty percent of patients had directed salvage therapy and 41% underwent systemic therapy. Eleven out of 79 patients (14%) had high-dose-rate brachytherapy alone for local recurrence, and 91% were free of recurrence at a median follow-up of 20 months. Conclusions: Most patients had a major change in actual management compared with pre–PSMA-targeted PET/CT planned management, and this was underestimated by post-PET/CT questionnaires.http://www.sciencedirect.com/science/article/pii/S2452109420302219 |
| spellingShingle | Wei Liu, MD Katherine Zukotynski, MD, PhD, FRCPC Louise Emmett, MD, FRACP Hans T. Chung, MD, FRCPC Peter Chung, MD, FRCPC Robert Wolfson, MD, FRCPC Irina Rachinsky, MD, MSc, FRCPC Anil Kapoor, MD, FRCSC Ur Metser, MD, FRCPC Andrew Loblaw, MD, MSc, FRCPC Gerard Morton, MB, FRCPC Tracy Sexton, MD, PhD, FRCPC Michael Lock, MD, FRCPC Joelle Helou, MD, MSc Alejandro Berlin, MD, MSc Colm Boylan, MB, FRCPC Susan Archer, BSc Gregory R. Pond, PhD, PStat Glenn Bauman, MD, FRCPC Utilization of Salvage and Systemic Therapies for Recurrent Prostate Cancer as a Result of 18F-DCFPyL PET/CT Restaging Advances in Radiation Oncology |
| title | Utilization of Salvage and Systemic Therapies for Recurrent Prostate Cancer as a Result of 18F-DCFPyL PET/CT Restaging |
| title_full | Utilization of Salvage and Systemic Therapies for Recurrent Prostate Cancer as a Result of 18F-DCFPyL PET/CT Restaging |
| title_fullStr | Utilization of Salvage and Systemic Therapies for Recurrent Prostate Cancer as a Result of 18F-DCFPyL PET/CT Restaging |
| title_full_unstemmed | Utilization of Salvage and Systemic Therapies for Recurrent Prostate Cancer as a Result of 18F-DCFPyL PET/CT Restaging |
| title_short | Utilization of Salvage and Systemic Therapies for Recurrent Prostate Cancer as a Result of 18F-DCFPyL PET/CT Restaging |
| title_sort | utilization of salvage and systemic therapies for recurrent prostate cancer as a result of 18f dcfpyl pet ct restaging |
| url | http://www.sciencedirect.com/science/article/pii/S2452109420302219 |
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