Early PSA Change after [<sup>177</sup>Lu]PSMA-617 Radioligand Therapy as a Predicator of Biochemical Response and Overall Survival
Purpose: Radioligand therapy with [<sup>177</sup>Lu]PSMA-617 (PSMA-RLT) is a promising therapeutic option for metastatic castration-resistant prostate cancer (mCPRP). This study assessed the prognostic value of early PSA measurements during PSMA-RLT. Methods: 27 patients with mCRPC sched...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-12-01
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| Series: | Cancers |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6694/14/1/149 |
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| author | Felix Kind Thomas F. Fassbender Geoffroy Andrieux Melanie Boerries Philipp T. Meyer Juri Ruf |
| author_facet | Felix Kind Thomas F. Fassbender Geoffroy Andrieux Melanie Boerries Philipp T. Meyer Juri Ruf |
| author_sort | Felix Kind |
| collection | DOAJ |
| description | Purpose: Radioligand therapy with [<sup>177</sup>Lu]PSMA-617 (PSMA-RLT) is a promising therapeutic option for metastatic castration-resistant prostate cancer (mCPRP). This study assessed the prognostic value of early PSA measurements during PSMA-RLT. Methods: 27 patients with mCRPC scheduled for PSMA-RLT were prospectively enrolled for a serial short-interval PSA-assessment. Change in PSA (∆%PSA) during two treatment cycles was correlated with biochemical response (BR) and change in tumor volume on PET (TV) after 16 weeks (w16), as well as overall survival (OS). PCWG3 criteria and the recently recommended threshold of ∆%PSA ≤ −30% were assessed for their predictive value. Results: ∆%PSA first correlated with BR, TV and OS after 4 weeks (c1w4). At c1w4, ∆%PSA ≤ −30% was associated with the biochemical response at w16 (<i>p</i> = 0.003) and a longer median OS (<i>p</i> = 0.025), whereas the PCWG3-derived threshold of ∆%PSA ≤ −50% showed no such correlation. In contrast, ∆%PSA ≥ 25% at c1w4 was associated with biochemical progression at w16 (<i>p</i> = 0.003) and a shorter median OS (<i>p</i> < 0.001). Conclusion: PSA changes as early as four weeks after PSMA-RLT allow a significant prediction of later biochemical and PET-based imaging response, as well as OS. At this early time point, a more lenient threshold for a PSA decrease of at least 30% appears better-suited for the prediction of a positive biochemical response and longer OS. In contrast, the PCWG3-derived threshold for PSA increase (+25%) reliably anticipates biochemical progression and shorter OS. |
| first_indexed | 2024-03-10T03:47:40Z |
| format | Article |
| id | doaj.art-d0665583f1894857bcc7af53c82158dc |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T03:47:40Z |
| publishDate | 2021-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-d0665583f1894857bcc7af53c82158dc2023-11-23T11:16:54ZengMDPI AGCancers2072-66942021-12-0114114910.3390/cancers14010149Early PSA Change after [<sup>177</sup>Lu]PSMA-617 Radioligand Therapy as a Predicator of Biochemical Response and Overall SurvivalFelix Kind0Thomas F. Fassbender1Geoffroy Andrieux2Melanie Boerries3Philipp T. Meyer4Juri Ruf5Department of Nuclear Medicine, Faculty of Medicine, Medical Center—University of Freiburg, University of Freiburg, Hugstetter Str. 55, D-79106 Freiburg, GermanyDepartment of Nuclear Medicine, Faculty of Medicine, Medical Center—University of Freiburg, University of Freiburg, Hugstetter Str. 55, D-79106 Freiburg, GermanyInstitute of Medical Bioinformatics and Systems Medicine, Faculty of Medicine, Medical Center—University of Freiburg, University of Freiburg, Breisacher Str. 153, D-79110 Freiburg, GermanyInstitute of Medical Bioinformatics and Systems Medicine, Faculty of Medicine, Medical Center—University of Freiburg, University of Freiburg, Breisacher Str. 153, D-79110 Freiburg, GermanyDepartment of Nuclear Medicine, Faculty of Medicine, Medical Center—University of Freiburg, University of Freiburg, Hugstetter Str. 55, D-79106 Freiburg, GermanyDepartment of Nuclear Medicine, Faculty of Medicine, Medical Center—University of Freiburg, University of Freiburg, Hugstetter Str. 55, D-79106 Freiburg, GermanyPurpose: Radioligand therapy with [<sup>177</sup>Lu]PSMA-617 (PSMA-RLT) is a promising therapeutic option for metastatic castration-resistant prostate cancer (mCPRP). This study assessed the prognostic value of early PSA measurements during PSMA-RLT. Methods: 27 patients with mCRPC scheduled for PSMA-RLT were prospectively enrolled for a serial short-interval PSA-assessment. Change in PSA (∆%PSA) during two treatment cycles was correlated with biochemical response (BR) and change in tumor volume on PET (TV) after 16 weeks (w16), as well as overall survival (OS). PCWG3 criteria and the recently recommended threshold of ∆%PSA ≤ −30% were assessed for their predictive value. Results: ∆%PSA first correlated with BR, TV and OS after 4 weeks (c1w4). At c1w4, ∆%PSA ≤ −30% was associated with the biochemical response at w16 (<i>p</i> = 0.003) and a longer median OS (<i>p</i> = 0.025), whereas the PCWG3-derived threshold of ∆%PSA ≤ −50% showed no such correlation. In contrast, ∆%PSA ≥ 25% at c1w4 was associated with biochemical progression at w16 (<i>p</i> = 0.003) and a shorter median OS (<i>p</i> < 0.001). Conclusion: PSA changes as early as four weeks after PSMA-RLT allow a significant prediction of later biochemical and PET-based imaging response, as well as OS. At this early time point, a more lenient threshold for a PSA decrease of at least 30% appears better-suited for the prediction of a positive biochemical response and longer OS. In contrast, the PCWG3-derived threshold for PSA increase (+25%) reliably anticipates biochemical progression and shorter OS.https://www.mdpi.com/2072-6694/14/1/149castration refractory metastatic prostate cancerPSMAPSAradioligand therapy[<sup>177</sup>Lu]PSMA-617 |
| spellingShingle | Felix Kind Thomas F. Fassbender Geoffroy Andrieux Melanie Boerries Philipp T. Meyer Juri Ruf Early PSA Change after [<sup>177</sup>Lu]PSMA-617 Radioligand Therapy as a Predicator of Biochemical Response and Overall Survival Cancers castration refractory metastatic prostate cancer PSMA PSA radioligand therapy [<sup>177</sup>Lu]PSMA-617 |
| title | Early PSA Change after [<sup>177</sup>Lu]PSMA-617 Radioligand Therapy as a Predicator of Biochemical Response and Overall Survival |
| title_full | Early PSA Change after [<sup>177</sup>Lu]PSMA-617 Radioligand Therapy as a Predicator of Biochemical Response and Overall Survival |
| title_fullStr | Early PSA Change after [<sup>177</sup>Lu]PSMA-617 Radioligand Therapy as a Predicator of Biochemical Response and Overall Survival |
| title_full_unstemmed | Early PSA Change after [<sup>177</sup>Lu]PSMA-617 Radioligand Therapy as a Predicator of Biochemical Response and Overall Survival |
| title_short | Early PSA Change after [<sup>177</sup>Lu]PSMA-617 Radioligand Therapy as a Predicator of Biochemical Response and Overall Survival |
| title_sort | early psa change after sup 177 sup lu psma 617 radioligand therapy as a predicator of biochemical response and overall survival |
| topic | castration refractory metastatic prostate cancer PSMA PSA radioligand therapy [<sup>177</sup>Lu]PSMA-617 |
| url | https://www.mdpi.com/2072-6694/14/1/149 |
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