Event-free survival after 68 Ga-PSMA-11 PET/CT in recurrent hormone-sensitive prostate cancer (HSPC) patients eligible for salvage therapy

• Published in: European journal of nuclear medicine and molecular imaging 2022-07, Vol.49 (9), p.3257-3268
• Main Authors: Ceci, Francesco, Rovera, Guido, Iorio, Giuseppe Carlo, Guarneri, Alessia, Chiofalo, Valeria, Passera, Roberto, Oderda, Marco, Dall’Armellina, Sara, Liberini, Virginia, Grimaldi, Serena, Bellò, Marilena, Gontero, Paolo, Ricardi, Umberto, Deandreis, Désirée
• Format: Article
• Language: English
• Subjects: Antigens; Cardiology; Imaging; Medicine; Medicine & Public Health; Nuclear Medicine; Oncology; Oncology – Genitourinary; Original; Original Article; Orthopedics; Patients; Positron emission; Positron emission tomography; Prostate cancer; Radiology; Statistical analysis; Survival; Therapy; Tomography
• ISSN: 1619-7070; 1619-7089
• DOI: 10.1007/s00259-022-05741-9

Background/aim Prostate-specific-membrane-antigen/positron emission tomography (PSMA-PET) detects with high accuracy disease-recurrence, leading to changes in the management of biochemically-recurrent (BCR) prostate cancer (PCa). However, data regarding the oncological outcomes of patients who performed PSMA-PET are needed. The aim of this study was to evaluate the incidence of clinically relevant events during follow-up in patients who performed PSMA-PET for BCR after radical treatment. Materials and methods This analysis included consecutive, hormone-sensitive, hormone-free, recurrent PCa patients (HSPC) enrolled through a prospective study. All patients were eligible for salvage therapy, having at least 24 months of follow-up after PSMA-PET. The primary endpoint was the Event-Free Survival (EFS), defined as the time between the PSMA-PET and the date of event/last follow-up. The Kaplan–Meier method was used to estimate the EFS curves. EFS was also investigated by Cox proportional hazards regression. Events were defined as death, radiological progression, or PSA recurrence after therapy. Results One-hundred and seventy-six ( n  = 176) patients were analyzed (median PSA 0.62 [IQR: 0.43–1.00] ng/mL; median follow-up of 35.4 [IQR: 26.5–40.3] months). The EFS was 78.8% at 1 year, 65.2% (2 years), and 52.2% (3 years). Patients experiencing events during study follow-up had a significantly higher median PSA (0.81 [IQR: 0.53–1.28] vs 0.51 [IQR: 0.36–0.80] ng/mL) and a lower PSA doubling time (PSAdt) (5.4 [IQR: 3.7–11.6] vs 12.7 [IQR: 6.6–24.3] months) ( p   0.5 ng/mL, PSAdt ≤ 6 months, and a positive PSMA-PET result were associated with a higher event rate ( p   0.5 ng/mL and PSAdt ≤ 6 months were statistically significant event-predictors in multivariate model ( p