Conclusion: There is rapid dichotomous response on 68Ga-PSMA PET imaging to AB-dependent on the presence of a hormone-sensitive or castrate-resistant PCa phenotype. PSA responses were more delayed in cohort 2 (−15% ), with 2 of 7 men demonstrating PSA progression. This increase at day 9 plateaued by day 28. All men demonstrated an increase in SUV max and SUV mean on PSMA PET compared with baseline ( P < 0.04). In cohort 2, a median 45% (IQR, 12.7–66) increase in intensity of PSMA SUV was recorded by day 9 after AB. After day 9, PSMA response heterogeneity was noted, with persistently high or increasing SUV max in 37.5% (3/8) and marked reduction in 62.5% (5/8). Total tumor volume reduced in all men by 74.5% (IQR, 27–97) ( P < 0.02). A reduction from baseline SUV max occurred in 86.5% (6/7) men by day 9 ( P < 0.04), with an associated PSA response in 100% men ( P < 0.03). Results: In cohort 1, a median 30% (interquartile range, 5–61) reduction in SUV max was recorded by day 9 after AB. PET/CT was quantitatively analyzed for SUV max, SUV mean, and total tumor volume. Testosterone and prostate-specific antigen (PSA) were measured at baseline and all imaging time points. Gleason score, age, time since diagnosis, and prior treatments were documented.
#Rapid jump on psa serial
Methods: Serial 68Ga-PSMA-11 PET was prospectively performed at baseline and on days 9, 18, and 28 in 8 men with measurable metastatic hormone-sensitive PCa commencing LHRH ± bicalutamide (cohort 1) and 7 men with castrate-resistant PCa commencing either enzalutamide or abiraterone (cohort 2). The aim of this study was to evaluate the effect of AB treatment on 68Ga-PSMA-11 PET imaging in hormone-naive (luteinizing hormone-releasing hormone ± bicalutamide) and in castrate-resistant men (enzalutamide or abiraterone) with metastatic PCa. In preclinical models, androgen blockade (AB) increases expression of PSMA in both hormone-sensitive and castrate-resistant xenotypes. Prostate-specific membrane antigen (PSMA) may be targeted for both diagnostic and therapeutic purposes in the management of prostate cancer (PCa).
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