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DOI: 10.1055/s-0040-1708395
Interim PSMA PET/CT Response Is Predictive of Survival of Prostate Cancer Patients Treatedwith Lu-177 PSMA DKFZ 617
Publikationsverlauf
Publikationsdatum:
08. April 2020 (online)
Ziel/Aim This study was performed to assess the predictive power of interim PSMA PET/CT (defined as PET performed after 2nd therapy cycle) in prediction of PFS and overall survival in metastastised castrate resistant prostate cancer (mCRPC) patients who received at least 2 therapy cycles of Lu-177 PSMA DKFZ 617 (RLT).
Methodik/Methods 38 mCRPC patients (68.9 ± 8.1 y) treated with at least 2 cycles (range 2–5) of RLT at 8 weeks interval were included for analyses. Interim Ga-68 PSMA 11 PET/CT (PET) was performed at 8–10 weeks after 2nd RLT. PSA values at the time of PET were evaluated. Response assessment of soft tissue and lymph node lesions was performed according to RECIST 1.1. For staging of bone lesions, as is proposed in RECIST 1.1, the PET component was used. Out of the Charité Comprehensive Cancer Center Register patients’ date of death were collected.
Ergebnisse/Results Patients were treated with 5.5 ± 1 GBq RLT/cycle. Median follow-up was 19.7 months (4.7–45.3). 63 % patients died during follow-up. Median overall survival (OS) was 22.5 months (95 %: 15.8–29.2). Based on PSA response criteria, 9/38 (23.5 %) achieved partial remission (PR), 50 % had disease stabilization (SD) and 26.5 % showed progressive disease (PD) after the 2nd therapy cycle. Based on PET response criteria, 20/38 (52.6 %) achieved PR, 9/38 (23.7 %) had SD, 23.7 % were PD after 2nd therapy cycle. Median OS stratified to PSA response criteria was as follows: for patients classified as PR 25.6 months, SD 21.7 months and PD 19.4 months (p = 0.496). Median OS stratified according to interim PET response was as follows: PR 25.6 months, SD 30.6 months, PD 13.1 months (p = 0.009). Median PFS for the cohort was 34 weeks (95 % CI 20.2–47.7).
Schlussfolgerungen/Conclusions Interim PSMA PET/CT after 2nd therapy cycle based response evaluation is predictive of overall survival and PD of patients treated with Lu-177 PSMA DKFZ and performed better than PSA in this relatively small cohort.
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