Use of prostate-specific membrane antigen (PSMA) PET/CT before undergoing salvage radiotherapy was associated with an improved overall survival and biochemical recurrence–free survival compared those who did not receive PSMA PET/CT scanning in male patients with biochemically recurrent prostate cancer following radical prostatectomy.
These real-world findings from Denmark, published in The Journal of Nuclear Medicine, highlight how valuable PSMA PET/CT scanning can be for pinpointing patients who are likely to benefit from salvage radiotherapy or not.
According to lead study author Anna W. Mogensen, MSc, Department of Nuclear Medicine, Aalborg University Hospital, Aalborg, Denmark, the study findings show that PSMA PET/CT scans can help clinicians select patients most likely to be sensitive to salvage radiotherapy, ultimately leading to fewer patients receiving unnecessary treatment and more patients receiving a more personalized treatment protocol.
Study Methods and Patient Population
Ms. Mogensen noted that PSMA PET/CT was first introduced in Denmark in 2015, but adoption of the imaging modality has been slower in some regions.
The researched obtained real-world data from routine clinical practice and Denmark's nationwide health registry of patients with biochemically recurrent prostate cancer after radical prostatectomy who were treated with salvage radiotherapy between 2015 and 2023. Only patients with a prostate-specific antigen level of 0.2–1.0 ng/mL were eligible for the final analysis.
The study included 844 patients treated with salvage radiotherapy, who were then categorized based on whether or not they received a pretreatment PSMA PET/CT scan. Only 36.5% had underwent PSMA PET/CT scanning prior to treatment.
Key Study Findings
At 1 year, the overall survival rate for patients who underwent a pretreatment PSMA PET/CT scan was 100% (95% confidence interval [CI] = 100%–100%) compared with 99% (95% CI = 98.2%–99.9%) in patients who did not get a PSMA PET/CT scan; at 2 years, the overall survival rates were 99.5% (95% CI = 98.6%–100%) vs 97.8% (95% CI = 96.5%–99.1%), respectively, and 98.1% (95% CI = 96%–100%) vs 93.8% (95% CI = 91.%–96.2%) at 5 years (crude hazard ratio [cHR] = 3.31; 95% CI = 1.01–10.88; P = .0486).
At 3 years, the biochemical recurrence–free survival rate in patients who received pretreatment PSMA PET/CT was 74.9% (95% CI = 68.5%–81.3%) compared with 69.4% (95% CI = 65.2%–73.7%) in patients who did not receive the scan (HR = 1.53; 95% CI = 1.07–2.19; P = .0187).
Ms. Mogensen said the findings support broader use of nuclear medicine techniques to guide treatment decisions. She suggested that nuclear imaging early on should become a standard practice for cancer care.
Disclosure: For full disclosures of the study authors, visit jnm.snmjournals.org.
