Response Assessment and Prediction of Progression-Free Survival by 68 Ga-PSMA-11 PET/CT Based on Tumor-to-Liver Ratio (TLR) in Patients with mCRPC Undergoing 177 Lu-PSMA-617 Radioligand Therapy.

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  • Additional Information
    • Source:
      Publisher: MDPI Country of Publication: Switzerland NLM ID: 101596414 Publication Model: Electronic Cited Medium: Internet ISSN: 2218-273X (Electronic) Linking ISSN: 2218273X NLM ISO Abbreviation: Biomolecules Subsets: MEDLINE
    • Publication Information:
      Original Publication: Basel, Switzerland : MDPI, 2011-
    • Subject Terms:
      Gallium Isotopes* ; Gallium Radioisotopes* ; Lutetium* ; Prostate-Specific Antigen* ; Radiopharmaceuticals*; Liver/*pathology ; Prostatic Neoplasms, Castration-Resistant/*radiotherapy ; Radiotherapy/*methods; Aged ; Aged, 80 and over ; Biomarkers/metabolism ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Liver/radiation effects ; Male ; Middle Aged ; Molecular Imaging ; Neoplasm Metastasis ; Progression-Free Survival ; Retrospective Studies ; Treatment Outcome
    • Abstract:
      At present, little is known about the molecular imaging-based response assessment of prostate-specific membrane antigen (PSMA)-targeted radioligand therapy with 177 Lutetium ( 177 Lu-PSMA-617 RLT) in metastatic castration-resistant prostate cancer (mCRPC). Our study evaluated the response to RLT using both molecular imaging and biochemical response assessments, and their potential prediction of progression-free survival (PFS). Fifty-one consecutive patients given two cycles of RLT at 6-week intervals were analyzed retrospectively. 68 Ga-PSMA-11 PET/CT was obtained about 2 weeks prior to the first and 4-6 weeks after the second cycle. Molecular imaging-based response using SUV peak and tumor-to-liver ratio (TLR) was determined by modified PERCIST criteria. ∆TLR and ∆SUV were significantly correlated with ∆PSA ( p < 0.001, each). After a median follow-up of 49 months, the median PFS (95% CI) was 8.0 (5.9-10.1) months. In univariate analysis, responders showing partial remission (PR PSA and PR TLR ) had significantly ( p < 0.001, each) longer PFS (median: 10.5 and 9.3 months) than non-responders showing either stable or progressive disease (median: 4.0 and 3.5 months). Response assessment using SUV peak failed to predict survival. In multivariable analysis, response assessment using TLR was independently associated with PFS ( p < 0.001), as was good performance status ( p = 0.002). Molecular imaging-based response assessment with 68 Ga-PSMA-11 PET/CT using normalization of the total lesion PSMA over healthy liver tissue uptake (TLR) could be an appropriate biomarker to monitor RLT in mCRPC patients and to predict progression-free survival (PFS) of this treatment modality.
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    • Contributed Indexing:
      Keywords: 68Ga-PSMA-11 PET/CT; Lutetium-177; PSMA-617; metastatic castration-resistant prostate cancer (mCRPC); molecular imaging-based response assessment; radioligand therapy; tumor-to-liver ratio (TLR)
    • Accession Number:
      0 (177Lu-PSMA-617)
      0 (Biomarkers)
      0 (Gallium Isotopes)
      0 (Gallium Radioisotopes)
      0 (Radiopharmaceuticals)
      0 (gallium 68 PSMA-11)
      5H0DOZ21UJ (Lutetium)
      EC 3.4.21.77 (Prostate-Specific Antigen)
    • Publication Date:
      Date Created: 20210827 Date Completed: 20211025 Latest Revision: 20211025
    • Publication Date:
      20231215
    • Accession Number:
      PMC8391209
    • Accession Number:
      10.3390/biom11081099
    • Accession Number:
      34439768