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000147386 0247_ $$2ISSN$$a0161-5505
000147386 0247_ $$2ISSN$$a1535-5667
000147386 0247_ $$2ISSN$$a2159-662X
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000147386 041__ $$aeng
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000147386 1001_ $$aRathke, Hendrik$$b0
000147386 245__ $$aResponse prediction of 177Lu-PSMA-617 RLT using PSA, Chromogranin A, and LDH.
000147386 260__ $$aNew York, NY$$bSoc.$$c2020
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000147386 500__ $$a2020 May;61(5):689-695
000147386 520__ $$aNeuroendocrine-like trans-differentiation of prostate cancer adenocarcinomas correlates with serum levels of Chromogranin A (CgA) and drives treatment resistance. Aim of this work was to evaluate whether CgA could serve as a response predictor for 177Lu-PSMA617 radio-ligand therapy (PSMA-RLT) in comparison to the established tumor markers. Methods: 100 consecutive patients with metastasized castration resistant prostate cancer (mCRPC) scheduled for PSMA-RLT were evaluated for prostate specific antigen (PSA), lactate dehydrogenase (LDH) and CgA at baseline and in follow-up of PSMA-RLT. Tumor-uptake of PSMA-ligand, a known predictive marker for response, was assessed as a control-variable. Results: From the 100 evaluated patients, 35 had partial remission (PR), 16 stable disease (SD), 15 mixed response (MR) and 36 progression of disease (PD). High tumor-uptake (above salivary gland uptake) translated into PR with an Odds Ratio (OR) of 60.265 (95%-CI 5.038-720.922). Elevated LDH implied a reduced chance for partial remission with an OR of 0.094 (95%-CI 0.017 - 0.518) but increases the frequency of progressive disease (OR 2.717, 95%-CI 1.391-5.304); All patients who achieved partial remission had a normal baseline LDH. Factor-2 elevation of CgA increased the risk for progression with an OR of 3.089 (95%-CI 1.302 - 7.332). Baseline PSA showed no significant odds. Conclusion: In our cohort baseline PSA had no prognostic value for response prediction. LDH was the marker with the strongest prognostic value and elevated LDH increased the risk for progression of disease under PSMA-RLT. Elevated CgA demonstrated moderate impact as a negative prognostic marker in general but was explicitly related with the presence of liver metastases. Well in line with literature, sufficient tumor uptake is a prerequisite to achieve tumor-response.
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000147386 7001_ $$0P:(DE-He78)457c042884c901eb0a02c18bb1d30103$$aHolland-Letz, Tim$$b1
000147386 7001_ $$aMier, Walter$$b2
000147386 7001_ $$aFlechsig, Paul$$b3
000147386 7001_ $$aMavriopoulou, Eleni$$b4
000147386 7001_ $$aRöhrich, Manuel$$b5
000147386 7001_ $$0P:(DE-He78)9793347ba83f527b81a22ab75af9378a$$aKopka, Klaus$$b6
000147386 7001_ $$aHohenfellner, Markus$$b7
000147386 7001_ $$aGiesel, Frederik L$$b8
000147386 7001_ $$0P:(DE-He78)13a0afba029f5f64dc18b25ef7499558$$aHaberkorn, Uwe A$$b9$$udkfz
000147386 7001_ $$aKratochwil, Clemens$$b10
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