Journal Article

DKFZ-2025-02170

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Prostate-specific membrane antigen positron emission tomography/computed tomography imaging as a precision diagnostic at prostate cancer recurrence after radical prostatectomy: Modeling long-term survival.

Gogebakan, K. C. ; Elsisi, Z. ; Montano-Campos, F. ; Owens, L. ; Zhao, Y. ; Gulati, R. ; Ferdinandus, J. ; Fendler, W. P.DKFZ* ; Calais, J. ; Hope, T. A. ; Carlsson, S. ; Fainberg, J. ; Laudone, V. ; Kunst, N. ; Berlin, A. ; Schipper, M. ; Barbour, A. ; Iravani, A. ; Etzioni, R.

2025
Wiley-Liss New York, NY

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Please use a persistent id in citations: doi:10.1002/cncr.70131

Abstract: Prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA-PET/CT) is affecting the management of patients with prostate cancer with biochemical recurrence after radical prostatectomy. The long-term outcomes of tailoring salvage treatment on the basis of PSMA-PET/CT status remain to be determined.A decision-analytic model was developed to project incremental life-years of strategies that allocate treatments at biochemical recurrence after radical prostatectomy on the basis of PSMA-PET/CT status (PSMA-metastatic vs. PSMA-nonmetastatic). Modeled treatments are local/regional (radiation) or systemic (hormone therapy and doublet therapy), administered immediately or delayed. PSMA-metastatic status was assumed to lead to treatment intensification, whereas PSMA-nonmetastatic status would lead to deintensification. To project survival, data on progression to metastasis from a clinical cohort were combined with registry data on postmetastasis survival. Because of the lack of data on long-term treatment benefits by PSMA status, survival was projected by varying the hazard ratio (HR) for disease-specific death among PSMA-metastatic versus PSMA-nonmetastatic patients under delayed or local/regional regimens (HR1) and under immediate systemic regimens (HR2).Mean life-years are projected to be 15.5 under the non-PSMA-tailored strategy, and mean incremental life-years range from 0.38 to 0.81 depending on HR1 and HR2. A greater benefit is projected when PSMA-metastatic status is more adverse under salvage regimens that do not include systemic agents.This decision-analytic modeling study projects that PSMA-PET/CT-guided management at biochemical recurrence after radical prostatectomy yields a modest survival benefit under the specified model inputs and assumptions regarding treatment distributions. These findings may complement emerging data on the corresponding economic costs and health-related quality of life.

Keyword(s): Humans (MeSH) ; Male (MeSH) ; Prostatic Neoplasms: diagnostic imaging (MeSH) ; Prostatic Neoplasms: mortality (MeSH) ; Prostatic Neoplasms: surgery (MeSH) ; Prostatic Neoplasms: pathology (MeSH) ; Prostatic Neoplasms: therapy (MeSH) ; Prostatectomy (MeSH) ; Positron Emission Tomography Computed Tomography: methods (MeSH) ; Neoplasm Recurrence, Local: diagnostic imaging (MeSH) ; Neoplasm Recurrence, Local: mortality (MeSH) ; Glutamate Carboxypeptidase II: metabolism (MeSH) ; Antigens, Surface: metabolism (MeSH) ; Salvage Therapy (MeSH) ; Aged (MeSH) ; Middle Aged (MeSH) ; biochemical recurrence ; decision‐analytic model ; prostate cancer ; prostate‐specific membrane antigen positron emission tomography/computed tomography (PSMA‐PET/CT) ; Glutamate Carboxypeptidase II ; FOLH1 protein, human ; Antigens, Surface

Note: ISSN 1097-0142

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Contributing Institute(s):

1. DKTK Koordinierungsstelle Essen/Düsseldorf (ED01)

Research Program(s):

1. 899 - ohne Topic (POF4-899) (POF4-899)

Appears in the scientific report 2025

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Database coverage:
; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Life Sciences ; DEAL Wiley ; Ebsco Academic Search ; Essential Science Indicators ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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