%0 Journal Article
%A Gogebakan, Kemal Caglar
%A Elsisi, Zizi
%A Montano-Campos, Felipe
%A Owens, Lukas
%A Zhao, Yibai
%A Gulati, Roman
%A Ferdinandus, Justin
%A Fendler, Wolfgang P
%A Calais, Jeremie
%A Hope, Thomas A
%A Carlsson, Sigrid
%A Fainberg, Jonathan
%A Laudone, Vincent
%A Kunst, Natalia
%A Berlin, Alejandro
%A Schipper, Matthew
%A Barbour, Andrew
%A Iravani, Amir
%A Etzioni, Ruth
%T 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.
%J Cancer
%V 131
%N 21
%@ 0008-543X
%C New York, NY
%I Wiley-Liss
%M DKFZ-2025-02170
%P e70131
%D 2025
%Z ISSN 1097-0142
%X 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.
%K Humans
%K Male
%K Prostatic Neoplasms: diagnostic imaging
%K Prostatic Neoplasms: mortality
%K Prostatic Neoplasms: surgery
%K Prostatic Neoplasms: pathology
%K Prostatic Neoplasms: therapy
%K Prostatectomy
%K Positron Emission Tomography Computed Tomography: methods
%K Neoplasm Recurrence, Local: diagnostic imaging
%K Neoplasm Recurrence, Local: mortality
%K Glutamate Carboxypeptidase II: metabolism
%K Antigens, Surface: metabolism
%K Salvage Therapy
%K Aged
%K Middle Aged
%K biochemical recurrence (Other)
%K decision‐analytic model (Other)
%K prostate cancer (Other)
%K prostate‐specific membrane antigen positron emission tomography/computed tomography (PSMA‐PET/CT) (Other)
%K Glutamate Carboxypeptidase II (NLM Chemicals)
%K FOLH1 protein, human (NLM Chemicals)
%K Antigens, Surface (NLM Chemicals)
%F PUB:(DE-HGF)16
%9 Journal Article
%$ pmid:41108673
%R 10.1002/cncr.70131
%U https://inrepo02.dkfz.de/record/305452