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000305583 1001_ $$aDjaileb, Loïc$$b0
000305583 245__ $$aClinical Impact of Changes in Tumor Uptake and Volume on PSMA PET/CT During [177Lu]Lu-PSMA Therapy in Metastatic Castration-Resistant Prostate Cancer.
000305583 260__ $$aNew York, NY$$bSoc.$$c2025
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000305583 520__ $$aAlthough tumor volume and new lesions (NLs) have been investigated previously as measures of response, the clinical impact of changes in tumor uptake on prostate-specific membrane antigen (PSMA) PET remains largely unknown. Methods: This multicenter retrospective study investigated the clinical impact of changes in tumor uptake and volume on PSMA PET during [177Lu]Lu-PSMA in metastatic castration-resistant prostate cancer (mCRPC). The primary outcomes were the associations of changes in SUVmax (ΔSUVmax) and SUVmean (ΔSUVmean), changes in total tumor volume (ΔTTV), and occurrence of NLs with prostate-specific antigen (PSA) progression-free survival (PSA-PFS) and overall survival (OS). The study included patients with mCRPC who received [177Lu]Lu-PSMA between 2014 and 2019. PSMA PET/CT was performed at baseline and after 2 cycles of therapy. Whole-body analyses (SUVmax, SUVmean, TTV, and NLs) were performed and calculated using qPSMA software. Results: In total, 124 patients with mCRPC (median age, 73 y; interquartile range, 67-76 y) were included in the study. Whole-body ΔTTV and the occurrence of NLs were significantly associated with shorter PSA-PFS (hazard ratio [HR], 5.7; 95% CI, 3.59-9.06; and HR, 1.6; 95% CI, 1.4-1.8; P < 0.0001) and with OS (HR, 2.3; 95% CI, 1.61-3.43; and HR, 1.3; 95% CI, 1.1-1.4; P < 0.001). Patient-based analysis showed that ΔSUVmax and ΔSUVmean were not associated with outcome (HR, 1.00; 95% CI, 0.99-1.00; P = 0.30; and HR, 0.90; 95% CI, 0.99-1.00; P = 0.11). Region-based analysis found that only ΔSUVmax in visceral lesions was significantly associated with PSA-PFS (P = 0.007) but not with OS. Conclusion: Only ΔTTV and the occurrence of NLs provided significant prognostic value and should be considered when evaluating treatment response to [177Lu]Lu-PSMA therapy.
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000305583 650_7 $$2Other$$aLuPSMA
000305583 650_7 $$2Other$$aPSMA PET
000305583 650_7 $$2Other$$aRECIP
000305583 650_7 $$2Other$$ametastatic castration-resistant prostate cancer
000305583 650_7 $$2Other$$aradiopharmaceutical therapy
000305583 650_7 $$2Other$$aresponse evaluation
000305583 7001_ $$aFarolfi, Andrea$$b1
000305583 7001_ $$aRauscher, Isabel$$b2
000305583 7001_ $$aHaghighatian, Mahan$$b3
000305583 7001_ $$aMercier, Alexis$$b4
000305583 7001_ $$0P:(DE-HGF)0$$aFendler, Wolfgang P$$b5
000305583 7001_ $$0P:(DE-HGF)0$$aHadaschik, Boris$$b6
000305583 7001_ $$0P:(DE-HGF)0$$aHerrmann, Ken$$b7
000305583 7001_ $$aSolnes, Lilja B$$b8
000305583 7001_ $$aRettig, Matthew$$b9
000305583 7001_ $$0P:(DE-He78)44ee3b9a92e23f6844eefca1ab816eb9$$aWeber, Manuel$$b10$$udkfz
000305583 7001_ $$aCzernin, Johannes$$b11
000305583 7001_ $$aCalais, Jeremie$$b12
000305583 7001_ $$aBenz, Matthias R$$b13
000305583 7001_ $$aEiber, Matthias$$b14
000305583 7001_ $$aGafita, Andrei$$b15
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