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@ARTICLE{Djaileb:305583,
author = {L. Djaileb and A. Farolfi and I. Rauscher and M.
Haghighatian and A. Mercier and W. P. Fendler$^*$ and B.
Hadaschik$^*$ and K. Herrmann$^*$ and L. B. Solnes and M.
Rettig and M. Weber$^*$ and J. Czernin and J. Calais and M.
R. Benz and M. Eiber and A. Gafita},
title = {{C}linical {I}mpact of {C}hanges in {T}umor {U}ptake and
{V}olume on {PSMA} {PET}/{CT} {D}uring [177{L}u]{L}u-{PSMA}
{T}herapy in {M}etastatic {C}astration-{R}esistant
{P}rostate {C}ancer.},
journal = {Journal of nuclear medicine},
volume = {nn},
issn = {0097-9058},
address = {New York, NY},
publisher = {Soc.},
reportid = {DKFZ-2025-02242},
pages = {nn},
year = {2025},
note = {epub / brief communication},
abstract = {Although 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.},
keywords = {LuPSMA (Other) / PSMA PET (Other) / RECIP (Other) /
metastatic castration-resistant prostate cancer (Other) /
radiopharmaceutical therapy (Other) / response evaluation
(Other)},
cin = {ED01},
ddc = {610},
cid = {I:(DE-He78)ED01-20160331},
pnm = {899 - ohne Topic (POF4-899)},
pid = {G:(DE-HGF)POF4-899},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:41167722},
doi = {10.2967/jnumed.125.270239},
url = {https://inrepo02.dkfz.de/record/305583},
}