Value of combined pet imaging with [18 f]fdg and [68 ga]ga-psma-11 in mcrpc patients with worsening disease during [177 lu]lu-psma-617 rlt

Khreish F, Ribbat K, Bartholomä M, Maus S, Stemler T, Hierlmeier I, Linxweiler J, Schreckenberger M, Ezziddin S, Rosar F (2021)

Publication Type: Journal article

Publication year: 2021

Journal

Cancers MDPI

Book Volume: 13

Article Number: 4134

Journal Issue: 16

DOI: 10.3390/cancers13164134

Abstract

Despite the promising results of prostate-specific membrane antigen (PSMA)-targeted radioligand therapy (RLT) in metastatic castration-resistant prostate cancer (mCRPC), some patients show worsening disease during PSMA-RLT. We investigated the value of combined [18 F]FDG and [68 Ga]Ga-PSMA-11 PET imaging in this setting. In n = 29 mCRPC patients with worsening disease after a median of four cycles of [177 Lu]Lu-PSMA-617 RLT, combined [18 F]FDG and [68 Ga]Ga-PSMA-11 PET imaging was performed to detect [18 F]FDG-avid lesions with low or no PSMA expression (mismatch lesions). To evaluate prognostic implication of mismatch, survival analyses regarding presence, location, and [18 F]FDG PET-derived parameters such as SUVmax, metabolic tumor volume (MTVm ), and total lesion glycolysis (TLGm ) of mismatch findings were performed. Seventeen patients (59%) showed at least one mismatch metastasis. From the time point of combined PET imaging, the median overall survival (OS) of patients with mismatch findings was significantly (p = 0.008) shorter than those without (3.3 vs. 6.1 mo). Patients with a high MTVm revealed a significantly (p = 0.034) shorter OS of 2.6 mo than patients with low MTVm (5.3 mo). Furthermore, patients with hepatic mismatch showed a significantly (p = 0.049) shorter OS than those without (2.9 vs. 5.3 mo). Difference in OS regarding SUVmax and TLGm was not significant. In mCRPC patients with worsening disease during PSMA-RLT, combined [18 F]FDG and [68 Ga]Ga-PSMA-11 PET imaging is essential to identify mismatch findings, as these are associated with poor outcomes requiring a change in therapy management.

Involved external institutions

Universitätsklinikum des Saarlandes (UKS) DE Germany (DE) Johannes Gutenberg-Universität Mainz (JGU) DE Germany (DE)

How to cite

APA:

Khreish, F., Ribbat, K., Bartholomä, M., Maus, S., Stemler, T., Hierlmeier, I.,... Rosar, F. (2021). Value of combined pet imaging with [18 f]fdg and [68 ga]ga-psma-11 in mcrpc patients with worsening disease during [177 lu]lu-psma-617 rlt. Cancers, 13(16). https://doi.org/10.3390/cancers13164134

MLA:

Khreish, Fadi, et al. "Value of combined pet imaging with [18 f]fdg and [68 ga]ga-psma-11 in mcrpc patients with worsening disease during [177 lu]lu-psma-617 rlt." Cancers 13.16 (2021).

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