Ferdinandus Justin, Violet John, Sandhu Shahneen, Hicks Rodney J, Ravi Kumar Aravind S, Iravani Amir, Kong Grace, Akhurst Tim, Thang Sue Ping, Murphy Declan G, Williams Scott, Hofman Michael S
Department of Nuclear Medicine, University Hospital Essen, Essen, Germany.
Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
Eur J Nucl Med Mol Imaging. 2020 Sep;47(10):2322-2327. doi: 10.1007/s00259-020-04723-z. Epub 2020 Mar 5.
We analysed quantitative biomarkers derived from both baseline whole-body imaging and blood serum to identify prognostic markers in patients treated within the lutetium-177 prostate-specific membrane antigen (LuPSMA) phase 2 trial.
PET image analysis was carried out using whole-body segmentation quantifying molecular tumour volume (SUV > 3 threshold for PSMA, SUV > liver+2sd for fluorodeoxyglucose (FDG) including SUVmax and SUVmean. For baseline bone scans, EXINI bone scan index (BSI) was used to calculate the percentage of involved bone. Baseline alkaline phosphatase (ALP), lactate dehydrogenase (LDH), prostate specific antigen (PSA) and PSA doubling time were also used in this analysis. We used univariate cox regression analysis and log-rank comparison with optimised cut-offs to find suitable biomarkers prognostic of overall survival from time of enrolment.
This analysis identified FDG-positive tumour volume (FDGvol; HR 2.6; 95% CI, 1.4-4.8), mean intensity of PSMA-avid tumour uptake (PSMAmean; HR 0.89; 95% CI, 0.8-0.98), bone scan index (BSI; HR 2.3; 95% CI, 1.2-4.4), ALP (HR 1.1; 95% CI, 1-1.2) and LDH (HR 1.2; 95% CI, 1-1.5) as biomarkers prognostic of overall survival.
In addition to established biomarkers, both FDG and PSMA PET/CT parameters have prognostic significance for survival in men undergoing LuPSMA therapy.
我们分析了来自基线全身成像和血清的定量生物标志物，以确定在镥-177前列腺特异性膜抗原（LuPSMA）2期试验中接受治疗的患者的预后标志物。
使用全身分割进行PET图像分析，量化分子肿瘤体积（PSMA的SUV>3阈值，氟脱氧葡萄糖（FDG）的SUV>肝脏+2sd，包括SUVmax和SUVmean）。对于基线骨扫描，使用EXINI骨扫描指数（BSI）计算受累骨的百分比。该分析还使用了基线碱性磷酸酶（ALP）、乳酸脱氢酶（LDH）、前列腺特异性抗原（PSA）和PSA倍增时间。我们使用单变量cox回归分析和具有优化临界值的对数秩比较，以从入组时间找到适合预测总生存期的生物标志物。
该分析确定FDG阳性肿瘤体积（FDGvol；HR 2.6；95%CI，1.4-4.8）、PSMA高摄取肿瘤的平均强度（PSMAmean；HR 0.89；95%CI，0.8-0.98）、骨扫描指数（BSI；HR 2.3；95%CI，1.2-4.4）、ALP（HR 1.1；95%CI，1-1.2）和LDH（HR 1.2；95%CI，1-1.5）作为总生存期的预后生物标志物。
除了已确立的生物标志物外，FDG和PSMA PET/CT参数对接受LuPSMA治疗的男性的生存也具有预后意义。
