新型雄激素受体信号抑制剂对去势抵抗性前列腺癌患者前列腺特异性膜抗原正电子发射断层扫描信号强度的影响：一项前瞻性探索性系列成像研究
Effects of novel androgen receptor signaling inhibitors on PSMA PET signal intensity in patients with castrate-resistant prostate cancer: a prospective exploratory serial imaging study.
作者信息
Sonni Ida, Gafita Andrei, Unterrainer Lena M, Alano Rejah M, Lira Stephanie, Shen John, Drakaki Alexandra, Grogan Tristan, Rettig Matthew B, Czernin Johannes, Calais Jeremie
机构信息
Department of Molecular and Medical Pharmacology, University of California, Los Angeles, Los Angeles, CA, USA.
Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095-7370, USA.
出版信息
EJNMMI Res. 2023 Oct 30;13(1):95. doi: 10.1186/s13550-023-01048-4.
BACKGROUND
PSMA expression is influenced by hormonal status. We evaluated changes in PSA and whole-body 68Ga-PSMA-11 PET/CT (WB-PSMA PET) after initiation of androgen receptor signaling inhibitors (ARSi).
METHODS
Prospectively enrolled patients with metastatic castration-resistant prostate cancer (mCRPC) initiating ARSi underwent serial PSA measurements and WB-PSMA PET at baseline, 1-week, and 3-months post-ARSi. We correlated WB-PSMA PET metrics and PSA kinetics after ARSi to 1-year clinical outcome.
RESULTS
Due to low enrollment rate, the study was closed before reaching the recruitment goal of 30 patients. Nine patients were enrolled. At 1-year, unfavorable outcome was documented in 6/9 (66%) patients. Nine/9 patients completed PSMA PET at 1-week, 5/9 at 3-months. Changes in PSA, PSMA-VOL, SUVmean and SUVmax were - 12%, + 5%, + 3%, and + 10% at 1-week, - 42%, - 16%, - 15% and - 17% at 3-months, respectively.
CONCLUSIONS
Our prospective trial involving 9 mCRPC patients initiating ARSi did not show significant modulation of PSMA expression measured on WB-PSMA PET at 1-week. This study was registered on clinicaltrials.gov (NCT04279561).
背景
前列腺特异性膜抗原（PSMA）的表达受激素状态影响。我们评估了雄激素受体信号抑制剂（ARSi）开始使用后前列腺特异性抗原（PSA）和全身68Ga-PSMA-11正电子发射断层扫描/计算机断层扫描（WB-PSMA PET）的变化。
方法
前瞻性纳入开始使用ARSi的转移性去势抵抗性前列腺癌（mCRPC）患者，在ARSi治疗基线、1周和3个月时进行系列PSA测量和WB-PSMA PET检查。我们将ARSi治疗后WB-PSMA PET指标和PSA动力学与1年临床结局相关联。
结果
由于入组率低，该研究在达到30例患者的招募目标之前就结束了。共纳入9例患者。1年时，9例患者中有6例（66%）记录了不良结局。9例患者均在1周时完成了PSMA PET检查，5例在3个月时完成。PSA、PSMA体积（PSMA-VOL）、平均标准摄取值（SUVmean）和最大标准摄取值（SUVmax）在1周时的变化分别为-12%、+5%、+3%和+10%，在3个月时分别为-42%、-16%、-15%和-17%。
结论
我们这项纳入9例开始使用ARSi的mCRPC患者的前瞻性试验未显示在1周时WB-PSMA PET测量的PSMA表达有显著调节。该研究已在ClinicalTrials.gov上注册（NCT04279561）。
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