Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy.
Department of Nuclear Medicine, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy.
Eur J Nucl Med Mol Imaging. 2024 Dec;52(1):326-334. doi: 10.1007/s00259-024-06887-4. Epub 2024 Aug 29.
to assess the utility of response monitoring to enzalutamide by using [Ga]Ga-PSMA PET in mCRPC patients treated with enzalutamide as first-line therapy.
patients underwent [Ga]Ga-PSMA PET less than 8 weeks before and 3 months after starting enzalutamide. On the basis of EAU/EANM criteria, patients were categorized as PSMA responders (PET-R) or PSMA non-responders (PET-NR), whilst, based on PSA, they were classified as biochemical responders (PSA-R) or non-responders (PSA-NR). Survival analysis was performed using the Cox regression hazard model and the Kaplan-Meier method.
69 patients were considered fully evaluable. We observed 47.8% of concordance between [68Ga]Ga-PSMA PET and PSA monitoring at 3 months after starting enzalutamide. For discordant cases, the PSA reduction has a weak impact on PFS and a significant impact on OS in PET-NR patients, whilst this change has no impact either for PFS and OS in PET-R ones.
[Ga]Ga-PSMA PET could be a useful imaging tool for monitoring response to enzalutamide in mCRPC patients, being more informative than PSA in this setting, and possibly better guiding clinicians in therapeutic decisions.
通过使用 [Ga]Ga-PSMA PET 评估 mCRPC 患者在一线接受恩扎卢胺治疗时对恩扎卢胺的反应监测的效用。
患者在开始恩扎卢胺治疗前不到 8 周和 3 个月时接受 [Ga]Ga-PSMA PET。根据 EAU/EANM 标准，患者被分为 PSMA 反应者（PET-R）或 PSMA 无反应者（PET-NR），而根据 PSA 则分为生化反应者（PSA-R）或无反应者（PSA-NR）。使用 Cox 回归风险模型和 Kaplan-Meier 方法进行生存分析。
69 名患者被认为是完全可评估的。我们观察到，在开始恩扎卢胺治疗后 3 个月，[68Ga]Ga-PSMA PET 与 PSA 监测之间的一致性为 47.8%。对于不一致的病例，PSA 降低对 PET-NR 患者的 PFS 有较弱的影响，对 OS 有显著的影响，而在 PET-R 患者中，这种变化对 PFS 和 OS 均无影响。
[Ga]Ga-PSMA PET 可能是 mCRPC 患者监测恩扎卢胺反应的有用影像学工具，在这种情况下比 PSA 更具信息性，并且可能更好地指导临床医生做出治疗决策。
