RT Journal Article
SR Electronic
T1 QUANTIFICATION OF METASTATIC PROSTATE CANCER WHOLE-BODY TUMOR BURDEN WITH FDG PET PARAMETERS AND ASSOCIATIONS WITH OVERALL SURVIVAL AFTER FIRST LINE ABIRATERONE OR ENZALUTAMIDE: A SINGLE- CENTER RETROSPECTIVE COHORT STUDY
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP jnumed.120.256602
DO 10.2967/jnumed.120.256602
A1 Andreas G. Wibmer
A1 Michael J. Morris
A1 Mithat Gonen
A1 Junting Zheng
A1 Hedvig Hricak
A1 Steven M. Larson
A1 Howard I. Scher
A1 Hebert Alberto Vargas
YR 2021
UL http://jnm.snmjournals.org/content/early/2021/01/08/jnumed.120.256602.abstract
AB RATIONALE: New biomarkers for metastatic prostate cancer are needed. The aim of this study was to evaluate the prognostic value of FDG-PET whole body tumor burden parameters in patients with metastatic prostate cancer who received first line abiraterone or enzalutamide therapy. METHODS: Retrospective study of patients with metastatic castration-sensitive (mCSPC, n = 25) and metastatic castration-resistant prostate cancer (mCRPC, n = 71) who underwent 18F-FDG-PET/CT within 90 days before first-line treatment with abiraterone or enzalutamide at a tertiary care academic cancer center. Whole-body tumor burden on PET/CT was quantified as metabolic tumor volume (MTV) and total lesion glycolysis (TLG) and correlated with overall survival (OS) probabilities using Kaplan-Meier curves and Cox models. RESULTS: The median follow-up in survivors was 56.3 months (IQR: 37.7, 66.8); the median OS for patients with mCRPC and mCSPC was 27.8 and 76.1 months (p<.001). On univariate analysis, the OS probability of mCRPC patients was significantly associated with plasma levels of alkaline phosphatase (HR: 1.90, p<.001) and lactate dehydrogenase (HR: 1.01, p<.001), hemoglobin levels (HR: 0.80, P = .013), whole body SUVmax (HR: 1.14, p<0.001), the number of FDG-avid metastases (HR: 1.08, p<0.001), whole body MTV (HR: 1.86, p<.001) and TLG (HR: 1.84, p<.001). In multivariable analysis with stepwise variable selection, hemoglobin levels (HR: 0.81, P = 0.013) and whole-body TLG (HR: 1.88, p<.001) were independently associated with OS. In mCSPC patients, no significant association was observed between these variables and OS. CONCLUSION: In patients with mCRPC receiving first-line treatment with abiraterone or enzalutamide, FDG PET WB TLG is independently associated with OS and might be used as quantitative prognostic imaging biomarker.