Article Figures & Data
Figures
- FIGURE 1.
Consolidated Standards of Reporting Trials (CONSORT) diagram of study population.
- FIGURE 2.
Swimmer plot of time from start of therapy to PSA progression (orange bars) or to death from any cause or last follow-up, SPECT/CT, NLs, and increase in TTV by 20% or more.
- FIGURE 3.
Kaplan–Meier plots of PSA PFS at start of cycle 2 (A), OS at start of cycle 2 (B), PSA PFS at start of cycle 3 (C), and OS at start of cycle 3 (D). Curves are stratified by median TTV at start of cycle 2 or 3.
- FIGURE 4.
Waterfall plots of change in PSA at start of cycle 2 (A), change in TTV at start of cycle 2 (B), change in PSA at start of cycle 3 (C), and change in TTV at start of cycle 3 (D). Bars are color-coded by identification of NLs, and changes are truncated beyond 100% (*). Gray bar in panel C shows patient with evaluable PSA but no available SPECT/CT.
- FIGURE 5.
Kaplan–Meier plots of PSA PFS at start of cycle 2 (A), OS at start of cycle 2 (B), PSA PFS at start of cycle 3 (C), and OS at start of cycle 3 (D).
- FIGURE 6.
Case examples of NLs in (from top to bottom) maximum-intensity projection, noncontrast CT, and SPECT/CT images. (A) Patient with new non–PSMA-avid liver lesion (blue arrow) at cycle 3 and decrease in TTV. (B) Patient with multiple new PSMA-avid bone lesions (red arrows) at cycle 2 and increase in TTV.
Tables
Characteristic Data (n = 66) Age (y) 74 (68–78) Baseline PSA (ng/mL) 109 (33–290) Baseline hemoglobin (g/L) 11.3 (9.95–12.5) Baseline white blood cell count (109/L) 6 (4.6–7.4) Baseline platelet count (109/L) 212 (180–264.75) Baseline lactate dehydrogenase (U/L) 201.5 (155–278.75)* Gleason score 8 (7–9)† Eastern Cooperative Oncology Group score 0–1 55/66 (83%) 2 11/66 (17%) Prostatectomy 23/66 (35%) Prior curative-intent radiotherapy 17/66 (25%) Androgen receptor pathway inhibitor regimens (n) 66/66 (100%) 1 21/66 (32%) ≥2 45/66 (68%) Chemotherapy regimens (n) 61/66 (92%) 0 5/66 (8%) 1 30/66 (45%) ≥2 31/66 (47%) Olaparib 8/66 (12%) 223Ra 9/66 (14%) Sipuleucel-T 21/66 (32%) Number of LuPSMA cycles 4.5 (3–6) Bone 61/66 (92%) Prostate/surgical site 21/66 (32%) Lymph nodes 35/66 (53%) Viscera 16/66 (24%) Bivariate Cox regression Multivariate Cox regression PSA PFS OS PSA PFS OS Cox model Parameter HR 95% CI P HR 95% CI P HR 95% CI P HR 95% CI P Cycle 2 TTV 1.42 1.10–1.83 0.006 2.11 1.50–2.95 <0.001 1.45 1.11–1.89 0.006 2.37 1.62–3.47 <0.001 NLs 3.17 0.82–12.3 0.1 5.81 1.93–17.5 0.002 3.30 0.86–12.7 0.083 7.67 2.77–21.3 <0.001 Cycle 3 TTV 1.99 1.38–2.87 <0.001 1.98 1.22–3.20 0.005 1.99 1.36–2.89 <0.001 2.19 1.24–3.88 0.007 NLs 3.34 0.84–13.3 0.087 4.92 1.3–18.6 0.019 2.10 0.53–8.28 0.3 5.50 1.46–20.7 0.012 Data are fitted bivariate Cox regressions for PSA PFS and OS conditional on TTV or NLs at start of cycle 2 or 3, and fitted multivariate Cox regressions for PSA PFS and OS conditional on both TTV and NLs combined. All regressions are adjusted for changes in PSA level measured at start of corresponding cycle relative to baseline.
Characteristic Number NLs at start of cycle 2 13/66 (20%) Location Liver 3/13 (23%) Bone 6/13 (46%) Liver and bone 4/13 (31%) PSMA avidity Avid 7/13 (54%) Nonavid 6/13 (46%) NLs at start of cycle 3 11/51 (22%) Location Liver 4/11 (36%) Bone 6/11 (55%) Liver and bone 1/11 (9%) PSMA avidity Avid 8/11 (73%) Nonavid 3/11 (27%)
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