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OtherClinical Investigations (Human)

Prospective, Single-Arm Trial Evaluating Changes in Uptake Patterns on Prostate-Specific Membrane Antigen (PSMA)-Targeted 18F-DCFPyL PET/CT in Patients with Castration-Resistant Prostate Cancer Starting Abiraterone or Enzalutamide

Katherine A. Zukotynski, Urban Emmenegger, Sebastien Hotte, Anil Kapoor, Wei Fu, Amanda L. Blackford, John Valliant, Francois Benard, Chun K. Kim, Mark C. Markowski, Mario A. Eisenberger, Emmanuel S. Antonarakis, Kenneth J. Pienta, Michael A. Gorin, Matthew Lubanovic, Jihyun Kim, Martin G. Pomper, Steve Y. Cho and Steven P. Rowe
Journal of Nuclear Medicine February 2021, jnumed.120.259069; DOI: https://doi.org/10.2967/jnumed.120.259069
Katherine A. Zukotynski
1 University of Toronto;
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Urban Emmenegger
1 University of Toronto;
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Sebastien Hotte
2 McMaster University;
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Anil Kapoor
2 McMaster University;
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Wei Fu
3 Johns Hopkins University School of Medicine, United States;
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Amanda L. Blackford
3 Johns Hopkins University School of Medicine, United States;
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John Valliant
4 McMaster;
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Francois Benard
5 British Columbia Cancer Agency;
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Chun K. Kim
6 Hanyang University College of Medicine;
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Mark C. Markowski
3 Johns Hopkins University School of Medicine, United States;
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Mario A. Eisenberger
3 Johns Hopkins University School of Medicine, United States;
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Emmanuel S. Antonarakis
3 Johns Hopkins University School of Medicine, United States;
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Kenneth J. Pienta
3 Johns Hopkins University School of Medicine, United States;
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Michael A. Gorin
3 Johns Hopkins University School of Medicine, United States;
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Matthew Lubanovic
2 McMaster University;
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Jihyun Kim
7 University of Wisconsin;
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Martin G. Pomper
8 Johns Hopkins Medical Institutions;
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Steve Y. Cho
9 University of Wisconsin School of Medicine and Public Health
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Steven P. Rowe
3 Johns Hopkins University School of Medicine, United States;
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Abstract

Purpose: Positron emission tomography (PET) with small molecules targeting prostate-specific membrane antigen (PSMA) is being adopted as a clinical standard for prostate cancer (PCa) imaging. In this study, we evaluated changes in uptake on PSMA-targeted PET in men starting abiraterone or enzalutamide. Methods: This prospective, single-arm, two-center, exploratory clinical trial enrolled men with metastatic castration-resistant prostate cancer (CRPC) initiating abiraterone or enzalutamide. Each patient was imaged with 18F-DCFPyL at baseline and within 2-4 months after starting therapy. Patients were followed for up to 48 months from enrollment. A central review evaluated baseline and follow-up PET scans recording change in maximum standardized uptake value (SUVmax) at all disease sites and classifying the pattern of change. Two parameters: the delta percent SUVmax (DPSM) of all lesions and the delta absolute SUVmax (DASM) of all lesions were derived. Kaplan-Meier curves were used to estimate time to therapy change (TTTC) and overall survival (OS). Results: Sixteen evaluable patients were accrued to the study. Median TTTC was 9.6 months (95% confidence interval (CI), 6.9-14.2) and median OS was 28.6 months (95% CI 18.3-not available (N/A)). Patients with a mixed-but-predominantly-increased pattern of radiotracer uptake had shorter TTTC and OS. Men with low DPSM had median TTTC 12.2 months (95% CI 11.3-N/A) and median OS 37.2 months (95% CI 28.9-N/A), while those with high DPSM had median TTTC 6.5 months (95% CI 4.6-N/A, P = 0.0001) and median OS 17.8 months (95% CI 13.9-N/A, P = 0.02). Men with low DASM had median TTTC 12.2 months (95% CI 11.3-N/A) and median OS N/A (95% CI 37.2 months-N/A), while those with high DASM had median TTTC 6.9 months (95% CI 6.1-N/A, P = 0.003) and median OS 17.8 months (95% CI 13.9-N/A, P = 0.002). Conclusion: Findings on PSMA-targeted PET 2-4 months after initiation of abiraterone or enzalutamide are associated with TTTC and OS. Development of new lesions and/or increasing intensity of radiotracer uptake at sites of baseline disease are poor prognostic findings suggesting shorter TTTC and OS.

  • Molecular Imaging
  • Oncology: GU
  • PET/CT
  • Anti-androgen
  • CRPC
  • prognosis
  • radiopharmaceutical
  • response assessment
  • Copyright © 2021 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

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Journal of Nuclear Medicine: 62 (3)
Journal of Nuclear Medicine
Vol. 62, Issue 3
March 1, 2021
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Prospective, Single-Arm Trial Evaluating Changes in Uptake Patterns on Prostate-Specific Membrane Antigen (PSMA)-Targeted 18F-DCFPyL PET/CT in Patients with Castration-Resistant Prostate Cancer Starting Abiraterone or Enzalutamide
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Prospective, Single-Arm Trial Evaluating Changes in Uptake Patterns on Prostate-Specific Membrane Antigen (PSMA)-Targeted 18F-DCFPyL PET/CT in Patients with Castration-Resistant Prostate Cancer Starting Abiraterone or Enzalutamide
Katherine A. Zukotynski, Urban Emmenegger, Sebastien Hotte, Anil Kapoor, Wei Fu, Amanda L. Blackford, John Valliant, Francois Benard, Chun K. Kim, Mark C. Markowski, Mario A. Eisenberger, Emmanuel S. Antonarakis, Kenneth J. Pienta, Michael A. Gorin, Matthew Lubanovic, Jihyun Kim, Martin G. Pomper, Steve Y. Cho, Steven P. Rowe
Journal of Nuclear Medicine Feb 2021, jnumed.120.259069; DOI: 10.2967/jnumed.120.259069

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Prospective, Single-Arm Trial Evaluating Changes in Uptake Patterns on Prostate-Specific Membrane Antigen (PSMA)-Targeted 18F-DCFPyL PET/CT in Patients with Castration-Resistant Prostate Cancer Starting Abiraterone or Enzalutamide
Katherine A. Zukotynski, Urban Emmenegger, Sebastien Hotte, Anil Kapoor, Wei Fu, Amanda L. Blackford, John Valliant, Francois Benard, Chun K. Kim, Mark C. Markowski, Mario A. Eisenberger, Emmanuel S. Antonarakis, Kenneth J. Pienta, Michael A. Gorin, Matthew Lubanovic, Jihyun Kim, Martin G. Pomper, Steve Y. Cho, Steven P. Rowe
Journal of Nuclear Medicine Feb 2021, jnumed.120.259069; DOI: 10.2967/jnumed.120.259069
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Clinical Investigations (Human)

  • Interobserver agreement in automated metabolic tumor volume measurements of Deauville score 4 and 5 lesions at interim 18F-FDG PET in DLBCL
  • PSMA- and GRPR-targeted PET: Results from 50 Patients with Biochemically Recurrent Prostate Cancer
  • Accuracy of 18F-fluorocholine PET for the detection of parathyroid adenomas: prospective single center study
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Clinical (Oncology: GU)

  • PSMA- and GRPR-targeted PET: Results from 50 Patients with Biochemically Recurrent Prostate Cancer
  • Matched-pair comparison of 18F-DCFPyL PET/CT and 18F-PSMA-1007 PET/CT in 240 prostate cancer patients; inter-reader agreement and lesion detection rate of suspected lesions
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Keywords

  • molecular imaging
  • Oncology: GU
  • PET/CT
  • Anti-androgen
  • CRPC
  • prognosis
  • radiopharmaceutical
  • response assessment
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