PT - JOURNAL ARTICLE AU - Chen, Mengxia AU - Fu, Yao AU - Peng, Shan AU - Zang, Shiming AU - Ai, Shuyue AU - Zhuang, Junlong AU - Wang, Feng AU - Qiu, Xuefeng AU - Guo, Hongqian TI - The Association Between [<sup>68</sup>Ga]PSMA PET/CT Response and Biochemical Progression in Patients with High-Risk Prostate Cancer Receiving Neoadjuvant Therapy AID - 10.2967/jnumed.122.265368 DP - 2023 Oct 01 TA - Journal of Nuclear Medicine PG - 1550--1555 VI - 64 IP - 10 4099 - http://jnm.snmjournals.org/content/64/10/1550.short 4100 - http://jnm.snmjournals.org/content/64/10/1550.full SO - J Nucl Med2023 Oct 01; 64 AB - Our previous study found that the prostate-specific membrane antigen (PSMA) PET/CT response of primary prostate cancer (PCa) to neoadjuvant therapy can predict the pathologic response. This study was designed to investigate the association between [68Ga]PSMA PET/CT changes and biochemical progression-free survival (bPFS) in high-risk patients who underwent neoadjuvant therapy before radical prostatectomy (RP). Methods: Seventy-five patients with high-risk PCa in 2 phase II clinical trials who received neoadjuvant therapy before RP were included. The patients received androgen deprivation therapy plus docetaxel (n = 33) or androgen deprivation therapy plus abiraterone (n = 42) as neoadjuvant treatment. All patients had serial [68Ga]PSMA PET/CT scans before and after neoadjuvant therapy. Age, initial prostate-specific antigen level, nadir prostate-specific antigen level before RP, tumor grade at biopsy, treatment regimen, clinical T stage, PET imaging features, pathologic N stage, and pathologic response on final pathology were included for univariate and multivariate Cox regression analyses to identify independent predictors of bPFS. Results: With a median follow-up of 30 mo, 18 patients (24%) experienced biochemical progression. Multivariate Cox regression analyses revealed that only SUVmax derived from posttreatment [68Ga]PSMA PET/CT and pathologic response on final pathology were independent factors for the prediction of bPFS, with hazard ratios of 1.02 (95% CI, 1.00–1.04; P = 0.02) and 0.12 (95% CI, 0.02–0.98; P = 0.048), respectively. Kaplan–Meier analysis revealed that patients with a favorable [68Ga]PSMA PET/CT response (posttreatment SUVmax &lt; 8.5) or a favorable pathologic response (pathologic complete response or minimal residual disease) had a significantly lower rate of 3-y biochemical progression. Conclusion: Our results indicated that [68Ga]PSMA PET/CT response was an independent risk factor for the prediction of bPFS in patients with high-risk PCa receiving neoadjuvant therapy and RP, suggesting [68Ga]PSMA PET/CT to be an ideal tool to monitor response to neoadjuvant therapy.