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Prognostic Significance of Baseline Clinical and [68Ga]Ga-Psma Pet Derived Parameters on Biochemical Response, Overall Survival, and Psa Progression-Free Survival in Metastatic Castration-Resistant Prostate Cancer (Mcrpc) Patients Undergoing [177Lu]Lu-Psma Therapy Publisher Pubmed



Jafari E1 ; Manafifarid R2 ; Ahmadzadehfar H3 ; Salek F1 ; Jokar N1 ; Keshavarz A4 ; Divband G5 ; Dadgar H6 ; Zohrabi F7 ; Assadi M1
Authors
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Authors Affiliations
  1. 1. The Persian Gulf Nuclear Medicine Research Center, Department of Nuclear Medicine, Molecular Imaging, and Theranostics, Bushehr Medical University Hospital, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
  2. 2. Research Center for Nuclear Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Nuclear Medicine, Klinikum Westfalen, Dortmund, Germany
  4. 4. IoT and Signal Processing Research Group, ICT Research Institute, Faculty of Intelligent Systems Engineering and Data Science, Persian Gulf University, Bushehr, Iran
  5. 5. Department of Nuclear Medicine, Jam Hospital, Tehran, Iran
  6. 6. Cancer Research Center, RAZAVI Hospital, Imam Reza International University, Mashhad, Iran
  7. 7. Department of Urology, Bushehr Medical University Hospital, Bushehr University of Medical Sciences, Bushehr, Iran

Source: Nuklearmedizin - NuclearMedicine Published:2024


Abstract

Background In this study, we sought to identify the clinical baseline characteristics and pre-therapy 68Ga-PSMA PET derived parameters that can have impact on PSA (biochemical) response, OS and PSA PFS in patients with metastatic castration-resistant prostate cancer (mCRPC) who undergo RLT with [177Lu]Lu-PSMA-617. Methods Various pre-treatment clinical and PSMA PET derived parameters were gathered and computed. We used PSA response as the criteria for more than a 50% decrease in PSA level, and OS and PSA PFS as endpoints. We assessed the collected parameters in relation to PSA response. Additionally, we employed univariable Cox regression and Kaplan-Meier analysis with log rank to evaluate the influence of the parameters on OS and PFS. Results A total of 125 mCRPC patients were included in this study. The median age was 68 years (range: 49-89). Among the cases, 77 patients (62%) showed PSARS, while 48 patients (38%) did not show PSA response. The median OS was 14 months (range: 1-60), and the median PSA-PFS was 10 months (range: 1-56). Age, prior history of chemotherapy, and SUVmax had a significant impact on PSA response (p<0.05). PSA response, RBC count, hemoglobin, hematocrit, neutrophil to lymphocyte ratio (NLR), alkaline phosphatase (ALP), number of metastases, wbPSMA-TV, and wbTL-PSMA significantly affected OS. GS, platelet count, NLR, and number of metastases were found to have a significant impact on PSA PFS. Conclusion We have identified several baseline clinical and PSMA PET derived parameters that can serve as prognostic factors for predicting PSA response, OS, and PSA PFS after RLT. Based on the findings, we believe that these clinical baseline characteristics can assist nuclear medicine specialists in identifying RLT responders who have long-term survival and PFS. © 2024. Thieme. All rights reserved.
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