Detecting PCa Recurrence in African Americans: Can 18F-Flotufolastat Have an Impact?

For African Americans with suspected prostate cancer (PCa) recurrence, the PET imaging agent ¹⁸F-flotufolastat (Posluma) provided a 93 percent patient-level detection rate (DR) that was six percent higher than that reported for other patients in the recent SPOTLIGHT trial.

Researchers also noted that ¹⁸F-flotufolastat had a 67 percent DR for African American patients with a prostate-specific antigen (PSA) level < 0.5 ng/mL and a 100 percent DR for those with a PSA level > 10 ng/mL in this patient population, according to the post-hoc analysis of the SPOTLIGHT trial that was recently published in Advances in Radiation Oncology.

In a recent interview, Soroush Rais-Bahrami, M.D., the lead author of the study, noted some small differences in regional detection rates between African Americans and other patients but said the findings were largely similar otherwise for the use of Posluma (Blue Earth Diagnostics) in diagnosing PCa recurrence.

“The findings holding true and being validated in large part both with imaging and histopathologic confirmation really make this new FDA-approved PSMA PET imaging agent valid in all populations of men, specifically African Americans as well as non-African American men included in the study,” maintained Dr. Rais-Bahrami, a professor in the Departments of Urology and Radiology at the University of Alabama School of Medicine in Birmingham, Ala.

Dr. Rais-Bahrami also noted that African American men comprised 17 percent of the SPOTLIGHT study cohort, nearly double the rate of African American participation reported in oncology clinical trials from 2010 to 2021.

“This shows promise that clinical trials, specifically in the realm of cancer, can have a good diversity of enrollment in terms of subjects. One of the real elements of our focus in terms of performing clinical trials should be sure to encourage not only diversity of race … but also different areas regionally throughout the country and internationally as well as different sites of practice to really reach patients with different points of access, socioeconomic status, race, ethnicity and cultural factors that may play a large role in their overall medical and specifically, in this case, cancer care,” emphasized Dr. Rais-Bahrami.

(Editor’s note: For related content, see “Emerging Research at SNMMI Examines 18F-Flotufolastat in Managing Primary and Recurrent Prostate Cancer,” “Can Targeted PSMA PET/CT Guided Radiotherapy Have an Impact for Oligometastatic Prostate Cancer?” and “Study: PSMA PET/CT More Advantageous than MRI for Locoregional Staging of Prostate Cancer.”)

For more insights from Dr. Rais-Bahrami, watch the video below.