SNMMI: PSMA-18F DCFPyL Changes Treatment for PCa Recurrence in Significant Number of Patients with Low PSAs

The use of PSMA-18F DCFPyL may be more advantageous than conventional imaging in detecting biomechanical recurrence of prostate cancer in patients with low prostate-specific antigen (PSA) values, according to new research presented at the 2024 Society of Nuclear Medicine and Molecular Imaging (SNMMI) Annual Meeting.

For the retrospective study, researchers evaluated the use of PET PSMA-18F DCFPyL (Pylarify, Lantheus) in 85 patients (mean age of 69) who had occult prostate cancer recurrence and PSA values less than 2 ng/mL. All patients in the cohort had negative computed tomography (CT), magnetic resonance imaging (MRI), ultrasound and positron emission tomography (PET)-choline exams, according to the study authors.

At a six-month follow-up, the researchers found that PET imaging with PSMA-18F DCFPyL led to treatment changes in 75 percent of patients with positive findings (31/41).

Here one can see PET/CT imaging with PSMA-18F DCFPyL that led to modification with a planned radiotherapy treatment for recurrent prostate cancer. (Images courtesy of SNMMI.)

“In PET-PSMA-positive patients, the therapeutic changes found were classified as indicating or changing the planning of salvage radiotherapy treatment and/or initiating systemic treatment with hormone therapy,” noted lead study author Pedro Jose Plana Lopez, M.D., who is affiliated with Hospital Del Mar in Barcelona, Spain, and colleagues.

The study authors noted a median PSA level of 0.08 ng/dL after treatment changes were instituted in patients with positive PET PSMA results.

(Editor’s note: For related content, see “Can an Emerging PET Radiotracer Be a Viable Alternative to Multiparametric MRI for Detecting Prostate Cancer Recurrence?,” “Utilizing AI for Quantitative Assessment of Prostate Cancer Recurrence” and “Emerging PET Radiotracer May Offer Multiple Advantages in Detecting Prostate Cancer.”)

“PET-PSMA is a powerful diagnostic tool for patients with occult biochemical recurrence with PSA < 2ng/mL,” added Lopez and colleagues.

Reference

1. Lopez PJP, Amorelli FG, Cano JSB, et al. PET/CT PSMA-18F DCFPyL promotes treatment changes in occult biochemical recurrence of prostate carcinoma even with low PSA values. Presented at the 2024 Society of Nuclear Medicine and Molecular Imaging Annual Meeting, June 8-11, Toronto, Canada. Available at: https://www.xcdsystem.com/snmmi/program/10OD8Tq/index.cfm . Accessed June 9, 2024.