Prospective evaluation of 68Ga-PSMA-11 PET/CT in Chinese men with biochemical recurrence after radical prostatectomy for prostate cancer: relationships between location of recurrence, time after prostatectomy, and serum PSA level

Abstract

To prospectively evaluate the distribution of PSMA-targeted PET-avid lesions in prostate cancer (PCa) patients with biochemical recurrence in a Chinese cohort. The relationships between PSA levels, disease-free time after prostatectomy, and 68Ga-PSMA-11 PET/computed tomography (CT) findings were investigated. Inclusion criteria included histopathologically proven prostate adenocarcinoma, two consecutive PSA levels > 0.20 ng/mL, and negative CT of the abdomen and pelvis or magnetic resonance imaging of the pelvis and whole-body bone scan. Exclusion criteria were non-prostate malignancy within 3 years and persistent PSA after radical prostatectomy. Patients with findings of recurrent disease on re-staging conventional imaging were excluded, as were patients previously treated with systemic therapy and/or salvage therapy. 51 patients were enrolled in this study. 34/51 (66.7%) patients had at least one site of 68Ga-PSMA-11 uptake consistent with PCa. 23.5% of patients had recurrence in the prostate bed, 27.4% had pelvic lymph nodes, 15.7% had extrapelvic lymph node metastases, and 17.6% had bone metastases. For patients with lymph node involvement/metastasis, bone metastasis, and patients with both, their median serum PSA levels were 1.83 ng/mL, 4.03 ng/mL, and 2.54 ng/mL, respectively. They were diagnosed with recurrence with a median of 2.06 years, 1.15 years, and 2.54 years after radical prostatectomy, respectively. In this study of Chinese men with biochemical recurrence, added value for the detection of lesions compatible with sites of PCa was found with 68Ga-PSMA-11 PET/CT over conventional imaging. The observed patterns of disease spread may have implications for understanding the biology of early prostate cancer metastasis.

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Acknowledgements

LD is supported by Shanghai Natural Science Foundation exploration Project (17ZR1447400). MX is supported by National Natural Science Foundation of China (81701725), Shanghai “Rising Stars of Medical Talent” Youth Development Program (SHDC2012105). SRA is supported by the Patrick C. Walsh Prostate Cancer Research Fund and the Prostate Cancer Foundation. WX is supported by Program of Shanghai Subject Chief Scientist (19XD1402300) and Program for Outstanding Medical Academic Leader (2019LJ11). KJP is supported by NCI grants U54CA143803, CA163124, CA093900, and CA143055, and the Prostate Cancer Foundation. SPR is supported by the Prostate Cancer Foundation.

Funding

LD is supported by Shanghai Natural Science Foundation exploration project (17ZR1447400). MX is supported by National Natural Science Foundation of China (81701725), Shanghai “Rising Stars of Medical Talent” Youth Development Program (SHDC2012105). SRA is supported by the Patrick C. Walsh Prostate Cancer Research Fund and the Prostate Cancer Foundation. WX is supported by Program of Shanghai Subject Chief Scientist (19XD1402300) and Program for Outstanding Medical Academic Leader (2019LJ11). KJP is supported by NCI grants U54CA143803, CA163124, CA093900, and CA143055, and the Prostate Cancer Foundation. SPR is supported by the Prostate Cancer Foundation.

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Correspondence to Jianjun Liu or Wei Xue or Steven P. Rowe.

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Dong, L., Zhu, Y., Xin, M. et al. Prospective evaluation of 68Ga-PSMA-11 PET/CT in Chinese men with biochemical recurrence after radical prostatectomy for prostate cancer: relationships between location of recurrence, time after prostatectomy, and serum PSA level. Med Oncol 37, 89 (2020). https://doi.org/10.1007/s12032-020-01412-7

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Keywords

  • Prostate-specific membrane antigen
  • Prostate cancer
  • Biochemical recurrence