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Role of baseline 68Ga-PSMA PET/CT-derived whole-body volumetric parameters in predicting survival outcomes of metastatic castration-resistant prostate cancer patients receiving first-line treatment

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Abstract

Objective

We aimed to evaluate whether baseline 68Ga-PSMA PET/CT-derived whole-body volumetric parameters could be used as predictive biomarkers for survival in metastatic castration-resistant prostate cancer (mCRPC) patients receiving first-line treatment.

Materials and methods

This retrospective study included 54 mCRPC patients, who underwent baseline 68Ga-PSMA PET/CT imaging within 1 month before starting first-line treatment. Pre-treatment prostate-specific antigen (PSA) levels and treatments were recorded. SUVmax, SUVmean, whole-body PSMA-derived tumor volume (wbPSMA-TV), and whole-body total lesion PSMA (wbTL-PSMA) were calculated for all patients. PSA response was defined as a decline of ≥ 50% from pre-treatment value at 12 weeks. Overall survival (OS) was measured from the start of the first-line treatment for mCRPC.

Results

Docetaxel and abiraterone/enzalutamide were administered to 32 and 22 patients in the first-line setting, respectively. wbPSMA-TV (rho = 0.582, p = 0.004) and wbTL-PSMA (rho = 0.564, p = 0.007) showed moderate positive correlations with PSA levels. Older age (p = 0.02), higher wbPSMA-TV (p = 0.007), higher PSA (p = 0.01), higher number of bone metastases (p = 0.02), and lack of PSA response (p = 0.03) were significantly associated with an increased risk of mortality. Multivariate analysis determined wbPSMA-TV (HR: 1.003, 95% CI 1.001–1.004, p = 0.001) and PSA response (HR: 2.241, 95% CI 1.189–4.222, p = 0.01) as independent predictors of OS.

Conclusion

The wbPSMA-TV may be a useful tool to reflect tumor burden and predict survival outcomes in patients with mCRPC.

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Funding

The authors did not receive support from any organization for the submitted work.

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Authors and Affiliations

  1. Division of Medical Oncology, School of Medicine, Marmara University, Istanbul, 34899, Turkey

    Tugba Akin Telli, Ozkan Alan, Mehmet Akif Ozturk, Selver Isik, Rukiye Arikan, Nazim Can Demircan, Tugba Basoglu, Ozlem Ercelep, Faysal Dane & Perran Fulden Yumuk

  2. Department of Nuclear Medicine, School of Medicine, Marmara University, Istanbul, 34899, Turkey

    Salih Ozguven, Nuh Filizoglu & Tunc Ones

  3. Department of Internal Medicine, School of Medicine, Marmara University, Istanbul, 34899, Turkey

    Nisanur Sariyar

  4. Department of Radiation Oncology, School of Medicine, Marmara University, Istanbul, 34899, Turkey

    Ilknur Alsan Cetin

  5. Division of Medical Oncology, School of Medicine, Koç University, Istanbul, Turkey

    Ozkan Alan & Perran Fulden Yumuk

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  1. Tugba Akin Telli
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Correspondence to Tugba Akin Telli.

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This retrospective study was approved by the Marmara University ethics committee (Date of approval: 24 July 2020, Protocol Code: 09.2020.888).

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Telli, T.A., Ozguven, S., Alan, O. et al. Role of baseline 68Ga-PSMA PET/CT-derived whole-body volumetric parameters in predicting survival outcomes of metastatic castration-resistant prostate cancer patients receiving first-line treatment. Ann Nucl Med 36, 964–975 (2022). https://doi.org/10.1007/s12149-022-01785-x

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