Prognostic value of baseline PSMA PET/CT for survival in synchronous metastatic hormone-sensitive prostate cancer: towards redefining low- and high-volume disease - Summary - MDSpire
Conexiant’s news site is now MDSpire News. Learn more
Advertisement
Evaluating the Prognostic Significance of Initial PSMA PET/CT Imaging for Survival Outcomes in Synchronous Metastatic Hormone-Sensitive Prostate Cancer: A Shift in Understanding Low- versus High-Volume Disease
To establish a foundation for revising risk stratification among patients with synchronous metastatic hormone-sensitive prostate cancer (mHSPC) using PSMA PET/CT imaging for improved prognostic assessment.
Approach:
Patient Population: A bicentric retrospective study included patients diagnosed with mHSPC at Leiden University Medical Centre or Alrijne Hospital from April 2017 to August 2023, who underwent PSMA PET/CT and initiated androgen deprivation therapy (ADT).
Imaging and Analysis: PSMA PET/CT scans were performed and analyzed to classify patients into low-volume disease (LVDMDT) or high-volume disease (HVDMDT) based on expert opinion in multidisciplinary team meetings.
Clinical Parameters: Clinical variables such as age, WHO performance status, initial prostate-specific antigen (iPSA) concentration, Gleason Score, alkaline phosphatase (ALP) concentration, and hemoglobin (Hb) concentration were recorded.
Study Endpoints: Overall survival (OS) and PSA progression-free survival (PSA-PFS) were the primary and secondary endpoints, respectively.
Key Findings:
PSMA PET/CT imaging demonstrates higher sensitivity and specificity than conventional imaging.
Approximately 40% of patients with mHSPC were restaged due to PSMA PET/CT identifying lesions missed by conventional imaging.
Current classifications of low-volume and high-volume disease may not accurately represent tumor burden as determined by PSMA PET/CT.
Interpretation:
The study indicates a need for a revised classification system for mHSPC that incorporates PSMA PET/CT findings.
Limitations:
The study's retrospective design and limitation to two centers may affect the generalizability of the findings.
No established threshold values for PSMA PET/CT findings exist for clinical application.
Conclusion:
A structured approach to integrating PSMA PET/CT findings into prognostic assessments is necessary for optimizing treatment strategies in mHSPC.
IBTV speaks with industry leaders at ASGCT 2026 about the technologies, processes, and manufacturing strategies helping advanced therapies progress toward commercial scale
U.S. News & World Report has recognized Dana-Farber/Boston Children’s Cancer and Blood Disorders Center as the #1 pediatric cancer program in the nation in its 2026-2027 Best Children’s Hospitals report.
