Diverse Imaging Methods May Influence Long-Term Oncologic Outcomes in Oligorecurrent Prostate Cancer Patients Treated...

Area of Science:

• Oncology
• Radiology
• Nuclear Medicine

Background:

• Metastasis-directed therapy (MDT) is a treatment option for oligorecurrent prostate cancer (PCa).
• The choice of imaging technique for guiding MDT in clinical trials is debated.
• Different PET/CT tracers, such as choline and prostate-specific membrane antigen (PSMA), are used.

Purpose of the Study:

• To evaluate the impact of different imaging techniques (choline vs. PSMA PET/CT) on outcomes in patients with oligorecurrent prostate cancer undergoing MDT.
• To compare the efficacy of MDT guided by various PSMA PET/CT tracers.

Main Methods:

• Retrospective analysis of 402 oligorecurrent PCa patients treated with MDT across 8 cancer centers.
• Patients had 5 or fewer metastases detected by choline or PSMA PET/CT.
• Propensity score matching was used to compare outcomes between imaging groups.

Main Results:

• PSMA PET/CT-guided MDT was associated with significantly longer progression-free survival (PFS), PFS2, and overall survival compared to choline PET/CT-guided MDT.
• Among PSMA tracers, [68Ga]Ga-PSMA-11 guided MDT showed longer PFS and PFS2 than [18F]F-PSMA-1007 guided MDT.
• Hazard ratios indicated improved survival outcomes with PSMA PET/CT guidance.

Conclusions:

• The choice of imaging modality significantly influences outcomes for oligorecurrent prostate cancer patients receiving MDT.
• PSMA PET/CT appears superior to choline PET/CT for guiding MDT in this patient population.
• Prospective, randomized trials are essential to validate these findings and guide clinical practice.