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Analysis Of Molecular Imaging And Laboratory Baseline Biomarkers In Psma-rlt: Whole-body Total Lesion Psma (tlp) Predicts Overall Survival.

Analysis of Molecular Imaging and Laboratory Baseline Biomarkers in PSMA-RLT: Whole-Body Total Lesion PSMA (TLP) Predicts Overall Survival.

Connor Hein¹, Caroline Burgard¹, Arne Blickle¹

¹Department of Nuclear Medicine, Saarland University-Medical Center, 66421 Homburg, Germany.

|August 10, 2024

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View abstract on PubMed

Summary

This summary is machine-generated.

This study identified predictive biomarkers for radioligand therapy in metastatic castration-resistant prostate cancer. Total Lesion PSMA (TLP) on PET/CT scans predicts overall survival, while mean SUV (SUVmean) predicts treatment response.

Area of Science:

Oncology
Nuclear Medicine
Radiopharmaceutical Therapy

Background:

Metastatic castration-resistant prostate cancer (mCRPC) requires effective treatment strategies.
Prostate-specific membrane antigen (PSMA)-targeted radioligand therapy (RLT) shows promise for mCRPC.
Identifying predictive biomarkers is crucial for optimizing RLT outcomes.

Purpose of the Study:

To identify pre-therapeutic laboratory and molecular imaging biomarkers for response and overall survival (OS) in mCRPC patients treated with PSMA-targeted RLT.
To evaluate the predictive value of various biochemical and imaging parameters.

Main Methods:

Retrospective analysis of 102 mCRPC patients undergoing [177Lu]Lu-PSMA-617 RLT.
Assessment of pre-therapeutic laboratory markers (e.g., PSA, ALP, Hb) and [68Ga]Ga-PSMA-11 PET/CT imaging parameters (e.g., SUVmax, SUVmean, MTV, TLP).

Keywords:

PET/CT biomarker metastatic castration-resistant prostate cancer (mCRPC)prostate-specific membrane antigen (PSMA)

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Statistical analysis using Mann-Whitney U test and Cox-regression models.

Main Results:

Mean standardized uptake value (SUVmean) of all lesions was significantly different between responders and non-responders (p=0.003).
Hemoglobin (Hb), molecular tumor volume (MTV), and total lesion PSMA (TLP) were associated with OS in univariate analysis.
TLP remained a significant predictor of OS in multivariable analysis (HR 1.033, p=0.009).

Conclusions:

Quantitative PET/CT imaging parameter SUVmean is associated with PSA response in mCRPC patients receiving RLT.
Baseline TLP is a significant independent predictor of overall survival in mCRPC patients undergoing RLT.

radioligand therapy (RLT)

total lesion PSMA (TLP)