在Lu-PSMA-617之后的PSMA PET/CT衍生指标和结果:来自美国扩展访问计划的多中心回顾分析
Koichiro Kimura1, Vishnu Murthy2, Andrew F Voter3
1Department of Nuclear Medicine and Theranostics, Ahmanson Translational Theranostics Division, David Geffen School of Medicine at UCLA, Los Angeles, California; koichirokimura@mednet.ucla.edu.
概括
基线总瘤SUVmean在PSMA PET/CT上是接受Lu-PSMA治疗的转移性割抵抗性前列腺癌患者治疗成功的强有力的预测指标. 较高的SUV平均值与改善的无进展和整体存活率相关,有助于患者选择.
科学领域:
- 核医学就是核医学.
- 在瘤学瘤学.
- 放射性药物 放射性药物 放射性药物
背景情况:
- 前列腺特异性膜抗原 (PSMA) PET/CT指标正在探索用于预测转移性割抵抗性前列腺癌 (mCRPC) 中对177Lu-PSMA治疗的反应.
- 在美国扩展访问计划队列中评估这些指标对于现实应用至关重要.
研究的目的:
- 评估和比较治疗前视觉和定量PSMA PET/CT指标的预后性能.
- 确定这些指标是否预测PSA50等结果,PSA无进展生存率 (PFS) 和总生存率 (OS) 在mCRPC患者治疗177Lu-PSMA.
主要方法:
- 在扩大访问计划中,美国3个机构的88名mCRPC患者的回顾性分析.
- 评估视觉 (例如,瘤与唾液腺的比) 和定量指标 (例如,总瘤SUV平均值,总病变吸收量).
- 分析了与PSA50,PSA PFS和OS的关联,使用单变量/多变量模型和一致性指数.
主要成果:
- 随访时间中位数为36.1个月;PSA50率为43%,PSA PFS中位数为4.5个月,OS中位数为12.5个月.
- 总瘤SUV平均值显示PSA50的预测精度最高 (AUC,0.81).
- 在多变量分析中,较高的总瘤SUV平均值独立预测了PSA PFS (HR,0.58) 和OS (HR,0.54) 的改善,单独优于临床变量.
结论:
- 基线总瘤SUV平均值在PSMA PET/CT上提供了超出临床因素的独立预后价值.
- 总瘤SUVmean可以作为患者选择和177Lu-PSMA疗法个性化治疗的生物标志物.
- 这一指标有助于优化mCRPC患者的治疗策略.
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