SNMMI: PET/CT with prostate agent changes therapy plans

2017 06 15 10 31 55 42 Prostate 400

Australian researchers found that treatment plans for more than half of prostate cancer patients were changed due to the results of PET/CT scans using a radiopharmaceutical that combines gallium-68 (Ga-68) with a molecular compound that homes in on prostate-specific membrane antigen (PMSA), according to a study presented at this week's Society of Nuclear Medicine and Molecular Imaging (SNMMI) meeting.

Researchers led by Dr. Paul Roach of Royal North Shore Hospital in Sydney studied a group of 431 prostate cancer patients who were seen at four institutions between January 2015 and June 2016. In all, 25% of patients had scans performed for primary staging, while 75% of scans were conducted for rising prostate-specific antigen (PSA) levels after surgery or radiotherapy.

Patients were injected with the Ga-68 PSMA radiopharmaceutical; after results were interpreted, the referring physicians were asked whether the scans would change their management plan.

PET/CT scans with Ga-68 PSMA led to a change in management in 51% of patients, the researchers found. Patients with an indication of biochemical recurrence after surgery had a management change rate of 64%, while those who had received radiation therapy had a rate of 69%. Patients who got scans for primary staging had a change rate of 23%.

Preliminary analysis of the data showed that the scans detected previously unsuspected disease in the prostate bed in 30% of patients, disease in the locoregional lymph nodes in 36% of patients, and distant disease in 16% of patients. What's more, using Ga-68 PSMA PET/CT for primary screening of intermediate- and high-risk prostate cancer patients led to a change in management in 23% of cases.

The findings demonstrate the need for additional government funding of Ga-68 PSMA scans and for insurers to pay for the procedure, according to Roach and colleagues.

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