PSMA-PET Guided Treatment in Prostate Cancer Patients with Oligorecurrent Progression after Previous Salvage Treatment.

PSMA-PET hormone sensitive prostate cancer metastasis-directed therapy oligorecurrent prostate cancer survival

Journal

Cancers
ISSN: 2072-6694
Titre abrégé: Cancers (Basel)
Pays: Switzerland
ID NLM: 101526829

Informations de publication

Date de publication:
29 Mar 2023
Historique:
received: 06 03 2023
revised: 27 03 2023
accepted: 28 03 2023
medline: 14 4 2023
entrez: 13 4 2023
pubmed: 14 4 2023
Statut: epublish

Résumé

Prostate Specific Membrane Antigen-Positron Emission Tomography (PSMA-PET) is used to select recurrent prostate cancer (PCa) patients for metastases-directed therapy (MDT). We aimed to evaluate the oncologic outcomes of second-line PSMA-guided MDT in oligo-recurrent PCa patients. we performed a retrospective analysis of 113 recurrent PCa after previous radical prostatectomy and salvage therapies with oligorecurrent disease at PSMA-PET (≤3 lesions in N1/M1a-b) in three high-volume European centres. Patients underwent second-line salvage treatments: MDT targeted to PSMA (including surgery and/or radiotherapy), and the conventional approach (observation or Androgen Deprivation Therapy [ADT]). Patients were stratified according to treatments (MDT vs. conventional approach). Patients who underwent MDT were stratified according to stage in PSMA-PET (N1 vs. M1a-b). The primary outcome of the study was Progression-free survival (PFS). Secondary outcomes were Metastases-free survival (MFS) and Castration Resistant PCa free survival (CRPC-FS). Kaplan-Meier analyses assessed PFS, MFS and CRPC-FS. Multivariable Cox regression models identified predictors of progression and metastatic disease. Overall, 91 (80%) and 22 (20%) patients were treated with MDT and the conventional approach, respectively. The median follow-up after PSMA-PET was 31 months. Patients who underwent MDT had a similar PFS compared to the conventional approach (

Sections du résumé

BACKGROUND BACKGROUND
Prostate Specific Membrane Antigen-Positron Emission Tomography (PSMA-PET) is used to select recurrent prostate cancer (PCa) patients for metastases-directed therapy (MDT). We aimed to evaluate the oncologic outcomes of second-line PSMA-guided MDT in oligo-recurrent PCa patients.
METHODS METHODS
we performed a retrospective analysis of 113 recurrent PCa after previous radical prostatectomy and salvage therapies with oligorecurrent disease at PSMA-PET (≤3 lesions in N1/M1a-b) in three high-volume European centres. Patients underwent second-line salvage treatments: MDT targeted to PSMA (including surgery and/or radiotherapy), and the conventional approach (observation or Androgen Deprivation Therapy [ADT]). Patients were stratified according to treatments (MDT vs. conventional approach). Patients who underwent MDT were stratified according to stage in PSMA-PET (N1 vs. M1a-b). The primary outcome of the study was Progression-free survival (PFS). Secondary outcomes were Metastases-free survival (MFS) and Castration Resistant PCa free survival (CRPC-FS). Kaplan-Meier analyses assessed PFS, MFS and CRPC-FS. Multivariable Cox regression models identified predictors of progression and metastatic disease.
RESULTS RESULTS
Overall, 91 (80%) and 22 (20%) patients were treated with MDT and the conventional approach, respectively. The median follow-up after PSMA-PET was 31 months. Patients who underwent MDT had a similar PFS compared to the conventional approach (

Identifiants

pubmed: 37046687
pii: cancers15072027
doi: 10.3390/cancers15072027
pmc: PMC10093227
pii:
doi:

Types de publication

Journal Article

Langues

eng

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Auteurs

Lorenzo Bianchi (L)

Division of Urology, IRCCS Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy.
Department of Medical and Surgical Sciences, University of Bologna, 40127 Bologna, Italy.

Francesco Ceci (F)

Division of Nuclear Medicine, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy.
Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy.

Eleonora Balestrazzi (E)

Division of Urology, IRCCS Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy.

Francesco Costa (F)

Division of Urology, IRCCS Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy.

Matteo Droghetti (M)

Division of Urology, IRCCS Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy.

Pietro Piazza (P)

Division of Urology, IRCCS Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy.

Alessandro Pissavini (A)

Division of Urology, IRCCS Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy.

Massimiliano Presutti (M)

Division of Urology, IRCCS Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy.

Andrea Farolfi (A)

Nuclear Medicine Division, IRCCS Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy.

Riccardo Mei (R)

Nuclear Medicine Division, IRCCS Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy.

Paolo Castellucci (P)

Nuclear Medicine Division, IRCCS Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy.

Giorgio Gandaglia (G)

Unit of Urology, Division of Experimental Oncology, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, 20132 Milan, Italy.

Alessandro Larcher (A)

Unit of Urology, Division of Experimental Oncology, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, 20132 Milan, Italy.

Daniele Robesti (D)

Unit of Urology, Division of Experimental Oncology, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, 20132 Milan, Italy.

Alexandre Mottrie (A)

Department of Urology, Onze-Lieve-Vrouwziekenhuis, 9300 Aalst, Belgium.
ORSI Academy, 9090 Melle, Belgium.

Alberto Briganti (A)

Unit of Urology, Division of Experimental Oncology, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, 20132 Milan, Italy.

Alessio Giuseppe Morganti (AG)

Radiation Oncology Division, IRCCS Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy.

Stefano Fanti (S)

Department of Medical and Surgical Sciences, University of Bologna, 40127 Bologna, Italy.
Division of Nuclear Medicine, IEO European Institute of Oncology IRCCS, 20141 Milan, Italy.

Francesco Montorsi (F)

Unit of Urology, Division of Experimental Oncology, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, 20132 Milan, Italy.

Riccardo Schiavina (R)

Division of Urology, IRCCS Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy.
Department of Medical and Surgical Sciences, University of Bologna, 40127 Bologna, Italy.

Eugenio Brunocilla (E)

Division of Urology, IRCCS Azienda Ospedaliero Universitaria di Bologna, 40138 Bologna, Italy.
Department of Medical and Surgical Sciences, University of Bologna, 40127 Bologna, Italy.

Classifications MeSH