Top Line: How does PSMA PET impact treatment planning for patients receiving salvage radiation after prostatectomy?
The Study: PSMA-SRT was a randomized, phase 3 trial where 193 patients with biochemical recurrence after radical prostatectomy were randomized to receive salvage radiation with or without a pre-treatment PSMA PET scan. This secondary analysis looked at the impact of PSMA PET results on radiation planning in the experimental arm. Of those patients, 37% had a positive scan including 13% with prostate fossa only recurrence, 16% with pelvic lymph node recurrence (with or without fossa recurrence), and 9% with distant recurrence outside the pelvis. Important to note is that other non-PSMA PET forms of imaging were allowed in the control arm including fluciclovine PET. The rate of significant changes in the intended treatment plan was significantly higher with the incorporation of PSMA PET (45% v 22%). Specifically, treatment intensification was more frequent in the PSMA PET arm (29% v 12%). The final results of the primary analysis will provide further data about whether incorporating pre-treatment PSMA PET improves treatment outcomes. These findings are similar to those of another trial, PSMAgRT, where PSMA PET changed treatment plans in roughly half of patients.
TBL: In the PSMA-SRT trial, performing a PSMA PET scan prior to salvage radiation resulted in a significant change in the intended treatment plan in nearly half of patients. | Armstrong, Eur Urol 2024
The Study: PSMA-SRT was a randomized, phase 3 trial where 193 patients with biochemical recurrence after radical prostatectomy were randomized to receive salvage radiation with or without a pre-treatment PSMA PET scan. This secondary analysis looked at the impact of PSMA PET results on radiation planning in the experimental arm. Of those patients, 37% had a positive scan including 13% with prostate fossa only recurrence, 16% with pelvic lymph node recurrence (with or without fossa recurrence), and 9% with distant recurrence outside the pelvis. Important to note is that other non-PSMA PET forms of imaging were allowed in the control arm including fluciclovine PET. The rate of significant changes in the intended treatment plan was significantly higher with the incorporation of PSMA PET (45% v 22%). Specifically, treatment intensification was more frequent in the PSMA PET arm (29% v 12%). The final results of the primary analysis will provide further data about whether incorporating pre-treatment PSMA PET improves treatment outcomes. These findings are similar to those of another trial, PSMAgRT, where PSMA PET changed treatment plans in roughly half of patients.
TBL: In the PSMA-SRT trial, performing a PSMA PET scan prior to salvage radiation resulted in a significant change in the intended treatment plan in nearly half of patients. | Armstrong, Eur Urol 2024