ArticleEuropean journal of nuclear medicine and molecular imaging2025
A visual whole-body tumor-burden classification based on PSMA PET/CT to predict response to novel androgen receptor signaling inhibitors for metastatic hormone-sensitive prostate cancer patients.
Article in European journal of nuclear medicine and molecular imaging, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThe incidence rates of metastatic hormone-sensitive prostate cancer (mHSPC) have increased rapidly. Androgen deprivation therapy (ADT) with AR signaling inhibitors (ARSIs) has been determined survival benefit for mHSPC patients in several randomized trials. However, patients do not respond uniformly. Whole-body tumor-burden schemes guided by prostate-specific membrane antigen (PSMA) PET/CT have been proven to be a useful predictive tool for PSMA-targeted radioligand therapy (RLT), while the value for hormone therapy was unclear. We hypothesized a visual whole-body tumor-burden classification based on PSMA PET/CT can enable selective patient stratification and prognostic evaluation for hormone treatment. MATERIALS AND
methodsPatients diagnosed with de novo mHSPC through pathological test and [
resultsA total of 165 patients were included. The average age was 69.30 ± 8.12 years. In univariate logistic regression analysis, MDT, PSMA-CHAARTED, revised-vPSG tumor-burden classifications, type of hormone treatment and primary-tumor TV were significantly related to PSA response, and PSMA-LATITUDE scheme wasn't relevant to PSA response. The results of further multivariate logistic regression revealed MDT scheme (MDT high group vs. low group: OR = 5.34, 95%CI: 2.40-11.87, P < 0.001), type of hormone treatment (ADT + second-generation ARSIs vs. ADT alone or ADT + first-generation antiandrogens: OR = 0.21, 95%CI: 0.08-0.53, P = 0.001), and primary-tumor TV (≥ 12.49 cm
conclusionThe visual whole-body tumor-burden classification based on PSMA PET/CT should be an effective stratification strategy for mHSPC patients treated with ADT + ARSIs, especially with ADT + second-generation ARSIs. PSA99 (PSA reduction ≥ 99%) could be a superior endpoint for patients with HSPC. This classification scheme could be a promising method for stratifying mHSPC patients. These findings need to be confirmed and validated through a longer follow-up, prospective and clinical data.
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