Biochemical Response of <0.1 ng/ml Predicts Therapy-free Survival of Prostate Cancer Patients following Prostate-specific Membrane Antigen–targeted Salvage Surgery

• DOI: 10.1016/j.euo.2024.04.019
• Publication Date: 2024-05-09T13:06:36Z
• Authors: Sophie Knipper; Flemming Lischewski; Daniel Koehler; Matthias Eiber; Fijs W.B. van Lee...; Hilda de Barros; Anne-Claire Berrens; Lotte Zuur; Pim J. van Leeuwen; Henk van der Poel; Francesca Ambrosini; Fabian Falkenbach; Lars Budäus; Thomas Steuber; Markus Graefen; Pierre Tennstedt; Jürgen E. Gschwend; Thomas Horn; Matthias M. Heck; Tobias Maurer
• Keywords: Glutamate carboxypeptidase II; Salvage therapy

BackgroundIn a subset of patients with oligorecurrent prostate cancer (PCa), salvage surgery prostate-specific membrane antigen (PSMA) radioguided (PSMA-RGS) seems to be value.ObjectiveTo evaluate whether lower level postoperative (PSA; <0.1 ng/ml) is predictive therapy-free survival (TFS) following PSMA-RGS.Design, setting, and participantsThis cohort study evaluated biochemical recurrence after radical prostatectomy PCa on PSMA positron emission tomography treated PSMA-RGS in three tertiary care centers (2014–2022).InterventionPSMA-RGS.Outcome measurements statistical analysisPostsalvage PSA response was categorized as <0.1, 0.1–<0.2, or >0.2 ng/ml. Kaplan-Meier multivariable Cox regression models TFS according response.Results limitationsAmong 553 assessed, 522 (94%) had metastatic soft tissue lesions removed during PSMA-RGS. At 2–16 wk PSMA-RGS, 192, 62, 190 achieved levels ng/ml, respectively. 2 yr follow-up, rate 81.1% versus 56.1% 43.1% (p < 0.001) for 0.1–<0.2 In analyses, 0.1–0.2 ng/ml (hazard ratio [HR]: 1.9, confidence interval [CI]: 1.1–3.1) ≥0.2 (HR: 3.2, CI: 2.2–4.6, p independently predicted the need additional therapy The main limitation lack control group.ConclusionsFor (PSA predict longer TFS. This insight may help counseling postoperatively well guiding timely selection therapy.Patient summaryWe studied what happened European who using special method called antigen–targeted radioguidance. We found that low soon were less likely further treatment time.