Updated prostate cancer risk groups by PSMA-PET PROMISE (PPP2): Results from an international multi-centre registry study.

• DOI: 10.1200/jco.2025.43.16_suppl.5045
• Publication Date: 2025-05-28T15:57:16Z
• Authors: Wolfgang Peter Fe...; Madeleine J. Karp...; Sebastian Hoberück; Isabel Rauscher; Lena Unterrainer; Sazan Rasul; Anders Bjartell; Francesco Lanfranchi; Andrea Di Giorgio; Christian Helmut ...; Timo Soeterik; Karolien Goffin; Felix Kind; Jonathan Miksch; Jeremie Calais; Michael S. Hofman; Thomas A. Hope; Ken Herrmann; Boris A. Hadaschik; Kambiz Rahbar

5045 Background: We previously established prognostic two-tier risk nomograms based on PSMA-PET and Prostate Cancer Molecular Imaging Standardized Evaluation (PROMISE) criteria in a large single-centre cohort. Here, we validate three-tier stratification by PROMISE (PPP2) international multi-centre registry study for prostate cancer survival. Methods: included patients who underwent at 20 hospitals EU, USA or Australia between 2013 2022. was standardized version 2 (V2). Total lesion count, total tumour volume, PSMA expression score, overall survival follow-up were obtained. Investigator sites split 2:1 into development validation cohorts, considering site characteristics. In the cohort assessed PPP predictors created visual quantitative Cox regression models with least absolute shrinkage selection operator penalty Performance of both measured using Harrell´s C-index calibration plots. Head-to-head comparison to National Comprehensive Network (NCCN) score examined ROC-curves. Results: analyzed 6128 male (4044 2084 cohorts) across all disease stages 1915 (31·2%) reported deaths median 4·8 years (IQR 3·4-6·4). Predictors PPP2 nomogram presence distant metastases (extrapelvic nodal [M1a], bone [M1b; oligometastatic, disseminated diffuse marrow involvement], visceral [M1c]), count. reassessed (M1a, M1b, M1c), score. C-indices (95% CI) 0·80 (0·78-0·82) (0·79-0·82) nomogram, respectively. (high, intermediate, low risk), accuracy superior when compared NCCN (n=1034, AUC 0·84 vs. 0·76; p<0·0001, respectively). independent from radiopharmaceutical (68Ga 18F) (V1 V2; n=2084, visual: 0·79, respectively, p=0·11; quantitative: p=0·56). Conclusions: improved an accurately stratify high intermediate cancer. yields Follow-up continues Registry (NCT06320223, promise-pet.org).