PSMA PET total tumor volume predicts outcome of patients with advanced prostate cancer receiving [177Lu]Lu-PSMA-617 radioligand therapy in a bicentric analysis
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Abstract Introduction [ 177 Lu]Lu-PSMA-617 (Lu-PSMA) radioligand therapy is an emerging treatment option for patients with end-stage prostate cancer. However, response to Lu-PSMA therapy is only achieved in approximately half of patients. It is clinically important to identify patients at risk of poor outcome. Therefore, the aim of this study was to evaluate pretherapeutic PSMA PET derived total tumor volume and related metrics as prognosticators of overall survival in patients receiving Lu-PSMA therapy. Methods A total number of 110 patients form the Departments of Nuclear Medicine Münster and Essen were included in this retrospective analysis. Baseline PSMA PET-CT was available for all patients. Employing a previously published approach, all tumor lesions were semi-automatically delineated in PSMA PET-CT acquisitions. Total lesion number, total tumor volume (PSMA-TV), total lesion uptake (PSMA-TLU = PSMA-TV * SUV mean ), and total lesion quotient (PSMA-TLQ = PSMA-TV / SUV mean) were quantified for each patient. Log2 transformation was used for regressions. Results Lesion number, PSMA-TV, and PSMA-TLQ were prognosticators of overall survival (HR = 1.255, p = 0.009; HR = 1.299, p = 0.005; HR = 1.326, p = 0.002). In a stepwise backward Cox regression including lesion number, PSMA-TV, PSA, LDH, and PSMA-TLQ, only the latter two remained independent and statistically significant negative prognosticators of overall survival (HR = 1.632, p = 0.011; HR = 1.239, p = 0.024). PSMA-TLQ and LDH were significant negative prognosticators in multivariate Cox regression in contrast to PSA value. Conclusion PSMA-TV was a statistically significant negative prognosticator of overall survival in patients receiving Lu-PSMA therapy. PSMA-TLQ was an independent and superior prognosticator of overall survival compared with PSMA-TV.
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Initial results show a prognostic value of PSMA-PET tumor volume in prostate cancer prior to radioligand therapy with [177Lu]Lu-PSMA-617.
“Initial results also show a prognostic value of PSMA-PET tumor volume in prostate cancer prior to radioligand therapy with [177Lu]Lu-PSMA-617 [204].”
From Influences on PET Quantification and Interpretation (2022) · cites this paper as [204]
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- Authors
- Seifert, R., Kessel, K., Schlack, K., Weber, M., Herrmann, K., Spanke, M., Fendler, W. P., Hadaschik, B., Kleesiek, J., Schäfers, M., Weckesser, M., Boegemann, M., & Rahbar, K.
- Affiliations
- University Hospital Münster (DE)
- Essen University Hospital (DE)
- German Cancer Research Center (DE)
- Corresponding author
- Rahbar, Kambiz
- ORCID
- Venue
- European Journal of Nuclear Medicine and Molecular Imaging
- Published
- 2020-09-24
- Volume
- 48
- Issue
- 4
- Pages
- 1200-1210
- ISSN
- 1619-7070 (ISSN-L)
- 1619-7089
- PMC
- PMC8041668
- OpenAlex
- W3088497176
- Cited by
- 160
- References
- 26
- Citations by year
- 2026: 31 · 2025: 31 · 2024: 25 · 2023: 26 · 2022: 20 · 2021: 24 · 2020: 2
- FWCI
- 8.77
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- European Journal of Nuclear Medicine and Molecular Imaging (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Informationszentrum Lebenswissenschaften (ZB MED) (submittedVersion, cc-by)
- Universitätsbibliographie, Universität Duisburg-Essen (submittedVersion)
- Funders
- Westfälische Wilhelms-Universität Münster
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiopharmaceutical Chemistry and Applications
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Prostate Cancer Diagnosis and Treatment
- Keywords
- 177Lu-PSMA-617, radioligand therapy, advanced prostate cancer, PSMA PET/CT, total tumor volume, prognostic factors, overall survival, PSMA-617, PSMA-11, tumor volume measurement
- MeSH terms
- Positron Emission Tomography Computed Tomography, Dipeptides, Heterocyclic Compounds, 1-Ring, Humans, Male, Retrospective Studies, Treatment Outcome, Prostate-Specific Antigen, Tumor Burden, Prostatic Neoplasms, Castration-Resistant
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