Extent of disease in recurrent prostate cancer determined by [68Ga]PSMA-HBED-CC PET/CT in relation to PSA levels, PSA doubling time and Gleason score

2015 ◽  
Vol 43 (3) ◽  
pp. 397-403 ◽  
Author(s):  
Frederik A. Verburg ◽  
David Pfister ◽  
Axel Heidenreich ◽  
Andreas Vogg ◽  
Natascha I. Drude ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Gleason Score ◽  
Doubling Time ◽  
Recurrent Prostate Cancer ◽  
Psa Doubling Time ◽  
Pet Ct ◽  
Extent Of Disease

PSA doubling time (PSADT) ≤6 months to identify a subgroup of men with biochemically-recurrent prostate cancer (BRPC) after prostatectomy (RP) at highest risk of distant metastasis (dMET).

2016 ◽  
Vol 34 (15_suppl) ◽  
pp. e16587-e16587
Author(s):  
Daniel L. Suzman ◽  
Jennifer Cullen ◽  
Bruce J. Trock ◽  
Yongmei Chen ◽  
Inger L. Rosner ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Distant Metastasis ◽  
Doubling Time ◽  
Recurrent Prostate Cancer ◽  
Psa Doubling Time

PSA and PSA Kinetics as Predictors for 18F-Fluciclovine PET/CT Positivity in Biochemically Recurrent Prostate Cancer

2021 ◽  
pp. 1-8
Author(s):  
Fabio Crocerossa ◽  
Umberto Carbonara ◽  
Jayashree Parekh ◽  
Alfredo Urdaneta ◽  
Samuel Weprin ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Sequential Analysis ◽  
Doubling Time ◽  
Alternative Hypothesis ◽  
Imaging Techniques ◽  
Psa Kinetics ◽  
Psa Doubling Time ◽  
Pet Ct ◽  
Wide Range ◽  
Psa Velocity

<b><i>Introduction:</i></b> <sup>18</sup>F-Fluciclovine PET/CT is one of the imaging techniques currently employed to restage prostate cancer (PCa). Due to the conflicting results reported in the literature, it is not yet known at what PSA threshold <sup>18</sup>F-fluciclovine PET/CT could reliably demonstrate the presence of recurring disease. We explored the association between <sup>18</sup>F-fluciclovine PET/CT positivity and prescan PSA, PSA doubling time, and PSA velocity in patients with biochemical recurrence (BCR) of PCa after curative-intent treatment. <b><i>Methods:</i></b> Data from 59 patients who underwent <sup>18</sup>F-fluciclovine PET/CT for BCR after radical prostatectomy or radiotherapy were retrieved from a single institution database. Patients already undergone salvage treatments at the time of PET/CT, with newly diagnosed PCa or with initial diagnosis of metastatic PCa were excluded. A 2-sided independent samples Bayesian <i>t</i> test and Bayesian Mann-Whitney U test were used to assess the association between PET/CT and prescan PSA, PSA doubling time, and PSA velocity. <b><i>Results:</i></b> Evidence for no difference between PET/CT-positive and -negative patients for log-transformed PSA was found (BF<sub>01</sub> 3.61, % error: 0.01). Robustness check and sequential analysis showed stability across a wide range of prior distribution specifications. The hypothesis of no difference in terms of PSA-dt and for PSA-vel between groups was found to be more likely compared to the alternative hypothesis (BF<sub>01</sub> of 3.44 and 3.48, respectively). <b><i>Conclusion:</i></b> PSA and PSA kinetics are unlikely to be associated with <sup>18</sup>F-fluciclovine PET/CT positivity in patients with BCR, and none of these serum biomarkers might be used as single predictors of PET/CT detection. Larger studies might be needed to evaluate the role of different predictors.

PSA levels, PSA doubling time, Gleason score and prior therapy cannot predict measured uptake of [68Ga]PSMA-HBED-CC lesion uptake in recurrent/metastatic prostate cancer

2017 ◽  
Vol 56 (06) ◽  
pp. 225-232 ◽  
Author(s):  
David Pfister ◽  
Natascha Drude ◽  
Felix Mottaghy ◽  
Florian Behrendt ◽  
Frederik Verburg
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Lymph Node ◽  
Androgen Deprivation Therapy ◽  
Gleason Score ◽  
Doubling Time ◽  
Lesion Size ◽  
Tracer Uptake ◽  
Androgen Deprivation ◽  
Pet Ct

SummaryAim: To assess whether clinical prostate cancer (PCA) related factors and therapy status can predict the degree of tracer uptake on [68Ga]PSMA-HBED-CC PET/CT.Materials & methods: We retrospectively studied 124 patients with recurrent an/or metastatic PCA who underwent [68Ga]PSMAHBED-CC PET/CT. The maximum standardized uptake value (SUVmax) was determined in the prostate bed as well as in three size categories (≤ 5 mm, > 5–15 mm, > 15 mm) in pelvic lymph node, extrapelvic lymph node, bone and visceral metastases.Results: Significant positive correlations between lesion size and SUVmax were found in pelvic lymph node metastases > 5 -≤15 mm (Spearmans rho = 0.502, p = 0.002) as well as in extrapelvic lymph node metastases5 mm (rho = 0.314, p = 0.033) and > 5 ≤-15 mm (rho = 0.614, p < 0.001). SUVmax tended to be higher in the largest diameter category in each anatomic station than in the middle and lower categories. We were unable to find evidence for a relationship between SUVmax and PSA, PSAdt, Gleason score, androgen deprivation therapy, radiation therapy or chemotherapy status.Conclusion: Measured tracer uptake in [68Ga]PSMA-HBED-CC PET/CT in patients with recurrent/metastasized prostate cancer is significantly influenced by lesion size as a result of partial volume effects in the very small lesions. Clinical indicators of aggressive prostate cancer behaviour such as PSA levels, PSA doubling time or the Gleason score of the primary tumour, as well as the androgen deprivation therapy, radiation therapy or chemotherapy status are not related to measured tracer uptake.

scholarly journals Predicting the Outcome of Salvage Radiation Therapy for Recurrent Prostate Cancer After Radical Prostatectomy

2007 ◽  
Vol 25 (15) ◽  
pp. 2035-2041 ◽  
Author(s):  
Andrew J. Stephenson ◽  
Peter T. Scardino ◽  
Michael W. Kattan ◽  
Thomas M. Pisansky ◽  
Kevin M. Slawin ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Radical Prostatectomy ◽  
Doubling Time ◽  
Medical Decision ◽  
Gleason Grade ◽  
Recurrent Prostate Cancer ◽  
Cox Regression Analysis ◽  
Salvage Radiation Therapy ◽  
Psa Doubling Time

Purpose An increasing serum prostate-specific antigen (PSA) level is the initial sign of recurrent prostate cancer among patients treated with radical prostatectomy. Salvage radiation therapy (SRT) may eradicate locally recurrent cancer, but studies to distinguish local from systemic recurrence lack adequate sensitivity and specificity. We developed a nomogram to predict the probability of cancer control at 6 years after SRT for PSA-defined recurrence. Patients and Methods Using multivariable Cox regression analysis, we constructed a model to predict the probability of disease progression after SRT in a multi-institutional cohort of 1,540 patients. Results The 6-year progression-free probability was 32% (95% CI, 28% to 35%) overall. Forty-eight percent (95% CI, 40% to 56%) of patients treated with SRT alone at PSA levels of 0.50 ng/mL or lower were disease free at 6 years, including 41% (95% CI, 31% to 51%) who also had a PSA doubling time of 10 months or less or poorly differentiated (Gleason grade 8 to 10) cancer. Significant variables in the model were PSA level before SRT (P < .001), prostatectomy Gleason grade (P < .001), PSA doubling time (P < .001), surgical margins (P < .001), androgen-deprivation therapy before or during SRT (P < .001), and lymph node metastasis (P = .019). The resultant nomogram was internally validated and had a concordance index of 0.69. Conclusion Nearly half of patients with recurrent prostate cancer after radical prostatectomy have a long-term PSA response to SRT when treatment is administered at the earliest sign of recurrence. The nomogram we developed predicts the outcome of SRT and should prove valuable for medical decision making for patients with a rising PSA level.

scholarly journals Phase II trial of acai juice product in biochemically recurrent prostate cancer.

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 230-230 ◽  
Author(s):  
Elizabeth Riley Kessler ◽  
Lih-Jen Su ◽  
Xiaoping Yang ◽  
Xian Lu ◽  
Diana Morales ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Clinical Trial ◽  
Phase Ii ◽  
Doubling Time ◽  
Recurrent Prostate Cancer ◽  
Psa Doubling Time ◽  
Psa Response ◽  
Psa Velocity ◽  
The One ◽  
Baseline Psa

230 Background: There are conflicting data as to the benefit of treating patients with biochemically recurrent prostate cancer (PCa). Plant derivatives, called “nutraceuticals” such as grape seed extract or milk thistle, have been studied as therapies for PCa based on their purported anti-inflammatory and anti-oxidant properties and low toxicities. Acai is a fruit rich in bioflavinoids shown to induce apoptosis in preclinical studies of PCa, leukemia and esophageal cancer. Anecdotal experience of two patients with falling prostate specific antigen (PSA) values while consuming acai juice prompted us to evaluate its efficacy in a clinical trial. Methods: This was a phase II Simon two-stage open-label single-arm single-institution study of the efficacy of Acai Juice Product in asymptomatic PCa patients with a rising PSA. Eligibility included lack of current hormone therapy, hormone sensitivity, and a PSA doubling time of >4 weeks. Patients consumed 2 oz of Acai Juice Product twice daily for 30 weeks, with a primary endpoint of PSA response. Secondary endpoints included PSA doubling time, PSA velocity, and duration of PSA response. Progression was defined as a rise of 25% from baseline PSA with absolute rise of 2ng/dL. Results: 21 patients were enrolled in the first stage of the trial. Median baseline PSA was 2.74 (range 0.38-36.88). Eighteen patients have completed therapy with 1 PSA response. In the one responder, the patient entered with a doubling time of 4 months and a PSA of 12.57, which was 2.15 at 36 weeks suggesting a prolonged and continued response. PSA either decreased or doubling time prolonged from baseline in 18 patients. PSA velocity was a negative rate of change per month in 4 patients. Conclusions: Acai juice did not produce enough PSA responses in this patient population to proceed beyond the first stage of this trial. However, PSA doubling time did slow in 85.7% of patients, and the one observed PSA response was sustained over at least 36 weeks at the time of data cutoff. Thus, we will analyze potential cellular signals through an M30 Apotosense ELISA assay and Human Cytokine 10-plex panel on patient samples with data available for presentation at the meeting. Clinical trial information: NCT01521949.

Metastatic Prostate Cancer Proven by 18F-FCH PET/CT Staging Scan in Patient With Normal PSA but High PSA Doubling Time

2013 ◽  
Vol 38 (9) ◽  
pp. 739-740 ◽  
Author(s):  
Marina Hodolič ◽  
Anna Margherita Maffione ◽  
Jure Fettich ◽  
Borut Gubina ◽  
Marino Cimitan ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Metastatic Prostate Cancer ◽  
Doubling Time ◽  
Psa Doubling Time ◽  
Pet Ct

Ultrasensitive PSA nadir on testosterone inactivating pharmaceuticals accurately predicts early prostate cancer progression

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 14531-14531 ◽  
Author(s):  
M. C. Scholz ◽  
R. Lam ◽  
B. Guess ◽  
S. Strum ◽  
H. Johnson ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Bone Metastasis ◽  
Gleason Score ◽  
Doubling Time ◽  
Median Response ◽  
Cox Regression Analysis ◽  
Psa Doubling Time ◽  
Tip Resistance ◽  
Early Progression ◽  
Psa Nadir

14531 Background: Prostate cancer has a variable natural history. Researchers and clinicians sorely need a marker identifying men destined for early progression to bone metastasis (EPBM). Prostate cancer is uniquely sensitive to testosterone inactivating pharmaceuticals (TIP) especially when TIP is initiated prior to the onset of bone metastasis. Moul 1 reported 10 year median response in men with a rising PSA after surgery. With such effective therapy, predicting EPBM requires a marker signaling TIP resistance. Elevated PSA nadir is a likely candidate. Methods: Retrospective chart review of 159 men with prostate cancer started on TIP before 1/1/00 with negative bone scan and PSA < 100. The predictive value of Gleason score, initial PSA, PSA doubling-time (DT), clinical stage, and ultra-sensitive PSA nadir were evaluated for their ability to predict EPBM within 72 months of starting TIP. TIP consisted of an antiandrogen and LHRH agonist. Results: Median follow was 9.25 years. Median values for patient age, initial PSA, PSA nadir, and PSA doubling time were 65.9, 9.6, 0.03 and 10 months respectively. Sixty men were staged as: T1c-T3b, 46 PSA relapse, and 53 stages T3c, D0 or D1. Thirty-five men developed EPBM. PSA nadir was the most accurate predictor of EPBM (see Table). Only 8% of men with PSA nadir ≤0.05 had EPBM compared to 78% with high nadirs. Cox regression analysis indicated that PSA nadir, Gleason score, and PSA doubling time < 12 months independently predicted EPBM. Median and maximum time to PSA nadir were 4 and 8 months respectively. Conclusions: Ultra-sensitive PSA nadir is a more accurate indicator of early progression to bone metastasis (90%) than Gleason score (75%) as well as being more sensitive and specific (72% vs. 37%) and (95% vs. 86%) respectively. This prognostic information provided by PSA nadir is obtainable within the first 8 months of starting TIP in virtually all patients (97%). 1. Moul JW et al. J Urol 2005, 171: 1141–7. [Table: see text] No significant financial relationships to disclose.

Risk factors for disease progression after post-prostatectomy salvage radiation: Long-term results of a large institutional experience.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 110-110
Author(s):  
Danielle Rodin ◽  
Lars Wiuff Andersen ◽  
Daniela Buscariollo ◽  
Michael Drumm ◽  
Rebecca Helen Clayman ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Disease Progression ◽  
Gleason Score ◽  
Doubling Time ◽  
Multivariable Analysis ◽  
Specific Antigen ◽  
Long Term Results ◽  
Recurrent Prostate Cancer ◽  
Cox Regression Analysis

110 Background: Salvage radiotherapy (SRT) has been successfully used to treat recurrent prostate cancer following radical prostatectomy (RP). The objective of this study was to identify risk factors for disease progression post-SRT. Methods: Retrospective review of 719 consecutive patients who had RP and received post-operative radiation (adjuvant/SRT) for recurrent prostate cancer from 1992-2013. Disease progression was defined by a prostate specific antigen (PSA) ≥0.2 ng/ml, local recurrence, nodal failure, or distant metastases. Analysis was restricted to patients treated after 2000, when the PSA detectability threshold decreased to 0.2. Univariable and multivariable Cox regression analysis with backwards selection was performed with the following variables: demographics (age, race), pathological features (Gleason score, positive margins, pT-stage), surgery type, radiation details, hormone therapy, and pre-SRT PSA. Secondarily, we included PSA velocity and doubling-time as continuous variables in the model. Results: 384 patients received SRT after 2000, of which 152 had disease progression, with a median time to recurrence of 6.2 years (95% CI 4.1-7.6 years). Multivariable analysis results are reported in the Table. Gleason score, T-stage, seminal vesicle invasion, and pre-SRT PSA were associated with progression. Pre-SRT PSA ≤ 0.3 conferred the lowest rate of disease progression. In a secondary model, PSA kinetics was evaluated in which doubling-time was associated with progression (HR 0.98 per month increase, 95% CI 0.96-1.00; p=0.03). Conclusions: The lowest rate of disease progression was found amongst patients treated with a PSA ≤ 0.3. A shorter DT may also be a useful predictor of disease progression after SRT. [Table: see text]

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