Retrospective analysis of PSMA PET/CT thyroid incidental uptake in adults: incidence, diagnosis, and treatment/outcome in a tertiary cancer referral center and University Medical Center

5548 Background: The aim of this international multicenter retrospective analysis was to identify prognostic markers for the clinical outcome in late-stage mCRPC patients treated with 177Lutetium-prostate-specific membrane antigen (LuPSMA) radionuclide treatment. Methods: Patients with progressive mCRPC treated with LuPSMA at six centers in Germany, USA, and Australia were considered for inclusion. Eligible patients had 24 predefined, pretherapeutic covariates (demographics, prior mCRPC treatments, and PSMA PET/CT derived parameters) and survival data available. Endpoints included overall survival (OS) and PSA progression-free survival (PSA-PFS). Covariates were tested using univariate and mulitvariate proportional hazards regression Cox models. Results: 267/414 (64%) patients met inclusion criteria and were analyzed. 113 patients participated in clinical trials (ACTRN12615000912583, NCT03042312), while 154 were enrolled in compassionate-access programs. After a median follow-up of 22.5 months, median OS was 13.0 months (95%CI 11.6-14.4); 83% of the patients died. Median PSA-PFS was 4.0 months (95%CI 3.2-4.7). In the multivariate analysis, factors associated with shorter OS were: shorter time since diagnosis of prostate cancer (HR=2.04; p=0.002), lower number of prior systemic therapies (≤3; HR=1.56; p=0.006), prior exposure to chemotherapy (HR=1.42; p=0.05), lower hemoglobin levels (HR=1.13; p=0.002), higher number of lesions (≥20: HR=1.53; p=0.009), multiple sites of metastases (bone/LN only vs. bone + LN; HR=1.39; p=0.03) and visceral involvement (M1c) (HR=1.45; p=0.01). Factors associated with longer PSA-PFS were: longer time since diagnosis of prostate cancer (HR=0.44; p<0.001), higher hemoglobin levels (HR=0.32; p=0.03), presence of pelvic lymph nodes (LN) metastasis (N1) (HR=0.68; p=0.01), no distant lymph node metastases (M1a) (HR=0.66; p=0.01), no skeleton involvement (HR=0.44; p=0.01), no visceral metastases (M1c) (HR=0.51; p<0.001), higher PSMA-positive tumor volume (HR=0.87; p=0.04), and higher SUVmean (HR=0.94; p=0.002). Conclusions: This retrospective analysis identified prognostic factors for survival and treatment response to LuPSMA. Along with the conventional risk factors in mCRPC, PSMA PET/CT can be a useful tool for stratifying patients and guide patient’s selection for LuPSMA radionuclide treatment.

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Anamnestic similarities in bulimic inpatients with and without a history of anorexia nervosa

Psychiatry and Psychobiology ◽

10.1017/s0767399x00002947 ◽

1989 ◽

Vol 4 (2) ◽

pp. 107-110

Author(s):

S. Bossert ◽

R. Laessle ◽

M. Junker

Keyword(s):

Body Weight ◽

Anorexia Nervosa ◽

Treatment Outcome ◽

Family History ◽

Retrospective Analysis ◽

Medical Records ◽

Diagnosis And Treatment ◽

Lower Body ◽

Lower Body Weight ◽

History Of

SummaryThe significance of a history of anorexia nervosa as regards the diagnosis and treatment outcome for bulimia is unclear. In a retrospective analysis of medical records of 59 inpatients with bulimia (DSM-III), variables related to personal and psychiatric family history did not reveal any differences in bulimics subtyped according to previous anorexia nervosa as defined in the criteria of Russell (1979). These anamnestic data support the results of studies indicating that no specific clinical and outcome variables are correlated with a history of anorexia nervosa in bulimia. The lower body weight and longer duration of bulimia found in bulimic inpatients with a history of anorexia nervosa, however, should be further examined.

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Impact of 68Ga-PSMA PET/CT on the Radiotherapeutic Approach to Prostate Cancer in Comparison to CT: A Retrospective Analysis

Journal of Nuclear Medicine ◽

10.2967/jnumed.118.220855 ◽

2018 ◽

Vol 60 (7) ◽

pp. 963-970 ◽

Cited By ~ 17

Author(s):

Nina-Sophie Schmidt-Hegemann ◽

Chukwuka Eze ◽

Minglun Li ◽

Paul Rogowski ◽

Christian Schaefer ◽

...

Keyword(s):

Prostate Cancer ◽

Retrospective Analysis ◽

Psma Pet ◽

Pet Ct

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68Ga-PSMA PET/CT for Recurrent Prostate Cancer after Radical Prostatectomy: What’s next? Analysis from a single, high volume tertiary referral center

European Urology ◽

10.1016/s0302-2838(21)01544-x ◽

2021 ◽

Vol 79 ◽

pp. S1654

Author(s):

D. Robesti ◽

G. Gandaglia ◽

N. Fossati ◽

A. Stabile ◽

E. Mazzone ◽

...

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

High Volume ◽

Recurrent Prostate Cancer ◽

Tertiary Referral ◽

Tertiary Referral Center ◽

Referral Center ◽

Psma Pet ◽

Pet Ct

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Comparison of recurrence patterns after surgery and radiation therapy with 68Ga-PSMA-11 PET/CT in nonmetastatic castrate-sensitive prostate cancer patients: A single-center post-hoc retrospective analysis in 787 patients.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.3577 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. 3577-3577

Author(s):

Wesley R Armstrong ◽

Pan Thin ◽

Kathleen Nguyen ◽

Rejah M. Alano ◽

Kiara M Booker ◽

...

Keyword(s):

Prostate Cancer ◽

Radiation Therapy ◽

Lymph Node ◽

Retrospective Analysis ◽

Recurrent Disease ◽

Psma Pet ◽

Pet Ct ◽

Definitive Therapy ◽

Recurrence Patterns ◽

Post Hoc

3577 Background: 20 to 50% of prostate cancer (PCa) patients undergoing radical prostatectomy (RP) or definitive radiation therapy (dRT) will experience disease recurrence. However, anatomical recurrence patterns may differ depending on the therapeutic approaches. The aim of this post-hoc retrospective analysis was to investigate if the relapse pattern as assessed by 68Ga-PSMA-11 PET/CT was different depending on the type of local pelvic therapy (RP, dRT, salvage RT (SRT), pelvic lymph node dissection (PLND), pelvic lymph node RT (PLNRT)) in patients with non-metastatic castrate sensitive (nmCS) recurrent disease after primary definitive therapy. Methods: Patients who underwent a 68Ga-PSMA-11 PET/CT for nmCS PCa recurrent disease after primary definitive therapy were screened from a database of 4 prospective studies (NCT02940262, NCT03515577, NCT04050215, NCT03582774). Patients who underwent primary staging (n = 95), without definitive therapy (n = 68), with known metastatic disease (M1) (n = 68) or with castrate resistant (CR) disease (n = 291) were excluded. We examined the relationship between recurrence patterns as assessed by 68Ga-PSMA-11 PET/CT (PROMISE criteria) and prior local treatments: i) RP, ii) dRT, iii) RP + SRT. Results: 787 patients were included in the analysis. Positive scan rates were 60%, 94% and 75% in RP, dRT and RP + SRT populations, respectively. Median pre-scan PSA levels were 0.50 (0.02-72.5) ng/ml, 4.4 (0.1-202) ng/ml, and 1.07 (0.04-33) ng/ml for patients who underwent RP (n = 464), dRT (n = 109) and post-RP SRT (n = 214). Median time to first recurrence was 27.7 after RP and 54.6 months after dRT (p = < 0.0001). Patients who underwent RP had lower local recurrence (LR) pattern (T+) rates by PSMA PET than those with dRT (99/464; 21% vs 69/109; 63%; p = < 0.0001). Nodal metastasis (N1) positivity rate was similar between RP and dRT (179/464; 39% vs 43/109; 39%; p = 0.87). Extrapelvic metastasis (M1) positivity rate was lower for RP than dRT (93/464; 20% vs 51/109; 47%; p = < 0.0001). Median time from post-RP SRT to second recurrence was 22.3 months. In patients who had a second recurrence after RP and SRT the positivity rate of LR (T+), N1 disease and M1 disease by PSMA PET/CT was 12% (24/214), 46% (99/214) and 44% (95/214). Conclusions: In this cohort of patients with nmCS PCa recurrent disease after primary definitive therapy, the patterns of failure differ based on prior local treatments.

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Experience on the diagnosis and treatment of multiple active primary cancers in our Institution.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e15097 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e15097-e15097

Author(s):

Shiyu Jiang ◽

Xin Liu ◽

Xiaowei Zhang ◽

Zhiguo Luo ◽

Silong Hu ◽

...

Keyword(s):

Breast Cancer ◽

Lung Cancer ◽

Multidisciplinary Team ◽

Primary Tumor ◽

Brca2 Mutation ◽

Diagnosis And Treatment ◽

Multiple Primary Cancers ◽

Psma Pet ◽

Pet Ct ◽

Multiple Primary

e15097 Background: Multiple active primary cancers (MAPC) deal with synchronous multiple primary cancers and heterochronous multiple primary cancers needing concurrent treatment for each primary. There are no standards in the diagnosis and treatment of MAPC. Here, we report our experiences with MAPC cases. Methods: Overall, 31 patients with MAPC between Apr 2017 and Dec 2020 were included. All of them had received treatment for their MAPC, either local intervention or systemic treatment. Results: Of the 31 MAPC, 5 cases having triple and 26 having double primary neoplasms. The most common primary sites were breast (n = 20) and lung (n = 13). The contribution of each diagnostic approach in the establishment of MAPC diagnosis were as follows: atypical metastatic spread, lymphatic or vascular; lesions in other organ sites indicating suspected primary tumor by imaging (11/26) and PET-CT (5/17); atypical increase of tumor marker panel (3/24) or clinical manifestations (7/31) not parallel or specific to the prior documented primary tumor; and patients with genetic predisposition (one germline BRCA2 mutation and one TP53 mutation). If biopsy was not available, utilization of other optimal imaging techniques, such as FES- and PSMA-PET-CT could be helpful in selected patients. Treatment decisions of patients with MAPC should be made with joint effort of the multidisciplinary team. Radical surgery or radiotherapy (17/31) was done in the setting when any primary cancer was considered localized. The severity of each primary malignance (aggressiveness, symptom, staging and etc.) was also evaluated, and the predominant primary tumor was handled with priority. Systemic therapy was administered in consideration of each active cancer, and any new drug combinations should be evaluated for drug interactions. Unexpectedly, use of palbociclib in a patient with breast cancer and chronic lymphoblastic leukemia might aggravate the leukemia, because one week of palbociclib plus letrozole led to a sharp WBC increase with a lymphocyte predominance and quickly reduced to the baseline after drug discontinuation. Notably, NGS in circulating tumor DNA was also useful since it might indicate a common treatment strategy for MAPC and a hint to the predominant cancer. Six MAPC patients including 1 ROS-1 rearranged lung cancer, 4 EGFR mutant lung cancer, and 2 HER2 positive breast cancer were treated with corresponding targeted agents (crizotinib, gefitinib and lapatinib). Four responses (1 CR and 3 PR) and 2 stable disease (PFS 33+ and 132 months) were observed. Three of the four responders had a PFS of 1+, 29+ and 27 months, whereas Case 13 who had multiple combinations of EGFR-TKI, chemotherapy and anti-HER2 treatment for her simultaneously advanced breast and lung cancers, was alive at 66 months. Conclusions: The diagnosis and treatment of MAPC has no standards and should integrate all available resources by a specific multidisciplinary team.

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Vergleich von Tc-99 m-PSMA I&S SPECT/CT und Ga-68-PSMA PET/CT vor Gammasonden-gesteuerter Operation bei Prostatakarzinomrezidiv

10.1055/s-0037-1682220 ◽

2019 ◽

Author(s):

F Stolzenbach ◽

M Sauer ◽

Y Kobayashi ◽

R Buchert ◽

J Mester ◽

...

Keyword(s):

Psma Pet ◽

Pet Ct

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