Positron emission tomography/computed tomography (PET/CT) with 68Ga-PSMA-11 is more accurate than 18F-fluciclovine PET/CT at detecting recurrent prostate cancer (PCa) in men with early biochemical recurrence following radical prostatectomy, investigators reported at the American Society of Clinical Oncology annual meeting in Chicago.
Jeremie Calais, MD, of UCLA, and colleagues compared the scanning modalities in 50 consecutive patients with biochemical recurrence (BCR) and PSA levels of ≥0.2 to ≤2.0 ng/mL. All patients underwent PSMA and fluciclovine PET/CT scans within a median time interval of 6 days. Each scan was interpreted by 3 independent blinded expert readers not involved in study and data acquisition.
Detection rates were significantly lower with fluciclovine than PSMA PET/CT per-patient (26% vs 56%; P = 0.003), per-region for pelvic nodes (8% vs 30%; P = 0.003), and any extra-pelvic lesions (0% vs 16%; P = 0.008), Dr Calais and his collaborators reported in a poster presentation. In addition, reader agreement for PSMA PET/CT image interpretations was significantly higher than for fluciclovine PET/CT (0.67 vs 0.20; P = 0.015).
The main explanation behind these results is a much higher tumor-to-background PET signal ratio with PSMA than with fluciclovine, the investigators stated.
PSMA should be the PET agent of choice when PET/CT imaging is considered for the management of patients with biochemical recurrence of PCa at low PSA levels (≤2.0 ng/mL) following radical prostatectomy, according to the investigators. PSMA PET/CT should become the standard of care for these patients, they concluded.
Calais J, Ceci F, Eiber M, et al. Prospective head-to-head comparative phase 3 study between 18F-fluciclovine 68Ga-PSMA-11 PET/CT in patients with early biochemical recurrence of prostate cancer. Presented at the 2019 American Society of Clinical Oncology annual meeting in Chicago, May 31 to June 4. Abstract 5014.
This article originally appeared on Renal and Urology News