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Purpose: to assess the utility of response monitoring to enzalutamide by using [Ga]Ga-PSMA PET in mCRPC patients treated with enzalutamide as first-line therapy.
Methods: patients underwent [Ga]Ga-PSMA PET less than 8 weeks before and 3 months after starting enzalutamide. On the basis of EAU/EANM criteria, patients were categorized as PSMA responders (PET-R) or PSMA non-responders (PET-NR), whilst, based on PSA, they were classified as biochemical responders (PSA-R) or non-responders (PSA-NR). Survival analysis was performed using the Cox regression hazard model and the Kaplan-Meier method.
Results: 69 patients were considered fully evaluable. We observed 47.8% of concordance between [68Ga]Ga-PSMA PET and PSA monitoring at 3 months after starting enzalutamide. For discordant cases, the PSA reduction has a weak impact on PFS and a significant impact on OS in PET-NR patients, whilst this change has no impact either for PFS and OS in PET-R ones.
Conclusions: [Ga]Ga-PSMA PET could be a useful imaging tool for monitoring response to enzalutamide in mCRPC patients, being more informative than PSA in this setting, and possibly better guiding clinicians in therapeutic decisions.
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http://dx.doi.org/10.1007/s00259-024-06887-4 | DOI Listing |
J Urol
September 2025
Department of Urology, Austin Health, Melbourne, Victoria, Australia.
Purpose: Prostate-specific membrane antigen positron emission tomography (PSMA PET) is increasingly used to diagnose and stage prostate cancer. A PRIMARY score uses anatomical localization and uptake patterns to improve diagnostic accuracy. We evaluated the histopathology of patients with no uptake pattern (PRIMARY score 1) and the prevalence of intraductal carcinoma of the prostate (IDC-P) in this subset compared with those with an uptake pattern (PRIMARY score ≥ 2).
View Article and Find Full Text PDFRev Esp Med Nucl Imagen Mol (Engl Ed)
September 2025
Department of Biostatistics, Gaziantep University, Gaziantep, Turkey.
Objective: This study aimed to assess the predictive value of metastatic distribution patterns on Ga-PSMA-11 PET/CT in patients with chemotherapy- and castration-resistant prostate cancer undergoing ¹⁷⁷Lu-PSMA-617 radioligand therapy.
Materials And Methods: A retrospective analysis was conducted on 48 patients who received ¹⁷⁷Lu-PSMA-617 therapy between April 2019 and August 2023. Demographic, clinical, and laboratory data, along with pre- and post-treatment Ga-PSMA-11 PET/CT images, were evaluated for associations with molecular response and progression.
J Med Chem
September 2025
State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100050, China.
We designed and synthesized a novel type of PSMA radioligand incorporating (2, 3) β-branched aromatic α-amino acids within the linker segment of its structure. PET/CT imaging and biodistribution analysis revealed that β-branched aromatic α-amino acids modified PSMA radioligands could maintain or even improve tumor targeting while exhibiting a more rapid renal clearance rate than [Ga]Ga-. With average renal uptake of less than 10%ID/g, as opposed to 25%ID/g for [Ga]Ga-, this substantial decrease in renal accumulation translates to a significantly improved safety profile by minimizing nephrotoxic risks.
View Article and Find Full Text PDFMol Imaging Biol
September 2025
Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA.
Purpose: While PSMA-targeted radioligand therapy (RLT) has shown remarkable efficacy for treating end-stage prostate cancer, the α-emitting RLT often results in severe salivary gland toxicity, limiting its use. Various strategies to mitigate this side effect have been attempted with limited success. Accordingly, this study introduced a new PSMA-targeting ligand with more favorable binding characteristics than the existing ligands.
View Article and Find Full Text PDFEJNMMI Res
August 2025
Department of Nuclear Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Background: Body composition (BC) analysis is performed to quantify the relative amounts of different body tissues as a measure of physical fitness and tumor cachexia. We hypothesized that relative changes in body composition (BC) parameters, assessed by an artificial intelligence-based, PACS-integrated software, between baseline imaging before the start of radioligand therapy (RLT) and interim staging after two RLT cycles could predict overall survival (OS) in patients with metastatic castration-resistant prostate cancer.
Methods: We conducted a single-center, retrospective analysis of 92 patients with mCRPC undergoing [Lu]Lu-PSMA RLT between September 2015 and December 2023.