Pd16-04 differential treatment response of prostate and metastatic lesions in patients with newly diagnosed metastatic prostate cancer

You have accessJournal of UrologyCME1 Apr 2023PD16-04 DIFFERENTIAL TREATMENT RESPONSE OF PROSTATE AND METASTATIC LESIONS IN PATIENTS WITH NEWLY DIAGNOSED METASTATIC PROSTATE CANCER Baris Esen, Hulya Seymen, Okan Falay, Kayhan Tarim, Mert Kilic, Sevil Bavbek, Yakup Kordan, Derya Tilki, Tarik Esen, and Mehmet Onur Demirkol Baris EsenBaris Esen More articles by this author , Hulya SeymenHulya Seymen More articles by this author , Okan FalayOkan Falay More articles by this author , Kayhan TarimKayhan Tarim More articles by this author , Mert KilicMert Kilic More articles by this author , Sevil BavbekSevil Bavbek More articles by this author , Yakup KordanYakup Kordan More articles by this author , Derya TilkiDerya Tilki More articles by this author , Tarik EsenTarik Esen More articles by this author , and Mehmet Onur DemirkolMehmet Onur Demirkol More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003271.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: We aimed to evaluate the response of primary tumor to systemic treatment in patients with newly diagnosed mPCa with serial PSMA PET/CT scans. METHODS: A total of 43 patients with newly diagnosed mPCa who had significant prostatic PSMA uptake at baseline PSMA PET/CT (bPSMA) and underwent at least one follow-up PSMA PET/CT (fPSMA) after receiving systemic treatment were included in the study. Those who received any definitive treatment at localized stage and those who underwent radiotherapy to prostate before fPSMA were excluded. Prostatic and metastatic PSMA responses after systemic treatment were categorized as complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD) as recommended by guidelines. Discordant behavior between prostate and metastases was defined as the condition when metastatic lesions are responding (CR or PR) to systemic treatment while prostate had progressed or vice versa. CHAARTED criteria was applied to categorize patients according to the volume of metastatic disease. RESULTS: The mean age of patients at bPSMA was 67.7±8.5 years. The median PSA at bPSMA was 31.7 ng/dL (IQR: 11.3 – 106.0). Patient characteristics and treatments were summarized in Table 1. The median time interval between bPSMA and the first fPSMA was 5.7 months (IQR: 4.6 – 7.5). Nine patients (20.9%) had CR, 25 (58.1%) had PR, 5 (11.6%) had SD and 4 (9.3%) had PD at prostate following systemic treatment. Patients with low-volume disease had prostatic CR twice more commonly than those with high-volume disease (27.3% vs 14.3%). In 6 (13%) cases, a significant PSMA uptake at prostate was detected despite a complete response of all metastatic sites. Discordant treatment responses at the prostate and metastatic sites were observed in 6 out of 43 (16%) patients. CONCLUSIONS: Discordant behavior between prostate and metastases are not rare in mPCa. Almost one-fourth of patients with low-volume mPCa achieved a complete prostatic response with systemic treatment only. Prostatic response on PSMA PET/CT following systemic treatment can be used to select ideal patients for the treatment of the primary tumor in patients with mPCa. Source of Funding: Baris Esen is supported by European Urological Scholarship Programme through a 1-year research scholarship © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e490 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Baris Esen More articles by this author Hulya Seymen More articles by this author Okan Falay More articles by this author Kayhan Tarim More articles by this author Mert Kilic More articles by this author Sevil Bavbek More articles by this author Yakup Kordan More articles by this author Derya Tilki More articles by this author Tarik Esen More articles by this author Mehmet Onur Demirkol More articles by this author Expand All Advertisement PDF downloadLoading ...