Progression-free and overall survival in metastatic castration-resistant prostate cancer treated with abiraterone acetate can be predicted with serial C11-acetate PET/CT
Progression-free and overall survival in metastatic castration-resistant prostate cancer treated with abiraterone acetate can be predicted with serial C11-acetate PET/CT
Jacob Farnebo, MDa,∗ , Agnes Wadelius, MDb , Per Sandström, MD, PhDb , Sten Nilsson, MD, PhDb , Hans Jacobsson, MD, PhDa , Lennart Blomqvist, MD, PhDa , Anders Ullén, MD, PhDb
Abstract In this retrospective study, we evaluated the benefit of repeated carbon 11 (C11)-acetate positron emission tomography/computed tomography (PET/CT) to assess response in patients with metastatic castration-resistant prostate cancer (mCRPC) treated with abiraterone acetate (AA). A total of 30 patients with mCRPC were monitored with C11-acetate PET/CT and PSA levels during their treatment with AA. Retrospective evaluation of their response was made after 102 days (median; range 70–155) of treatment. Statistical analyses were employed to detect predictors of progression-free survival (PFS) and overall survival (OS), and potential correlation between serum levels of PSA, standardized uptake values (SUVpeak), and bone lesion index measured from PET were investigated. At follow-up 10 patients exhibited partial response (PR), 10 progressive disease (PD), and 10 stable disease (SD), as assessed by PET/CT. In survival analysis, both PR and PD were significantly associated with PFS and OS. CT response was also associated with OS, but only 19/30 patients demonstrated a lesion meeting target lesion criteria according to RECIST 1.1. No PET/CT baseline characteristic was significantly associated with PFS or OS. A PSA response (reduction in the level by >50%) could also predict PFS and OS. In the subgroup lacking a PSA response, those with PD had significantly shorter OS than those with PR or SD. PFS and OS in patients with mCRPC treated with AA can be predicted from repeated C11-acetate PET/CT. This may be of particular clinical value in patients who do not exhibit a PSA response to treatment. Abbreviations: AA = abiraterone acetate, ADT = androgen deprivation treatment, ALP = alkaline phosphatase, C11 = carbon 11, CI = confidence interval, CRPC = castration-resistant prostate cancer, CT = computed tomography, FASN = fatty acid synthase, HR = hazard ratio, HU = hounsfield unit, kV = kilovolt, MBq = mega Becquerel, mCi = millicurie, MRI = magnetic resonance imaging, OS = overall survival, PD = progressive disease, PET/CT = positron emission tomography, PFS = progression free survival, PR = partial response, PSA = prostate-specific antigen, RECIST = response evaluation criteria in solid tumors, SD = stable disease, SUV = standardized uptake value. Keywords: abiraterone acetate, C11-acetate PET/CT, metastatic castration-resistant prostate cancer
Jacob Farnebo, MDa,∗ , Agnes Wadelius, MDb , Per Sandström, MD, PhDb , Sten Nilsson, MD, PhDb , Hans Jacobsson, MD, PhDa , Lennart Blomqvist, MD, PhDa , Anders Ullén, MD, PhDb
Abstract In this retrospective study, we evaluated the benefit of repeated carbon 11 (C11)-acetate positron emission tomography/computed tomography (PET/CT) to assess response in patients with metastatic castration-resistant prostate cancer (mCRPC) treated with abiraterone acetate (AA). A total of 30 patients with mCRPC were monitored with C11-acetate PET/CT and PSA levels during their treatment with AA. Retrospective evaluation of their response was made after 102 days (median; range 70–155) of treatment. Statistical analyses were employed to detect predictors of progression-free survival (PFS) and overall survival (OS), and potential correlation between serum levels of PSA, standardized uptake values (SUVpeak), and bone lesion index measured from PET were investigated. At follow-up 10 patients exhibited partial response (PR), 10 progressive disease (PD), and 10 stable disease (SD), as assessed by PET/CT. In survival analysis, both PR and PD were significantly associated with PFS and OS. CT response was also associated with OS, but only 19/30 patients demonstrated a lesion meeting target lesion criteria according to RECIST 1.1. No PET/CT baseline characteristic was significantly associated with PFS or OS. A PSA response (reduction in the level by >50%) could also predict PFS and OS. In the subgroup lacking a PSA response, those with PD had significantly shorter OS than those with PR or SD. PFS and OS in patients with mCRPC treated with AA can be predicted from repeated C11-acetate PET/CT. This may be of particular clinical value in patients who do not exhibit a PSA response to treatment. Abbreviations: AA = abiraterone acetate, ADT = androgen deprivation treatment, ALP = alkaline phosphatase, C11 = carbon 11, CI = confidence interval, CRPC = castration-resistant prostate cancer, CT = computed tomography, FASN = fatty acid synthase, HR = hazard ratio, HU = hounsfield unit, kV = kilovolt, MBq = mega Becquerel, mCi = millicurie, MRI = magnetic resonance imaging, OS = overall survival, PD = progressive disease, PET/CT = positron emission tomography, PFS = progression free survival, PR = partial response, PSA = prostate-specific antigen, RECIST = response evaluation criteria in solid tumors, SD = stable disease, SUV = standardized uptake value. Keywords: abiraterone acetate, C11-acetate PET/CT, metastatic castration-resistant prostate cancer
Comentários
Postar um comentário