{"doi":"10.1016/j.adro.2024.101507","title":"Prostate-Specific Membrane Antigen PET Response Associates with Metastasis-Free Survival After Stereotactic Ablative Radiation in Oligometastatic Prostate Cancer","abstract":"PurposeEmerging data suggest metastasis-directed therapy (MDT) improves outcomes in patients with oligometastatic castration-sensitive prostate cancer (omCSPC). Prostate-specific membrane antigen positron emission tomography (PSMA-PET) can detect occult metastatic disease and has been proposed as a biomarker for treatment response. Herein we identify and validate a PSMA-PET biomarker for metastasis-free survival (MFS) following MDT in omCSPC.Methods and materialsWe performed an international multi-institutional retrospective study of patients with omCSPC, defined as ≤3 lesions, treated with metastasis-directed stereotactic ablative radiation therapy who underwent PSMA-PET/CT prior to and after (median 6.2 months, range 2.4-10.9 months) treatment. Pre- and post-MDT PSMA-PET/CT SUVmax was measured for all lesions and PSMA response was defined as percent change in SUVmax of the least responsive lesion. PSMA response was evaluated as both a continuous variable and dichotomized as PSMA responders with a complete/partial response (at least 30% reduction in SUVmax) and PSMA non-responders with stable/progressive disease (less than a 30% reduction in SUVmax). PSMA response was correlated conventional imaging defined metastasis-free survival (MFS) with Kaplan-Meier and cox regression.ResultsA total of 131 patients with 261 treated metastases were included in the analysis, with median follow-up of 29 months (IQR 18.5-41.3). Following SABR, 70.2% of patients were classified as PSMA responders. Multivariable analysis demonstrated PSMA response as a continuous variable was associated with significantly worse MFS (HR=1.003, 95%CI 1.001-1.006; p=0.016). Patients classified as PSMA responders were found to have significantly improved median MFS of 39.9 vs 12 months (p=0.001) compared to PSMA non-responders. Our study is limited as it is a retrospective review of a heterogenous population.ConclusionsFollowing SABR, PSMA-PET response appears to be a radiographic biomarker that correlates with MFS in omCSPC. This approach holds promise for guiding clinical management of omCSPC and should be validated in a prospective setting.","journal":"Advances in Radiation Oncology","year":2024,"id":444479,"datarank":0.31191623125197543,"base_score":2.0794415416798357,"endowment":2.0794415416798357,"self_citation_contribution":0.31191623125197543,"citation_network_contribution":0.0,"self_endowment_contribution":0.31191623125197543,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":7,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9593,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":483254,"name":"Matthew P. Deek","orcid":"0000-0002-5949-5058","position":1,"is_corresponding":false},{"id":715416,"name":"Rebecca A. Deek","orcid":"0000-0002-8783-4694","position":2,"is_corresponding":false},{"id":1228569,"name":"Ozan Cem Güler","orcid":"0000-0001-6908-3412","position":3,"is_corresponding":false},{"id":782425,"name":"Pervin Hürmüz","orcid":"0000-0003-1221-9192","position":4,"is_corresponding":false},{"id":1228571,"name":"Mehmet Reyhan","orcid":"0000-0001-8550-3368","position":5,"is_corresponding":false},{"id":267038,"name":"Steven P. Rowe","orcid":"0000-0003-2897-4694","position":6,"is_corresponding":false},{"id":483257,"name":"Noura Radwan","orcid":"0000-0002-3511-0125","position":7,"is_corresponding":false},{"id":484029,"name":"Shirl Dipasquale","orcid":null,"position":8,"is_corresponding":false},{"id":1229637,"name":"William T. Hrinivich","orcid":"0000-0002-0048-9411","position":9,"is_corresponding":false},{"id":1260387,"name":"Kathryn Lowe","orcid":null,"position":10,"is_corresponding":false},{"id":1058496,"name":"Lei Ren","orcid":"0000-0003-3021-7246","position":11,"is_corresponding":false},{"id":263636,"name":"Biren Saraiya","orcid":"0000-0002-3522-4579","position":12,"is_corresponding":false},{"id":420685,"name":"Ronald D. Ennis","orcid":"0000-0002-0871-8258","position":13,"is_corresponding":false},{"id":707611,"name":"Michael R. Folkert","orcid":"0000-0003-3062-9793","position":14,"is_corresponding":false},{"id":568343,"name":"Tina Mayer","orcid":"0000-0003-0078-3773","position":15,"is_corresponding":false},{"id":484034,"name":"Theodore L. DeWeese","orcid":null,"position":16,"is_corresponding":false},{"id":356944,"name":"Daniel Y. Song","orcid":"0000-0002-3495-8677","position":17,"is_corresponding":false},{"id":469247,"name":"Ana P. Kiess","orcid":"0000-0001-6928-3852","position":18,"is_corresponding":false},{"id":1260388,"name":"Ezgi Oymak","orcid":null,"position":19,"is_corresponding":false},{"id":64727,"name":"Kenneth J. Pienta","orcid":"0000-0002-4138-2186","position":20,"is_corresponding":false},{"id":259327,"name":"Felix Y. Feng","orcid":"0000-0002-0963-7687","position":21,"is_corresponding":false},{"id":7932,"name":"Martin G. Pomper","orcid":"0000-0001-6753-3010","position":22,"is_corresponding":false},{"id":1259969,"name":"Gökhan Özyiğit","orcid":"0000-0002-7497-4348","position":23,"is_corresponding":false},{"id":262587,"name":"Phuoc T. Tran","orcid":"0000-0002-0147-0376","position":24,"is_corresponding":false},{"id":1220803,"name":"Cem Önal","orcid":"0000-0002-2742-9021","position":25,"is_corresponding":false},{"id":483255,"name":"Ryan Phillips","orcid":"0000-0003-4895-9838","position":26,"is_corresponding":false},{"id":942039,"name":"Philip Sutera","orcid":"0000-0002-4021-5909","position":0,"is_corresponding":true}],"reference_count":45,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:01:37.886033Z","pmid":"38799104","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}