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EAU-EANM Consensus Statements on the Role of Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography in Patients with Prostate Cancer and with Respect to [177Lu]Lu-PSMA Radioligand Therapy.

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Affiliations

  • 1. Nuclear Medicine Division, IRCCS AOU Bologna, Bologna, Italy; Alma Mater Studiorum, University of Bologna, Bologna, Italy.
      Authors
    • Fanti S 1
    (1 author)
  • 2. Department of Urology, Division of Experimental Oncology, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy.
      Authors
    • Briganti A 2
    (1 author)
  • 3. Department of Theranostics and Nuclear Medicine, St. Vincent's Hospital, Sydney, Australia.
      Authors
    • Emmett L 3
    (1 author)
  • 4. Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Saclay, Villejuif, France.
      Authors
    • Fizazi K 4
    (1 author)
  • 5. Institute of Oncology of Southern Switzerland, EOC, Bellinzona, Switzerland; Università della Svizzera Italiana, Lugano, Switzerland.
      Authors
    • Gillessen S 5
    (1 author)
    • Show all (23)

ORCIDs linked to this article

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European Urology Oncology, 11 Jun 2022, 5(5):530-536
https://doi.org/10.1016/j.euo.2022.05.003 PMID: 35697600 

A comment on this article appears in "Re: Stefano Fanti, Alberto Briganti, Louise Emmett, et al. EAU-EANM Consensus Statements on the Role of Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography in Patients with Prostate Cancer and with Respect to [177Lu]Lu-PSMA Radioligand Therapy. Eur Urol Oncol. 2022;5:530-6: Extended Use of PSMA PET/CT in Candidates for Focal Therapy." Eur Urol Oncol. 2022 Oct;5(5):601-602.

Abstract 

Background

Prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) is useful for selected clinical indications in patients with prostate cancer (PCa) but it may have broader clinical utility owing to the emergence of lutetium-177-PSMA-617 ([177Lu]Lu-PSMA) therapy. However, robust data regarding the impact of PSMA PET/CT on patient management and treatment are lacking, and in many areas, the role of next-generation imaging has not been defined.

Objective

To assess expert opinion on the use of PSMA-based imaging and therapy to develop interim guidance.

Design, setting, and participants

A panel of 21 PCa experts from various disciplines received thematic topics and relevant literature. A questionnaire to assess proposed guidance statements regarding PSMA PET/CT and [177Lu]Lu-PSMA therapy was developed for completion remotely in a first e-Delphi round. A subsequent panel discussion was conducted during a 1-d meeting, which included a second Delphi round.

Outcome measurements and statistical analysis

Panellists voted anonymously on statements using a nine-point Likert scale from 1 = strongly disagree to 9 = strongly agree. Median scores were calculated and consensus was assessed using methods proposed by the Research and Development (RAND) corporation.

Results and limitations

Statements were developed to cover the following topics: PSMA PET/CT utility, clinical use, and choice of tracer; patient selection; and management of patients receiving [177Lu]Lu-PSMA for metastatic PCa. Consensus was reached for 33/36 statements. In-group bias is a potential limitation, as some statements were rephrased during discussions at the 1-d meeting.

Conclusions

Adoption of PSMA PET/CT as an imaging tool to guide [177Lu]Lu-PSMA therapy should be supported by indications for appropriate use.

Patient summary

A panel of experts in prostate cancer reached a consensus for the majority of statements proposed regarding the role of prostate-specific membrane antigen (PSMA)-based imaging and therapy, particularly the use of PSMA-based imaging in patients suitable for [177Lu]Lu-PSMA therapy and the need to perform PSMA-based imaging before considering patients as candidates for this therapy.

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Read article at publisher's site: https://doi.org/10.1016/j.euo.2022.05.003

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