The effect of androgen blockade on [⁶⁸Ga]Ga-PSMA-11 and [¹⁸F]FDG PET uptake in patients with recurrent or metastatic salivary duct carcinoma: a prospective imaging study.

IF 3.1 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

EJNMMI Research Pub Date : 2025-07-15 DOI:10.1186/s13550-025-01275-x

Niels J van Ruitenbeek, Maike J M Uijen, Chantal M L Driessen, Maartje C van Rijk, Steffie M B Peters, Bastiaan M Privé, Gerald W Verhaegh, Adriana C H van Engen-van Grunsven, Martin Gotthardt, James Nagarajah, Carla M L van Herpen

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引用次数: 0

Abstract

Background: The expression of prostate-specific membrane antigen (PSMA), a target for oncological imaging and treatment, is upregulated by androgen blockade in prostate cancer. Salivary duct carcinoma (SDC), an aggressive histological subtype of salivary gland cancer, resembles prostate cancer in terms of PSMA and androgen receptor (AR) expression. A similar upregulation of PSMA in SDC would have implications for future studies with PSMA-targeted imaging and therapy. Additionally, FDG PET/CT scans are frequently used for SDC imaging, but the effect of androgen blockade on FDG uptake is unknown. This study investigated the effect of combined androgen blockade (CAB) on tumour PSMA and FDG uptake in patients with SDC.

Results: Eight patients with recurrent and/or metastatic AR-positive SDC who started CAB (goserelin plus bicalutamide) as standard of care were prospectively enrolled. [⁶⁸ Ga]Ga-PSMA-11 and [¹⁸F]FDG PET/CT scans were performed within 21 days before and 21 ± 7 days after CAB initiation. PET parameters, including SUV_max, were obtained for PSMA and FDG positive lesions. A total of 80 metastatic lesions were analysed on a per-lesion basis. SUV_max changes after CAB initiation were categorised as increased (≥ + 20%), stable (between -20% and + 20%), or decreased (≤ -20%). The PSMA SUV_max increased in 20 lesions (25%), remained stable in 46 lesions (58%), and decreased in 14 lesions (18%), with no significant overall change (Wilcoxon signed rank test, p = 0.74). The FDG SUV_max increased in 35 lesions (44%), remained stable in 39 lesions (49%), and decreased in 6 lesions (8%), with a significant overall median increase of + 0.97 (Wilcoxon signed rank test, p < 0.001). The median PFS was 2.2 months (95% confidence interval 1.7-2.7 months).

Conclusions: Androgen blockade in patients with recurrent and/or metastatic SDC did not induce a significant increase in tumour PSMA uptake after three weeks. In contrast, tumour FDG uptake increased significantly after three weeks of CAB, which may reflect the poor tumour response in this cohort and/or a transient treatment-related effect.

Trial registration: ClinicalTrials.gov, NCT04214353. Registered 13 December 2019.

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雄激素阻断对复发或转移性涎腺导管癌患者[68Ga]Ga-PSMA-11和[18F]FDG PET摄取的影响：一项前瞻性影像学研究

背景：前列腺特异性膜抗原（PSMA）是肿瘤成像和治疗的靶标，在前列腺癌中雄激素阻断可上调其表达。涎腺导管癌（SDC）是涎腺癌的一种侵袭性组织学亚型，在PSMA和雄激素受体（AR）表达方面与前列腺癌相似。SDC中PSMA的类似上调将对PSMA靶向成像和治疗的未来研究产生影响。此外，FDG PET/CT扫描经常用于SDC成像，但雄激素阻断对FDG摄取的影响尚不清楚。本研究探讨了联合雄激素阻断（CAB）对SDC患者肿瘤PSMA和FDG摄取的影响。结果：8例复发和/或转移性ar阳性SDC患者开始使用CAB（戈舍雷林加比卡鲁胺）作为标准治疗。[68 Ga]Ga- psma -11和[18F]FDG PET/CT扫描于CAB开始前21天和开始后21±7天进行。获得PSMA和FDG阳性病变的PET参数，包括SUVmax。在每个病灶的基础上分析了总共80个转移性病变。CAB启动后的SUVmax变化分为增加（≥+ 20%）、稳定（-20%至+ 20%之间）或减少（≤-20%）。PSMA SUVmax在20个病变中增加（25%），在46个病变中保持稳定（58%），在14个病变中下降（18%），总体无显著变化（Wilcoxon符号秩检验，p = 0.74）。FDG SUVmax在35个病变中增加（44%），在39个病变中保持稳定（49%），在6个病变中下降（8%），总体中位数显著增加+ 0.97 （Wilcoxon签署rank检验，p）。结论：复发和/或转移性SDC患者的雄激素阻断在三周后并未诱导肿瘤PSMA摄取显著增加。相比之下，肿瘤FDG摄取在CAB三周后显著增加，这可能反映了该队列中较差的肿瘤反应和/或短暂的治疗相关效应。试验注册：ClinicalTrials.gov, NCT04214353。2019年12月13日注册。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

EJNMMI Research RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING&nb-

CiteScore

5.90

自引率

3.10%

发文量

审稿时长

13 weeks

期刊介绍： EJNMMI Research publishes new basic, translational and clinical research in the field of nuclear medicine and molecular imaging. Regular features include original research articles, rapid communication of preliminary data on innovative research, interesting case reports, editorials, and letters to the editor. Educational articles on basic sciences, fundamental aspects and controversy related to pre-clinical and clinical research or ethical aspects of research are also welcome. Timely reviews provide updates on current applications, issues in imaging research and translational aspects of nuclear medicine and molecular imaging technologies. The main emphasis is placed on the development of targeted imaging with radiopharmaceuticals within the broader context of molecular probes to enhance understanding and characterisation of the complex biological processes underlying disease and to develop, test and guide new treatment modalities, including radionuclide therapy.