PSMA-PET imaging in prostate cancer patients with high-risk biochemical recurrence: implications from an “EMBARK-Like” cohort

IF 6.9 2区医学 Q1 ONCOLOGY

Prostate Cancer and Prostatic Diseases Pub Date : 2026-02-25 DOI:10.1038/s41391-026-01096-6

Matteo Droghetti, Valerio Pirelli, Francesco Ceci, Andrea Farolfi, Matteo Bauckneht, Francesco Lanfranchi, Andrea Di Giorgio, Paolo Castellucci, Caterina Maria Paola Sgro, Carlos Artigas, Jose Leite, Paola Corona, Qaid Ahmed Shagera, Renata Moreira, Christian González, Marcelo Queiroz, Felipe de Galiza Barbosa, Guido Rovera, Desiree Deandreis, Sara Tamburini, Lorenzo Nanni, Federico Bevilacqua, Pietro Piazza, Angelo Mottaran, Veronica Mollica, Francesco Massari, Stefano Fanti, Lorenzo Bianchi, Riccardo Schiavina

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引用次数: 0

Abstract

The EMBARK trial demonstrated improved survival with enzalutamide plus androgen deprivation therapy (ADT) in non-metastatic hormone-sensitive prostate cancer patients with high-risk biochemical recurrence (BCR), although staged using conventional imaging. Given the higher sensitivity of PSMA-PET, many of these patients could harbor metastatic disease. We retrospectively analyzed 587 patients with first BCR after radical treatment who underwent PSMA-PET. Patients were stratified according to EMBARK criteria for high-risk BCR. 169 patients (29%) met EMBARK criteria. They more often showed PSMA-PET positivity for any localization (82% vs 39%; p < 0.001) and metastatic disease (46% vs 15%; p < 0.001). Median PSA was higher and PSA doubling-time (PSADT) shorter (2.23 vs 0.43 ng/mL; 4.3 vs 9 months). Most High-risk BCR patients have a positive PSMA-PET, and many of these harbor metastatic disease at molecular imaging. Given the survival benefit from intensified systemic treatment with ARPI in this cohort, how to best combine systemic therapy with PSMA-PET guided metastases-directed-treatments remains an important future area of research.

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前列腺癌高危生化复发患者的PSMA-PET成像：来自“embark样”队列的意义

EMBARK试验表明，恩杂鲁胺加雄激素剥夺疗法（ADT）可改善高风险生化复发（BCR）的非转移性激素敏感前列腺癌患者的生存率，尽管采用常规影像学进行分期。鉴于PSMA-PET的敏感性较高，这些患者中许多可能存在转移性疾病。我们回顾性分析了587例根治性治疗后首次出现BCR并行PSMA-PET的患者。根据EMBARK高危BCR标准对患者进行分层。169例患者（29%）符合EMBARK标准。对于任何定位，他们更常显示PSMA-PET阳性(82% vs 39%

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来源期刊

Prostate Cancer and Prostatic Diseases 医学-泌尿学与肾脏学

CiteScore

10.00

自引率

6.20%

发文量

142

审稿时长

6-12 weeks

期刊介绍： Prostate Cancer and Prostatic Diseases covers all aspects of prostatic diseases, in particular prostate cancer, the subject of intensive basic and clinical research world-wide. The journal also reports on exciting new developments being made in diagnosis, surgery, radiotherapy, drug discovery and medical management. Prostate Cancer and Prostatic Diseases is of interest to surgeons, oncologists and clinicians treating patients and to those involved in research into diseases of the prostate. The journal covers the three main areas - prostate cancer, male LUTS and prostatitis. Prostate Cancer and Prostatic Diseases publishes original research articles, reviews, topical comment and critical appraisals of scientific meetings and the latest books. The journal also contains a calendar of forthcoming scientific meetings. The Editors and a distinguished Editorial Board ensure that submitted articles receive fast and efficient attention and are refereed to the highest possible scientific standard. A fast track system is available for topical articles of particular significance.