18F-flotufolastat PET alters treatment approach for nearly 90% of patients with recurrent prostate cancer

Research from the SPOTLIGHT trial presented at the 2024 ASCO Genitourinary Cancers Symposium showed that imaging with ¹⁸F-flotufolastat PET (Posluma) led to treatment changes in 89% of a group of patients with recurrent prostate cancer.¹

¹⁸F-flotufolastat is approved by the FDA for use in patients with suspected prostate cancer metastasis who are potentially curable by definitive surgery or radiation, and patients with suspected prostate cancer recurrence based on elevated PSA levels.²

For their analysis, the study authors reviewed treatment plans prior to and after 97 patients with recurrent prostate cancer had received PET scans with ¹⁸F-flotufolastat. The researchers noted that this patient subgroup had comparable percentages of prostatectomy procedures, Gleason scores, and median PSA levels as the overall SPOTLIGHT study population.

(Editor’s note: This article has been adapted from its original publication on our sister site Diagnostic Imaging.)

The findings showed that 89% of the subgroup cohort (86 of 97 patients) had treatment changes after PET imaging and major changes to management plans occurred in 78 patients (80%). The study authors also noted negative ¹⁸F-flotufolastat PET scans for 75% of patients whose management plans were revised to watchful waiting.

“Both positive and negative ¹⁸F-flotufolastat PET scans did influence patient management…Treatment based on visualization of ¹⁸F-flotufolastat avid lesions may facilitate improved management of recurrent lesions,” noted study author Przemyslaw Twardowski, MD, the director of clinical research in urology and urologic oncology at the Saint John’s Cancer Institute at Providence St. John’s Health Center in Santa Monica, Calif.

The study findings also revealed that ¹⁸F-flotufolastat PET scans revealed distant/extrapelvic lesions for all 15 patients whose treatment was changed from salvage therapy to non-curative systemic therapy.

“Treatment based on visualization of ¹⁸F-flotufolastat-avid lesions may facilitate optimal targeting of recurrence sites and avoid futile salvage therapy,” added Dr Twardowski.

¹⁸F-flotufolastat is approved by the FDA for use in patients with suspected prostate cancer metastasis who are potentially curable by definitive surgery or radiation, and patients with suspected prostate cancer recurrence based on elevated PSA levels.²

References

1. Twardowski P. Impact of 18F-flotufolastat PET on management of patients with recurrent prostate cancer: data from the SPOTLIGHT study. J Clin Oncol 42, 2024 (suppl 4; abstr 38). doi: 10.1200/JCO.2024.42.4_suppl.38

2. US FDA approves Blue Earth Diagnostics’ Posluma (flotufolastat F-18 injection, first radiohybrid PSMA-targeted PET imaging agent for prostate cancer. News release. Blue Earth Diagnostics. May 30, 2023. Accessed February 8, 2024. https://www.businesswire.com/news/home/20230530005180/en/U.S.-FDA-Approves-Blue-Earth-Diagnostics%E2%80%99-POSLUMA%C2%AE-Flotufolastat-F-18-Injection-First-Radiohybrid-PSMA-targeted-PET-Imaging-Agent-for-Prostate-Cancer