Opinion
Video
Expert: PSMA-PET should be considered at lower PSA levels
Author(s):
In this video, Eric Li, MD, shares the take-home message from The Journal of Urology paper “Clinical Factors Associated with Suspicious 18F-DCFPyL PSMA PET Activity in Patients Initially Managed with Radical Prostatectomy including PSA <0.5 ng/mL.” Li is a urology resident at Northwestern University Feinberg School of Medicine in Chicago, Illinois.
Transcription:
What are the next steps for this research?
I think the main question is, how does PSA-directed therapy and metastasis-directed therapy affect recurrent metastasis-free survival and survival outcomes eventually? There are a number of trials and a number of studies looking at that currently. I do think that that's going to be an important step. I think our paper is just kind of getting the word out there that these patients with low PSAs do have suspicious PSMA findings. But really, the question is going to be, how does this affect longer term outcomes? There are a lot of trials ongoing in the area, and the question is, can metastasis-directed therapy also potentially improve quality of life and maybe decrease the amount of androgen deprivation therapy that patients need? These are all questions that are currently be investigated with other studies.
What is the take-home message for the practicing urologist?
I think the main takeaway is just that we can consider PSMA-PET at lower PSA values, below 0.2, certainly below 0.5. There are potentially PSMA findings that would change your management in this situation. I do think it's important to also emphasize that a negative PSMA-PET should not delay salvage therapy such as salvage radiation. It's been shown that these patients should get salvage radiation. But, I think that urologists can use PSMA-PET, along with other factors such as PSA doubling time, pathology, and radical prostatectomy and maybe genomics to just counsel the patient and to really personalize their treatment plan.
This transcript was AI generated and edited by human editors for clarity.
