Main Session
Sep
30
PQA 07 - Genitourinary Cancer, Patient Safety, Nursing/Supportive Care
3334 - Prostate-Specific Membrane Antigen Targeted Imaging Utilization and its Association with Disease Progression and Treatment Changes in Patients with Metastatic Hormone-Sensitive Prostate Cancer and Metastatic Castration-Resistant Prostate Cancer
Presenter(s)
Jeetvan Patel, PhD - Novartis, East Hanover, NJ
A. O. Sartor1, E. I. Heath1, X. X. Wei2, N. Shore3, J. Patel4, J. Nguyen4, X. Wang4, A. Sawhney4, B. Kang4, C. Byrne5, K. Runeckles5, and D. J. George6; 1Mayo Clinic, Rochester, MN, 2Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, 3Carolina Urologic Research Center, Mrytle Beach, SC, 4Novartis Pharmaceuticals Corporation, East Hanover, NJ, 5Asclepius Analytics, New York, NY, 6Department of Medicine, Duke Cancer Institute, Duke University School of Medicine, Durham, NC
Purpose/Objective(s):
Prostate-specific membrane antigen (PSMA)-targeted imaging aids in assessing PSMA-positive disease burden in patients (pts) with metastatic prostate cancer (mPC) and can guide treatment decisions, including selection of [177Lu]Lu-PSMA-617 (177Lu-PSMA-617) treatment. In this study, we examined the utilization of PSMA imaging in pts with mPC since approval of the first PSMA-targeted radioactive diagnostic agent in 2020 and evaluated its association with disease assessment and clinical management decisions.Materials/Methods:
This retrospective, non-interventional cohort study used real-world data from PRECISION (PRostatE Cancer dISease observatION), a harmonized dataset of pts with advanced prostate cancer (PC) in the US from diverse clinical settings. Adult men with mPC diagnosis from Jan 1, 2020 to Sept 30, 2024 were included. Analyses were performed in all pts with mPC and in two subgroups: metastatic hormone-sensitive PC (mHSPC) and metastatic castration-resistant PC (mCRPC). The index dates were the dates of mPC, mHSPC, and mCRPC diagnosis, respectively. Pts could be included in both subgroups; analyses in pts with mHSPC were censored at progression to mCRPC. Pt characteristics and PSMA scan utilization in the 1–5 years pre- and post-index were evaluated. Clinician-documented disease progression and new treatment initiation were assessed over the 90 days post-scan among pts with =1 scan. All analyses were descriptive.Results:
Overall, 33,255 pts with mPC were included (mHSPC: 28,439; mCRPC: 8,742). The median age was 74 years and 57% were White. Overall, 96% were managed in community settings and 82% by urologists at index, 69% had a Gleason score of =7, and the median prostate specific antigen level was 5.6 ng/mL (interquartile range 1.6–17.7). Among all pts, 29% had =1 PSMA scan at any point (80% of whom had 1 scan in total); rates were similar in both the mHSPC and mCRPC subgroups. The rate of PSMA scan utilization increased over time, from 12% of pts with mPC in 2020 to 40% in 2023 receiving =1 scan. Overall, 74% of pts had a new clinician-documented progression and 40% changed treatment in the 90 days post-PSMA scan. Both rates were higher in pts with mCRPC (78% and 48%, respectively) than in those with mHSPC (65% and 39%, respectively).Conclusion:
This is one of the first studies to examine PSMA imaging utilization in pts with mPC. Within a dataset largely representing the community urology setting, this study demonstrates the rapid increase in PSMA imaging utilization in recent years. Furthermore, in the 90 days post-PSMA scan, most pts had a new documented progression, and many initiated a new treatment. These results indicate that PSMA scanning provides clinically meaningful information that contributes to the management of pts with advanced PC.