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Concordance between Response Assessment Using Prostate-Specific Membrane Antigen PET and Serum Prostate-Specific Antigen Levels after Systemic Treatment in Patients with Metastatic Castration Resistant Prostate Cancer: A Systematic Review and Meta-Analysis

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Abstract
Prostate-specific membrane antigen positron emission tomography (PSMA PET) has recently gained interest as a promising tool for treatment response evaluation in metastatic castration-resistant prostate cancer (CRPC). We performed a systematic review and meta-analysis assessing the concordance between response evaluation using PSMA PET and serum prostate-specific antigen (PSA) level after systemic treatment and the association between PSMA PET and overall survival in metastatic CRPC patients. PubMed, Embase, and Cochrane library databases were searched until August 2020. Studies that reported the concordance between PSMA PET and PSA response were included. PSMA PET and PSA response evaluation were dichotomized into response vs. non-response to construct two-by-two contingency tables; an >= 30% increase in PSMA PET according to PET Response Criteria in Solid Tumors 1.0 and as an increase in serum PSA level of >= 25% as per Prostate Cancer Working Group 3 guidelines were defined as non-response. The percent agreement rates were pooled using random-effect model. Ten studies (268 patients) were included. The concordance rates ranged 0.50-0.84 with a pooled proportion of 0.73 (95% confidence interval 0.67-0.79). Patients were treated with Lu-177-PSMA therapy in five, chemotherapy in three, Ra-223 in one, and more than one type in one study. Various PET parameters were used: the most widely evaluated was PSMA tumor volume (PSMA-TV). Similar proportions were found across different therapeutic agents, PET response parameters, and regarding directionality of discordance (PSA response/PSMA non-response vs. PSMA response/PSA non-response). Two studies reported that a decrease in PSMA-TV was associated with better overall survival. PSMA PET and PSA response assessments were discordant in nearly a fourth of metastatic CRPC patients. Further studies are warranted to establish the clinical meaning of this discordance and define appropriate management for such clinical situation.
Author(s)
김용일류진숙우승민이재련한상원Hebert Alberto VargasHeiko Schoder
Issued Date
2021
Type
Article
Keyword
AndrogensAntigensCancer therapiesChemotherapyMagnetic resonance imagingMeta-analysisMetastasismetastatic castration-resistant prostate cancerPatientspositron emission tomographyProstate cancerprostate specific membrane antigenprostate-specific antigenresponse assessmentReviewScintigraphySystematic reviewTumors
DOI
10.3390/diagnostics11040663
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7977
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_doaj_primary_oai_doaj_org_article_f24a2cb13bdb4d3083ddf46c9b4a719f&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Concordance%20between%20Response%20Assessment%20Using%20Prostate-Specific%20Membrane%20Antigen%20PET%20and%20Serum%20Prostate-Specific%20Antigen%20Levels%20after%20Systemic%20Treatment%20in%20Patients%20with%20Metastatic%20Castration%20Resistant%20Prostate%20Cancer:%20A%20Systematic%20Review%20and%20Meta-Analysis&offset=0&pcAvailability=true
Publisher
DIAGNOSTICS
Location
스위스
Language
영어
ISSN
2075-4418
Citation Volume
11
Citation Number
4
Citation Start Page
0
Citation End Page
0
Appears in Collections:
Medicine > Medicine
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