BERKELEY, CA (UroToday.com) - In metastatic castration-resistant prostate cancer (mCRPC), the lack of reliable biomarkers of treatment efficacy, coupled with a potentially exaggerated reliance on changes in serum PSA, represent a barrier to management of drugs that have the potential for PSA modulation, such as abiraterone.
This study aimed to identify the role of early 18F-fluorocholine (FCH-PET/CT) in the outcome prediction to abiraterone in patients with CRPC. FCH-PET/CT after 3-6 weeks of treatment with abiraterone was able to accurately predict clinical outcome in CRPC beyond PSA response. Moreover, an important observation that emerged from our study was the evidence of a mismatch highlighted in 4 patients between the reduction of the value of serum PSA and the detection of an increased uptake of bone lesions shown in the PET/CT after 1-2 months. This mismatch was evaluated as related to the phenomena of "bone flare," already reported in patients after treatment with abiraterone in chemotherapy-naive CRPC who had undergone bone scintigraphy.
To our knowledge, this is the first study that used FCH-PET/CT for outcome prediction and tumor monitoring in CRPC. The metabolic tumor changes as detected with FCH-PET/CT make possible new ways of managing and investigating CRPC. Further prospective studies are needed to better address the use of FCH-PET/CT in outcome prediction and tumor monitoring in CRPC.
Ugo De Giorgi as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.
Department of Medical Oncology, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.) IRCCS, Meldola, Italy