Complete biochemical response below 0.1 ng/ml predicts long-term therapy-free survival via PSMA-radioguided surgery

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Published: 16 Mar 2023
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Prof Tobias Maurer - Martini-Klinik Prostate Cancer Center, Hamburg, Germany

Prof Tobias Maurer speaks to ecancer about a study that evaluated if very low postoperative PSA (complete biochemical response <0.1 ng/ml) helps predict long-term oncological outcomes of salvage PSMA-RGS.

This cohort study evaluated patients with biochemical recurrence after radical prostatectomy and with oligorecurrent PCa on PSMA PET treated with PSMA-RGS in two tertiary care centres from 2014-2022.

The results of this study showed that complete biochemical response with a PSA below 0.1 ng/ml seems to predict long-term therapy-free survival of patients treated with salvage lymph node dissection via PSMA-radioguided surgery. 

He concludes by discussing the clinical impact of these results.

We are also presenting our data on PSMA-radioguided surgery. This as a basis has a PSMA-PET and these are patients with biochemical recurrence that are now showing maybe one or two lymph node metastases in the pelvis. Those patients have mostly undergone radical prostatectomy as primary treatment and salvage radiation so the only management they would have now is expectant management or then androgen deprivation therapy but they might also be targeted, again, by a specific treatment. We, several years back, developed radioguided surgery also with the use of PSMA tracers that then dock to these lymph node metastases. You can detect them intraoperatively by gamma probes then remove those lymph nodes. This might be a new treatment possibility in those patients, prolonging systemic therapy-free survival or maybe even, in a small subset of patients, in carefully selected patients, even cure, although they have already spread to lymph nodes. 

Here we present, then, over 400 patients with follow-up data showing that the patients who respond very well with the PSA values after surgery, below 0.1, that they have a really long therapy-free survival. So this is another abstract that somebody wants to look up.