According to a study published in JAMA Network Open, prostate-specific membrane antigen (PSMA)-PET/CT can detect metastatic disease in prostate cancer patients that was missed by conventional imaging techniques.

These findings challenge the interpretation of previous studies, such as the EMBARK trial, and support the increasing role of PSMA-PET in patient selection for clinical applications and research trials, wrote study author Dr. Jeremie Calais, MD, PhD, from the University of California, Los Angeles (UCLA), along with colleagues.

Dr. Calais and his team analyzed PSMA-PET/CT findings from 182 patients enrolled in four prospective studies. These patients had high-risk, hormone-sensitive prostate cancer without evidence of metastatic disease on conventional imaging. All patients had recurrent prostate cancer after radical prostatectomy (RP), definitive radiotherapy (RT), or salvage RT.

PSMA-PET/CT results were positive in 84% of patients. Additionally, PSMA-PET/CT detected distant metastatic disease in 46% of cases, including:

• 34% of patients after RP,
• 56% after definitive RT,
• 60% after RP and salvage RT.

Moreover, five or more metastatic lesions were identified in 24% of patients.

"Our study demonstrates the critical role of PSMA-PET in accurately staging prostate cancer, which can significantly impact treatment decisions and outcomes," said Dr. Calais.

Dr. Calais also emphasized that further studies are needed to evaluate the independent prognostic value of PSMA-PET and its role in guiding treatment strategies. However, he stressed that its use in clinical trials is necessary.

Disclosure: Some study authors have declared affiliations with biotechnology, pharmaceutical, and/or medical device companies.