MP11-09 SECOND LINE PSMA-TARGETED SALVAGE TREATMENT IN PATIENTS WITH miN1/M1a-b OLIGORECURRENT PCa

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP11-09 SECOND LINE PSMA-TARGETED SALVAGE TREATMENT IN PATIENTS WITH miN1/M1a-b OLIGORECURRENT PCa Lorenzo Bianchi, Eleonora Balestrazzi, Francesco Ceci, Francesco Costa, Matteo Droghetti, Alessandro Pissavini, Pietro Piazza, Andrea Farolfi, Riccardo Mei, Paolo Castellucci, Stefano Puliatti, Giorgio Gandaglia, Alessandro Larcher, Alexandre Mottrie, Alberto Briganti, Alessio Giuseppe Morganti, Stefano Fanti, Francesco Montorsi, Riccardo Schiavina, and Eugenio Brunocilla Lorenzo BianchiLorenzo Bianchi More articles by this author , Eleonora BalestrazziEleonora Balestrazzi More articles by this author , Francesco CeciFrancesco Ceci More articles by this author , Francesco CostaFrancesco Costa More articles by this author , Matteo DroghettiMatteo Droghetti More articles by this author , Alessandro PissaviniAlessandro Pissavini More articles by this author , Pietro PiazzaPietro Piazza More articles by this author , Andrea FarolfiAndrea Farolfi More articles by this author , Riccardo MeiRiccardo Mei More articles by this author , Paolo CastellucciPaolo Castellucci More articles by this author , Stefano PuliattiStefano Puliatti More articles by this author , Giorgio GandagliaGiorgio Gandaglia More articles by this author , Alessandro LarcherAlessandro Larcher More articles by this author , Alexandre MottrieAlexandre Mottrie More articles by this author , Alberto BrigantiAlberto Briganti More articles by this author , Alessio Giuseppe MorgantiAlessio Giuseppe Morganti More articles by this author , Stefano FantiStefano Fanti More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , Riccardo SchiavinaRiccardo Schiavina More articles by this author , and Eugenio BrunocillaEugenio Brunocilla More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003226.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: PSMA-PET is considered the imaging of choice in patients with recurrent prostate cancer (PCa) after primary treatments. Recurrent PCa includes various clinical settings. Thus, we aimed to explore the oncologic benefit of second-line salvage PSMA-guided MDT (metastases directed treatment) in PCa patients with recurrence after previous salvage treatments and oligo-recurrent N1/M1a-b disease at PSMA-PET. METHODS: We retrospectively analyzed patients underwent RP (radical prostatectomy) for PCa and PSMA-PET (from January 2016 to February 2021) performed for biochemical recurrence (BCR) after first-line salvage therapies for BCR after PR at 3 high volume European Centers. Oligo-recurrent (≤3 lesions) patients with N1/M1a-b disease at PSMA-PET and eligible for MDT were identified. MDT consist of salvage lymph node dissection (sLND) and stereotactic body radiotherapy (SBRT) or combination of both. Conventional approach includes observation or androgen deprivation therapy. Men were stratified according to treatment after PSMA-PET (MDT vs. conventional approach). Kaplan Meier curves were used to assess progression free survival (PFS), metastases free survival (MFS) and CRPC free survival (CRPC-FS) at 3 years of follow up after stratifying according to treatment after PSMA-PET. Multivariable Cox regression was performed to identify independent predictors of progression and metastases. RESULTS: Overall, 113 patients were enrolled: 91 patients were treated with MDT approach and 22 with conventional approach. The median (IQR) follow-up after PSMA-PET was 31 (19-42) months. Overall, no significant differences were found concerning 3-years PFS according to type of treatment (p=0.3). MFS and CRPC-FS estimates at 3 years were 73.5% and 94.7% in patients underwent MDT vs 30.5% and 79.5% in men treated with conventional approach, respectively (all p<0.001). At the multivariable Cox regression analysis, age (HR=0.96) and pT3b-pT4 (HR=2.02) were independent predictors of progression (all p≤0.03), while MDT (HR 0.37) was the only independent predictor of metastases (p= 0.02). CONCLUSIONS: In a selected population of oligo-recurrent N1/M1a-b Pca patients with limited therapeutic chances due to previous salvage treatments, the MDT targeted to PSMA-PET may represent a promising second-line salvage approach to delay further progression to CRPC status. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e126 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Lorenzo Bianchi More articles by this author Eleonora Balestrazzi More articles by this author Francesco Ceci More articles by this author Francesco Costa More articles by this author Matteo Droghetti More articles by this author Alessandro Pissavini More articles by this author Pietro Piazza More articles by this author Andrea Farolfi More articles by this author Riccardo Mei More articles by this author Paolo Castellucci More articles by this author Stefano Puliatti More articles by this author Giorgio Gandaglia More articles by this author Alessandro Larcher More articles by this author Alexandre Mottrie More articles by this author Alberto Briganti More articles by this author Alessio Giuseppe Morganti More articles by this author Stefano Fanti More articles by this author Francesco Montorsi More articles by this author Riccardo Schiavina More articles by this author Eugenio Brunocilla More articles by this author Expand All Advertisement PDF downloadLoading ...