Quantification of metastatic prostate cancer whole-body tumor burden with (18)F-FDG PET parameters and associations with overall survival after first-line abiraterone or enzalutamide: A single-center retrospective cohort study Journal Article


Authors: Wibmer, A. G.; Morris, M. J.; Gonen, M.; Zheng, J.; Hricak, H.; Larson, S.; Scher, H. I.; Vargas, H. A.
Article Title: Quantification of metastatic prostate cancer whole-body tumor burden with (18)F-FDG PET parameters and associations with overall survival after first-line abiraterone or enzalutamide: A single-center retrospective cohort study
Abstract: New biomarkers for metastatic prostate cancer are needed. The aim of this study was to evaluate the prognostic value of F-18-FDG PET whole-body tumor burden parameters in patients with metastatic prostate cancer who received first-line abiraterone or enzalutamide therapy. Methods: This was a retrospective study of patients with metastatic castration-sensitive prostate cancer (mCSPC, n = 25) and metastatic castration-resistant prostate cancer (mCRPC, n = 71) who underwent F-18-FDG PET/CT within 90 d before first-line treatment with abiraterone or enzalutamide at a tertiary-care academic cancer center. Whole-body tumor burden on PET/CT was quantified as metabolic tumor volume (MTV) and total lesion glycolysis (TLG) and correlated with overall survival (OS) probabilities using Kaplan-Meier curves and Cox models. Results: The median follow-up in survivors was 56.3 mo (interquartile range, 37.7-66.8 mo); the median OSs for patients with mCRPC and mCSPC were 27.8 and 76.1 mo, respectively (P < 0.001). On univariate analysis, the OS probability of mCRPC patients was significantly associated with plasma levels of alkaline phosphatase (hazard ratio [HR], 1.90; P < 0.001), plasma levels of lactate dehydrogenase (HR, 1.01; P < 0.001), hemoglobin levels (HR, 0.80; P = 0.013), whole-body SUVmax (HR, 1.14; P < 0.001), the number of F-18-FDG-avid metastases (HR, 1.08; P < 0.001), whole body metabolic tumor volume (HR, 1.86; P < 0.001), and TLG (HR, 1.84; P < 0.001). On multivariable analysis with stepwise variable selection, hemoglobin levels (HR, 0.81; P = 0.013) and whole-body TLG (HR, 1.88; P < 0.001) were independently associated with OS. In mCSPC patients, no significant association was observed between these variables and OS. Conclusion: In patients with mCRPC receiving first-line treatment with abiraterone or enzalutamide, F-18-FDG PET WB TLG is independently associated with OS and might be used as a quantitative prognostic imaging biomarker.
Keywords: overall survival; ct; model; positron-emission-tomography; variability; agreement; abiraterone; activity; 18f-fdg pet; metastatic prostate cancer; androgen receptor expression; whole-body tumor burden; glycolytic
Journal Title: Journal of Nuclear Medicine
Volume: 62
Issue: 8
ISSN: 0161-5505
Publisher: Society of Nuclear Medicine  
Date Published: 2021-08-01
Start Page: 1050
End Page: 1056
Language: English
ACCESSION: WOS:000711570000012
DOI: 10.2967/jnumed.120.256602
PROVIDER: wos
PUBMED: 33419944
PMCID: PMC8833874
Notes: Article -- Source: Wos
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MSK Authors
  1. Junting Zheng
    200 Zheng
  2. Michael Morris
    583 Morris
  3. Mithat Gonen
    1031 Gonen
  4. Hedvig Hricak
    421 Hricak
  5. Steven M Larson
    959 Larson
  6. Howard Scher
    1130 Scher
  7. Andreas Georg Wibmer
    54 Wibmer