Dr. Morris on Impact of PSMA-Targeted Imaging on Clinical Management of Prostate Cancer

Michael J. Morris, MD, medical oncologist, clinical director, Genitourinary Medical Oncology Service, and Prostate Cancer Section Head, Division of Solid Tumor Oncology at Memorial Sloan Kettering Cancer Center, discusses the impact of prostate-specific membrane antigen (PSMA)-targeted imaging with ¹⁸F-DCFPyL-PET/CT on the clinical management of patients with prostate cancer.

The phase 3 CONDOR study enrolled men with biochemically recurrent prostate cancer. The results of the study were extremely positive, says Morris. The correct localization rate (CLR) served as the primary end point of the trial. The CLR was defined as the percentage of patients with a 1:1 correspondence between at least 1 lesion that was identified by PyL-PET/CT and the composite standard of truth, encompassing pathology, correlative imaging, or prostate-specific antigen response.

The trial was successful if the lower bound of the 95% confidence interval for CLR surpassed 20% for 2 of the 3 independent, blinded central PyL-PET/CT reviewers. The CLR rates among the 3 independent reviewers were 85.6%, 87%, and 84.8%, exceeding the 20% benchmark that had been established for positivity.

Additionally, investigators looked at the resulting impact on clinical decisions. Sixty-four percent of patients who underwent PSMA-targeted imaging had an adjusted treatment course. These changes included salvage therapy to systemic therapy, observation prior to initiating therapy, noncurative systemic therapy to salvage local therapy, and planned treatment to observation.