PD17-09 PROSTATE-SPECIFIC MEMBRANE ANTIGEN POSITRON EMISSION TOMOGRAPHY (PSMA-PET) IN HIGH-RISK NONMETASTATIC CASTRATION-RESISTANT PROSTATE CANCER (NMCRPC) SPARTAN-LIKE PATIENTS (PTS) NEGATIVE BY CONVENTIONAL IMAGING
Bibliographic record
Abstract
You have accessJournal of UrologyProstate Cancer: Staging II (PD17)1 Apr 2019PD17-09 PROSTATE-SPECIFIC MEMBRANE ANTIGEN POSITRON EMISSION TOMOGRAPHY (PSMA-PET) IN HIGH-RISK NONMETASTATIC CASTRATION-RESISTANT PROSTATE CANCER (NMCRPC) SPARTAN-LIKE PATIENTS (PTS) NEGATIVE BY CONVENTIONAL IMAGING Boris Hadaschik*, Manuel Weber, Amir Iravani, Michael S. Hofman, Jérémie Calais, Johannes Czernin, Harun Ilhan, Fred Saad, Eric J. Small, Matthew R. Smith, Paola M. Perez, Thomas A. Hope, Isabel Rauscher, Anil Londhe, Angela Lopez-Gitlitz, Shinta Cheng, Tobias Maurer, Ken Herrmann, Matthias Eiber, and Wolfgang Fendler Boris Hadaschik*Boris Hadaschik* More articles by this author , Manuel WeberManuel Weber More articles by this author , Amir IravaniAmir Iravani More articles by this author , Michael S. HofmanMichael S. Hofman More articles by this author , Jérémie CalaisJérémie Calais More articles by this author , Johannes CzerninJohannes Czernin More articles by this author , Harun IlhanHarun Ilhan More articles by this author , Fred SaadFred Saad More articles by this author , Eric J. SmallEric J. Small More articles by this author , Matthew R. SmithMatthew R. Smith More articles by this author , Paola M. PerezPaola M. Perez More articles by this author , Thomas A. HopeThomas A. Hope More articles by this author , Isabel RauscherIsabel Rauscher More articles by this author , Anil LondheAnil Londhe More articles by this author , Angela Lopez-GitlitzAngela Lopez-Gitlitz More articles by this author , Shinta ChengShinta Cheng More articles by this author , Tobias MaurerTobias Maurer More articles by this author , Ken HerrmannKen Herrmann More articles by this author , Matthias EiberMatthias Eiber More articles by this author , and Wolfgang FendlerWolfgang Fendler More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000555569.70342.60AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: In SPARTAN, pts with nmCRPC assessed by conventional imaging benefited from apalutamide (APA). PSMA-PET detects localized and metastatic PC with superior sensitivity to conventional imaging. We retrospectively characterized the extent of disease using PSMA-PET in SPARTAN-like pts and compared the risk factors for M1 disease detected by PSMA-PET to those in SPARTAN. METHODS: A total of 200 pts with nmCRPC at high risk of developing metastases (prostate-specific antigen doubling time [PSADT] ≤ 10 mo, or Gleason score ≥ 8) and no known extrapelvic metastases on prior conventional imaging were assessed with PSMA-PET. Detection rate on PSMA-PET, including local/pelvic and distant M1 disease, was determined. Association of baseline (BL) variables with M1 disease in the PSMA-PET cohort was assessed using univariate and multivariate analyses. SPARTAN pts were stratified according to risk factors for PSMA-PET-detected M1 disease and analyzed using Cox proportional-hazards models. RESULTS: BL characteristics of PSMA-PET and SPARTAN pts were generally similar. PSMA-PET detected PC in 196/200 (98%) pts; 55% had local recurrence, 54% had pelvic nodes (N1), 55% had any extrapelvic distant metastatic disease despite negative conventional imaging; 24% were diagnosed with local recurrence only, 29% with oligometastatic (1-3 lesions) and 46% with polymetastatic disease. PSA ≥ 5.5 ng/mL, pN1 disease, and prior local therapy were significantly associated with M1 disease detected by PSMA-PET (Table). All clinically relevant subgroups of SPARTAN pts, including pts with independent predictors of PSMA-PET-M1 disease, significantly benefited from APA (Table). CONCLUSIONS: PSMA-PET-positive CRPC pts were similar to those at high-risk of developing metastases in SPARTAN. APA showed significant benefit in all clinically relevant subgroups of SPARTAN pts, including pts with risk factors for distant metastases detected by PSMA-PET. Therefore, APA should be considered for pts negative by conventional imaging but positive by PSMA-PET (stage migration). The added value of PSMA-PET over PSADT in pts with high-risk nmCRPC should be explored in prospective studies. Source of Funding: Janssen Research & Development: SPARTAN. Participating centers: PSMA-PET. Essen, Germany; Melbourne, Australia; Los Angeles, CA; Munich, Germany; Montréal, Canada; San Francisco, CA; Boston, MA; San Francisco, CA; Munich, Germany; Titusville, NJ; Los Angeles, CA; Raritan, NJ; Munich, Germany; Essen, Germany; Munich, Germany; Essen, Germany© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e309-e309 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Boris Hadaschik* More articles by this author Manuel Weber More articles by this author Amir Iravani More articles by this author Michael S. Hofman More articles by this author Jérémie Calais More articles by this author Johannes Czernin More articles by this author Harun Ilhan More articles by this author Fred Saad More articles by this author Eric J. Small More articles by this author Matthew R. Smith More articles by this author Paola M. Perez More articles by this author Thomas A. Hope More articles by this author Isabel Rauscher More articles by this author Anil Londhe More articles by this author Angela Lopez-Gitlitz More articles by this author Shinta Cheng More articles by this author Tobias Maurer More articles by this author Ken Herrmann More articles by this author Matthias Eiber More articles by this author Wolfgang Fendler More articles by this author Expand All Advertisement PDF downloadLoading ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".