F-PSMA-1007 PET/CT tumor volume quantification: a game-changing prognostic biomarker for first-line ARPI therapy in metastatic castration-resistant prostate cancer.
[PURPOSE] This study evaluates the prognostic value of baseline F-PSMA-1007 PET/CT-derived volumetric metabolic parameters in metastatic castration-resistant prostate cancer (mCRPC) patients initiatin
- p-value P < 0.001
- 95% CI 0.11-0.35
APA
Yang L, She T, et al. (2026). F-PSMA-1007 PET/CT tumor volume quantification: a game-changing prognostic biomarker for first-line ARPI therapy in metastatic castration-resistant prostate cancer.. Japanese journal of radiology, 44(2), 383-393. https://doi.org/10.1007/s11604-025-01920-4
MLA
Yang L, et al.. "F-PSMA-1007 PET/CT tumor volume quantification: a game-changing prognostic biomarker for first-line ARPI therapy in metastatic castration-resistant prostate cancer.." Japanese journal of radiology, vol. 44, no. 2, 2026, pp. 383-393.
PMID
41486328
Abstract
[PURPOSE] This study evaluates the prognostic value of baseline F-PSMA-1007 PET/CT-derived volumetric metabolic parameters in metastatic castration-resistant prostate cancer (mCRPC) patients initiating first-line androgen receptor pathway inhibitor (ARPI) therapy, while exploring their relationship with serum PSA and developing a risk stratification model.
[RESULTS] Both wbPSMA-TV (r = 0.70) and wbTL-PSMA (r = 0.67) correlated with baseline PSA. Multivariable analysis identified bone metastasis count (adjusted OR [aOR] 0.19, 95% CI 0.11-0.35; P < 0.001) and wbPSMA-TV (aOR = 0.77, 95% CI 0.65-0.91; P < 0.001) as independent predictors of early PSA response. Baseline wbTL-PSMA ≥ 231.4 SUV cm independently predicted shorter OS (10.3 vs. 22.2 months, P < 0.001). Multivariable Cox regression confirmed wbTL-PSMA (adjusted hazard ratio [aHR] 3.160, 95% CI 2.490-4.016; P < 0.001), wbPSMA-TV (aHR 3.010, 95% CI 2.467-3.683; P < 0.001), number of bone metastases (aHR 2.510, 95% CI 1.893-3.148; P < 0.001), and PSA level (aHR 2.995, 95% CI 2.810-3.190; P < 0.001) as OS determinants. The RF model stratified patients into low- (median OS not reached), intermediate-(11.8 months), and high-risk (9.55 months) groups (P < 0.001).
[CONCLUSION] Baseline F-PSMA-1007 PET/CT-derived volumetric parameters (wbPSMA-TV and wbTL-PSMA) serve as independent prognostic biomarkers for survival in mCRPC patients receiving ARPI therapy. Integration of these metrics with clinical variables enhances risk stratification, potentially guiding personalized therapeutic strategies. Prospective validation is warranted to confirm clinical utility.
[RESULTS] Both wbPSMA-TV (r = 0.70) and wbTL-PSMA (r = 0.67) correlated with baseline PSA. Multivariable analysis identified bone metastasis count (adjusted OR [aOR] 0.19, 95% CI 0.11-0.35; P < 0.001) and wbPSMA-TV (aOR = 0.77, 95% CI 0.65-0.91; P < 0.001) as independent predictors of early PSA response. Baseline wbTL-PSMA ≥ 231.4 SUV cm independently predicted shorter OS (10.3 vs. 22.2 months, P < 0.001). Multivariable Cox regression confirmed wbTL-PSMA (adjusted hazard ratio [aHR] 3.160, 95% CI 2.490-4.016; P < 0.001), wbPSMA-TV (aHR 3.010, 95% CI 2.467-3.683; P < 0.001), number of bone metastases (aHR 2.510, 95% CI 1.893-3.148; P < 0.001), and PSA level (aHR 2.995, 95% CI 2.810-3.190; P < 0.001) as OS determinants. The RF model stratified patients into low- (median OS not reached), intermediate-(11.8 months), and high-risk (9.55 months) groups (P < 0.001).
[CONCLUSION] Baseline F-PSMA-1007 PET/CT-derived volumetric parameters (wbPSMA-TV and wbTL-PSMA) serve as independent prognostic biomarkers for survival in mCRPC patients receiving ARPI therapy. Integration of these metrics with clinical variables enhances risk stratification, potentially guiding personalized therapeutic strategies. Prospective validation is warranted to confirm clinical utility.
MeSH Terms
Humans; Male; Prostatic Neoplasms, Castration-Resistant; Positron Emission Tomography Computed Tomography; Aged; Prognosis; Middle Aged; Tumor Burden; Retrospective Studies; Prostate-Specific Antigen; Radiopharmaceuticals; Fluorine Radioisotopes; Niacinamide; Oligopeptides; Aged, 80 and over; Androgen Receptor Antagonists
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