Impact of 68Gallium prostate‐specific membrane antigen tracers on the management of patients with prostate cancer who experience biochemical recurrence. (20th October 2020)

• Record Type: Journal Article
• Authors: Diao, Wei; Cao, Yuan; Su, Dunyan; Jia, Zhiyun
• Is Part Of: BJU international. Volume 127:Number 2(2021)
• Page Start: 153
• Page End: 163
• Publication Date: 2020-10-20
• Subjects: 68Ga‐PSMA -- prostate‐specific membrane antigen -- management -- prostate cancer -- biochemical recurrence -- meta‐analysis -- #PCSM -- #ProstateCancer -- #uroonc; Genitourinary organs -- Diseases -- Periodicals; Genitourinary organs -- Surgery -- Periodicals; Urology -- Periodicals; 616.6
• DOI: 10.1111/bju.15257
• Languages: English
• ISSNs: 1464-4096

Abstract

Abstract : Objective: To investigate the impact of 68 Gallium prostate‐specific membrane antigen ( 68 Ga‐PSMA) tracers on the management of prostate cancer (PCa) patients with biochemical recurrence (BCR) by conducting a systematical review and meta‐analysis. Materials and Methods: We performed a literature search of the PubMed, Embase and Web of Science databases up to 29 October 2019. We included studies that reported the proportion of patients whose management changed after 68 Ga‐PSMA tracers were used in patients with BCR. We used the Quality Assessment of Diagnostic Accuracy Studies‐2 tool to evaluate the quality of the included studies. The proportion of patients with management changes were pooled using a random‐effects model. Subgroup analyses and meta‐regression analyses were performed to explore the source of heterogeneity. A Sankey diagram was used to show treatment change from before to after the use of 68 Ga‐PSMA tracers. Results: We included 20 eligible studies (2026 patients). The pooled proportion of patients with management change was 53% (95% confidence interval [CI] 46–60) in patients with BCR and 51% (95% CI, 34–67) in patients with early BCR (prostate‐specific antigen [PSA] <0.5 ng/mL). The pooled positron‐emission tomography‐positive rate in patients with BCR was 68% (95% CI 59–78). Fourteen studies reported management change, with most changes being intermodal in nature (42%, vs 17% intramodal change). Conclusions: The use of 68 Ga‐PSMA tracers altered the management of more than half of PCa patients with BCR, including those with early BCR. 68 Ga‐PSMA tracers might be used to guide individualized treatment in patients with BCR, particularly those with early BCR.