Tamara Thomas

Urban Health Today

A study presented at the American Society for Radiation Oncology (ASTRO) 2024 Annual Meeting revealed that both 18 F-Fluciclovine PET/CT and 68Ga PSMA PET/CT guided radiation therapy would significantly change pre-PET radiation therapy volumes and had similar toxicity.
68Ga-prostate specific membrane antigen (PSMA) and 18F-Fluciclovine (fluciclovine) positron emission tomography/ computed tomography (PET/CT) are approved for use in prostate cancer patients who have had surgery but whose cancer has recurred.
For this study, Dr. Vishal Dhere of the Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia, and colleagues evaluated the radiotherapy target volume or acute toxicity changes using PSMA versus fluciclovine.
About 140 patients were randomly chosen; 70 (arm 1) received fluciclovine, and the other 70 (arm 2) received PSMA. Patients recruited in these studies have undergone prostatectomy to remove the tumor but are experiencing recurrence. The patients were assessed for acute toxicity less than 30 days after treatment completion.
The researchers observed that fluciclovine and PSMA significantly increased target volumes in the prostate bed and pelvic lymph nodes.  There were no significant differences in pelvic nodal boosts (10/16 pts vs 5/14 pts, P=.14). However, Fluciclovine gave a greater increase in prostate bed boosts (45/60 vs 26/61, P&lt;.01).
The study findings also revealed that acute toxicity rates (grade 2 gastrointestinal and genitourinary side effects) were mild and similar across both groups. There was also no significant difference in severe (grade 3+) toxicity.
The researchers concluded, “Though both PSMA and fluciclovine integration increased target volumes, significantly more fluciclovine patients received prostate bed boosts. Planning directives were met for most patients, and acute toxicity was mild in both arms”.
They also recommended further follow-up for biochemical control and late toxicity analysis.
<h4>Reference 
</h4>
Dhere V, Schuster DM, Goyal S, et al. Volumetric Changes and Acute Toxicity with 68Ga Prostate-Specific Membrane Antigen vs 18F-Fluciclovine PET/CT Guided Post-Prostatectomy Radiation: Final Analysis of a Randomized Trial. Abstract #318. Presented at the 2024 American Society for Radiation Oncology Annual Meeting; September 29-October 2, 2024; Washington DC.

A study presented at the American Society for Radiation Oncology (ASTRO) 2024 Annual Meeting revealed that both 18 F-Fluciclovine PET/CT and 68Ga PSMA PET/CT guided radiation therapy would significantly change pre-PET radiation therapy volumes and had similar toxicity.68Ga-prostate specific membrane antigen (PSMA) and 18F-Fluciclovine (fluciclovine) positron emission tomography/ computed tomography (PET/CT) are approved for use in prostate cancer patients who have had surgery but whose cancer has recurred.For this study, Dr. Vishal Dhere of the Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia, and colleagues evaluated the radiotherapy target volume or acute toxicity changes using PSMA versus fluciclovine.About 140 patients were randomly chosen; 70 (arm 1) received fluciclovine, and the other 70 (arm 2) received PSMA. Patients recruited in these studies have undergone prostatectomy to remove the tumor but are experiencing recurrence. The patients were assessed for acute toxicity less than 30 days after treatment completion.The researchers observed that fluciclovine and PSMA significantly increased target volumes in the prostate bed and pelvic lymph nodes.  There were no significant differences in pelvic nodal boosts (10/16 pts vs 5/14 pts, P=.14). However, Fluciclovine gave a greater increase in prostate bed boosts (45/60 vs 26/61, P&lt;.01).The study findings also revealed that acute toxicity rates (grade 2 gastrointestinal and genitourinary side effects) were mild and similar across both groups. There was also no significant difference in severe (grade 3+) toxicity.The researchers concluded, “Though both PSMA and fluciclovine integration increased target volumes, significantly more fluciclovine patients received prostate bed boosts. Planning directives were met for most patients, and acute toxicity was mild in both arms”.They also recommended further follow-up for biochemical control and late toxicity analysis.<h4>Reference 
</h4>Dhere V, Schuster DM, Goyal S, et al. Volumetric Changes and Acute Toxicity with 68Ga Prostate-Specific Membrane Antigen vs 18F-Fluciclovine PET/CT Guided Post-Prostatectomy Radiation: Final Analysis of a Randomized Trial. Abstract #318. Presented at the 2024 American Society for Radiation Oncology Annual Meeting; September 29-October 2, 2024; Washington DC.

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Both Fluciclovine and PSMA PET/CT guided radiation therapy would significantly change pre-PET radiation therapy volumes.