EAU-EANM Consensus Statements on the Role of Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography in Patients with Prostate Cancer and with Respect to [177Lu]Lu-PSMA Radioligand Therapy

Stefano Fanti; Alberto Briganti; Louise Emmett; Karim Fizazi; Silke Gillessen; Karolien Goffin; Boris A. Hadaschik; Ken Herrmann; Jolanta Kunikowska; Tobias Maurer; Steven MacLennan; Nicolas Mottet; Declan G. Murphy; Daniela E. Oprea-Lager; Joe M. O'Sullivan; Wim J. G. Oyen; Olivier Rouvière; Oliver Sartor; Arnulf Stenzl; Hendrik van Poppel; Jochen Walz; Wim Witjes; Anders Bjartell

doi:https://doi.org/10.1016/j.euo.2022.05.003

EAU-EANM Consensus Statements on the Role of Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography in Patients with Prostate Cancer and with Respect to [177Lu]Lu-PSMA Radioligand Therapy

Stefano Fanti, Alberto Briganti, Louise Emmett, Karim Fizazi, Silke Gillessen, Karolien Goffin, Boris A. Hadaschik, Ken Herrmann, Jolanta Kunikowska, Tobias Maurer, Steven MacLennan, Nicolas Mottet, Declan G. Murphy, Daniela E. Oprea-Lager, Joe M. O'Sullivan, Wim J. G. Oyen, Olivier Rouvière, Oliver Sartor, Arnulf Stenzl, Hendrik van PoppelJochen Walz, Wim Witjes, Anders Bjartell

Research output: Contribution to journal › Article › Academic › peer-review

22 Citations (Scopus)

Abstract

BACKGROUND: Prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) is useful for selected clinical indications in patients with prostate cancer (PCa) but it may have broader clinical utility owing to the emergence of lutetium-177-PSMA-617 ([177Lu]Lu-PSMA) therapy. However, robust data regarding the impact of PSMA PET/CT on patient management and treatment are lacking, and in many areas, the role of next-generation imaging has not been defined. OBJECTIVE: To assess expert opinion on the use of PSMA-based imaging and therapy to develop interim guidance. DESIGN, SETTING, AND PARTICIPANTS: A panel of 21 PCa experts from various disciplines received thematic topics and relevant literature. A questionnaire to assess proposed guidance statements regarding PSMA PET/CT and [177Lu]Lu-PSMA therapy was developed for completion remotely in a first e-Delphi round. A subsequent panel discussion was conducted during a 1-d meeting, which included a second Delphi round. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Panellists voted anonymously on statements using a nine-point Likert scale from 1 = strongly disagree to 9 = strongly agree. Median scores were calculated and consensus was assessed using methods proposed by the Research and Development (RAND) corporation. RESULTS AND LIMITATIONS: Statements were developed to cover the following topics: PSMA PET/CT utility, clinical use, and choice of tracer; patient selection; and management of patients receiving [177Lu]Lu-PSMA for metastatic PCa. Consensus was reached for 33/36 statements. In-group bias is a potential limitation, as some statements were rephrased during discussions at the 1-d meeting. CONCLUSIONS: Adoption of PSMA PET/CT as an imaging tool to guide [177Lu]Lu-PSMA therapy should be supported by indications for appropriate use. PATIENT SUMMARY: A panel of experts in prostate cancer reached a consensus for the majority of statements proposed regarding the role of prostate-specific membrane antigen (PSMA)-based imaging and therapy, particularly the use of PSMA-based imaging in patients suitable for [177Lu]Lu-PSMA therapy and the need to perform PSMA-based imaging before considering patients as candidates for this therapy.

Original language	English
Pages (from-to)	530-536
Number of pages	7
Journal	European Urology Oncology
Volume	5
Issue number	5
DOIs	https://doi.org/10.1016/j.euo.2022.05.003
Publication status	Published - 1 Oct 2022

Keywords

Computed tomography
Consensus
Diagnosis
Lutetium
Patient selection
Positron emission tomography
Prostate cancer
Prostate-specific membrane antigen
Radioactive tracer
Therapy

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Fanti, S., Briganti, A., Emmett, L., Fizazi, K., Gillessen, S., Goffin, K., Hadaschik, B. A., Herrmann, K., Kunikowska, J., Maurer, T., MacLennan, S., Mottet, N., Murphy, D. G., Oprea-Lager, D. E., O'Sullivan, J. M., Oyen, W. J. G., Rouvière, O., Sartor, O., Stenzl, A., ... Bjartell, A. (2022). EAU-EANM Consensus Statements on the Role of Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography in Patients with Prostate Cancer and with Respect to [177Lu]Lu-PSMA Radioligand Therapy. European Urology Oncology, 5(5), 530-536. https://doi.org/10.1016/j.euo.2022.05.003

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title = "EAU-EANM Consensus Statements on the Role of Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography in Patients with Prostate Cancer and with Respect to [177Lu]Lu-PSMA Radioligand Therapy",

abstract = "BACKGROUND: Prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) is useful for selected clinical indications in patients with prostate cancer (PCa) but it may have broader clinical utility owing to the emergence of lutetium-177-PSMA-617 ([177Lu]Lu-PSMA) therapy. However, robust data regarding the impact of PSMA PET/CT on patient management and treatment are lacking, and in many areas, the role of next-generation imaging has not been defined. OBJECTIVE: To assess expert opinion on the use of PSMA-based imaging and therapy to develop interim guidance. DESIGN, SETTING, AND PARTICIPANTS: A panel of 21 PCa experts from various disciplines received thematic topics and relevant literature. A questionnaire to assess proposed guidance statements regarding PSMA PET/CT and [177Lu]Lu-PSMA therapy was developed for completion remotely in a first e-Delphi round. A subsequent panel discussion was conducted during a 1-d meeting, which included a second Delphi round. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Panellists voted anonymously on statements using a nine-point Likert scale from 1 = strongly disagree to 9 = strongly agree. Median scores were calculated and consensus was assessed using methods proposed by the Research and Development (RAND) corporation. RESULTS AND LIMITATIONS: Statements were developed to cover the following topics: PSMA PET/CT utility, clinical use, and choice of tracer; patient selection; and management of patients receiving [177Lu]Lu-PSMA for metastatic PCa. Consensus was reached for 33/36 statements. In-group bias is a potential limitation, as some statements were rephrased during discussions at the 1-d meeting. CONCLUSIONS: Adoption of PSMA PET/CT as an imaging tool to guide [177Lu]Lu-PSMA therapy should be supported by indications for appropriate use. PATIENT SUMMARY: A panel of experts in prostate cancer reached a consensus for the majority of statements proposed regarding the role of prostate-specific membrane antigen (PSMA)-based imaging and therapy, particularly the use of PSMA-based imaging in patients suitable for [177Lu]Lu-PSMA therapy and the need to perform PSMA-based imaging before considering patients as candidates for this therapy.",

keywords = "Computed tomography, Consensus, Diagnosis, Lutetium, Patient selection, Positron emission tomography, Prostate cancer, Prostate-specific membrane antigen, Radioactive tracer, Therapy",

author = "Stefano Fanti and Alberto Briganti and Louise Emmett and Karim Fizazi and Silke Gillessen and Karolien Goffin and Hadaschik, {Boris A.} and Ken Herrmann and Jolanta Kunikowska and Tobias Maurer and Steven MacLennan and Nicolas Mottet and Murphy, {Declan G.} and Oprea-Lager, {Daniela E.} and O'Sullivan, {Joe M.} and Oyen, {Wim J. G.} and Olivier Rouvi{\`e}re and Oliver Sartor and Arnulf Stenzl and {van Poppel}, Hendrik and Jochen Walz and Wim Witjes and Anders Bjartell",

year = "2022",

month = oct,

day = "1",

doi = "https://doi.org/10.1016/j.euo.2022.05.003",

language = "English",

volume = "5",

pages = "530--536",

journal = "European Urology Oncology",

issn = "2588-9311",

publisher = "Elsevier BV",

number = "5",

}

Fanti, S, Briganti, A, Emmett, L, Fizazi, K, Gillessen, S, Goffin, K, Hadaschik, BA, Herrmann, K, Kunikowska, J, Maurer, T, MacLennan, S, Mottet, N, Murphy, DG, Oprea-Lager, DE, O'Sullivan, JM, Oyen, WJG, Rouvière, O, Sartor, O, Stenzl, A, van Poppel, H, Walz, J, Witjes, W & Bjartell, A 2022, 'EAU-EANM Consensus Statements on the Role of Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography in Patients with Prostate Cancer and with Respect to [177Lu]Lu-PSMA Radioligand Therapy', European Urology Oncology, vol. 5, no. 5, pp. 530-536. https://doi.org/10.1016/j.euo.2022.05.003

EAU-EANM Consensus Statements on the Role of Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography in Patients with Prostate Cancer and with Respect to [177Lu]Lu-PSMA Radioligand Therapy. / Fanti, Stefano; Briganti, Alberto; Emmett, Louise et al.
In: European Urology Oncology, Vol. 5, No. 5, 01.10.2022, p. 530-536.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - EAU-EANM Consensus Statements on the Role of Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography in Patients with Prostate Cancer and with Respect to [177Lu]Lu-PSMA Radioligand Therapy

AU - Fanti, Stefano

AU - Briganti, Alberto

AU - Emmett, Louise

AU - Fizazi, Karim

AU - Gillessen, Silke

AU - Goffin, Karolien

AU - Hadaschik, Boris A.

AU - Herrmann, Ken

AU - Kunikowska, Jolanta

AU - Maurer, Tobias

AU - MacLennan, Steven

AU - Mottet, Nicolas

AU - Murphy, Declan G.

AU - Oprea-Lager, Daniela E.

AU - O'Sullivan, Joe M.

AU - Oyen, Wim J. G.

AU - Rouvière, Olivier

AU - Sartor, Oliver

AU - Stenzl, Arnulf

AU - van Poppel, Hendrik

AU - Walz, Jochen

AU - Witjes, Wim

AU - Bjartell, Anders

PY - 2022/10/1

Y1 - 2022/10/1

N2 - BACKGROUND: Prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) is useful for selected clinical indications in patients with prostate cancer (PCa) but it may have broader clinical utility owing to the emergence of lutetium-177-PSMA-617 ([177Lu]Lu-PSMA) therapy. However, robust data regarding the impact of PSMA PET/CT on patient management and treatment are lacking, and in many areas, the role of next-generation imaging has not been defined. OBJECTIVE: To assess expert opinion on the use of PSMA-based imaging and therapy to develop interim guidance. DESIGN, SETTING, AND PARTICIPANTS: A panel of 21 PCa experts from various disciplines received thematic topics and relevant literature. A questionnaire to assess proposed guidance statements regarding PSMA PET/CT and [177Lu]Lu-PSMA therapy was developed for completion remotely in a first e-Delphi round. A subsequent panel discussion was conducted during a 1-d meeting, which included a second Delphi round. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Panellists voted anonymously on statements using a nine-point Likert scale from 1 = strongly disagree to 9 = strongly agree. Median scores were calculated and consensus was assessed using methods proposed by the Research and Development (RAND) corporation. RESULTS AND LIMITATIONS: Statements were developed to cover the following topics: PSMA PET/CT utility, clinical use, and choice of tracer; patient selection; and management of patients receiving [177Lu]Lu-PSMA for metastatic PCa. Consensus was reached for 33/36 statements. In-group bias is a potential limitation, as some statements were rephrased during discussions at the 1-d meeting. CONCLUSIONS: Adoption of PSMA PET/CT as an imaging tool to guide [177Lu]Lu-PSMA therapy should be supported by indications for appropriate use. PATIENT SUMMARY: A panel of experts in prostate cancer reached a consensus for the majority of statements proposed regarding the role of prostate-specific membrane antigen (PSMA)-based imaging and therapy, particularly the use of PSMA-based imaging in patients suitable for [177Lu]Lu-PSMA therapy and the need to perform PSMA-based imaging before considering patients as candidates for this therapy.

AB - BACKGROUND: Prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) is useful for selected clinical indications in patients with prostate cancer (PCa) but it may have broader clinical utility owing to the emergence of lutetium-177-PSMA-617 ([177Lu]Lu-PSMA) therapy. However, robust data regarding the impact of PSMA PET/CT on patient management and treatment are lacking, and in many areas, the role of next-generation imaging has not been defined. OBJECTIVE: To assess expert opinion on the use of PSMA-based imaging and therapy to develop interim guidance. DESIGN, SETTING, AND PARTICIPANTS: A panel of 21 PCa experts from various disciplines received thematic topics and relevant literature. A questionnaire to assess proposed guidance statements regarding PSMA PET/CT and [177Lu]Lu-PSMA therapy was developed for completion remotely in a first e-Delphi round. A subsequent panel discussion was conducted during a 1-d meeting, which included a second Delphi round. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Panellists voted anonymously on statements using a nine-point Likert scale from 1 = strongly disagree to 9 = strongly agree. Median scores were calculated and consensus was assessed using methods proposed by the Research and Development (RAND) corporation. RESULTS AND LIMITATIONS: Statements were developed to cover the following topics: PSMA PET/CT utility, clinical use, and choice of tracer; patient selection; and management of patients receiving [177Lu]Lu-PSMA for metastatic PCa. Consensus was reached for 33/36 statements. In-group bias is a potential limitation, as some statements were rephrased during discussions at the 1-d meeting. CONCLUSIONS: Adoption of PSMA PET/CT as an imaging tool to guide [177Lu]Lu-PSMA therapy should be supported by indications for appropriate use. PATIENT SUMMARY: A panel of experts in prostate cancer reached a consensus for the majority of statements proposed regarding the role of prostate-specific membrane antigen (PSMA)-based imaging and therapy, particularly the use of PSMA-based imaging in patients suitable for [177Lu]Lu-PSMA therapy and the need to perform PSMA-based imaging before considering patients as candidates for this therapy.

KW - Computed tomography

KW - Consensus

KW - Diagnosis

KW - Lutetium

KW - Patient selection

KW - Positron emission tomography

KW - Prostate cancer

KW - Prostate-specific membrane antigen

KW - Radioactive tracer

KW - Therapy

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U2 - https://doi.org/10.1016/j.euo.2022.05.003

DO - https://doi.org/10.1016/j.euo.2022.05.003

M3 - Article

C2 - 35697600

SN - 2588-9311

VL - 5

SP - 530

EP - 536

JO - European Urology Oncology

JF - European Urology Oncology

IS - 5

ER -

Fanti S, Briganti A, Emmett L, Fizazi K, Gillessen S, Goffin K et al. EAU-EANM Consensus Statements on the Role of Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography in Patients with Prostate Cancer and with Respect to [177Lu]Lu-PSMA Radioligand Therapy. European Urology Oncology. 2022 Oct 1;5(5):530-536. doi: https://doi.org/10.1016/j.euo.2022.05.003

EAU-EANM Consensus Statements on the Role of Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography in Patients with Prostate Cancer and with Respect to [177Lu]Lu-PSMA Radioligand Therapy

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Keywords

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