Jeremie Calais, MD, MSc, presented “Current Status of PSMA Diagnostics” during the 31st International Prostate Cancer Update in July 2021 in Snowbird, Utah.
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How to cite: Calais, Jeremie. “Current Status of PSMA Diagnostics.” July 2021. Accessed Nov 2024. https://dev.grandroundsinurology.com/current-status-of-psma-diagnostics/
Current Status of PSMA Diagnostics – Summary
Jeremie Calais, MD, MSc, Assistant Professor and Director of the Clinical Research Program in the Ahmanson Translational Theranostics Division of the Department of Molecular and Medical Pharmacology at UCLA, discusses PSMA diagnostics and compares imaging modalities to establish which modality is ideal for prostate cancer staging. He shares the FDA guidelines, stating that Ga 68 PSMA-11 is to be used for patients with prostate cancer (PCa) with suspected metastasis who are candidates for definitive therapy, and with suspected recurrence based on elevated serum prostate-specific antigen (PSA) level. Dr. Calais summarizes two trials used to support FDA approval of the diagnostic agent, including one on biochemical recurrence localization showing an overall detection rate of 75%, and another on primary nodal N1 staging that shows a sensitivity of 40% and a specificity of 95% for Ga 68 PSMA-11. Dr. Calais also notes the weaknesses of PSMA-11, including PET/CT’s inability to detect microscopic cancer cells, the way bone trauma in the ribs can lead to false positives, the challenge of accurately reading faint uptake lymph nodes, and how urine can disrupt analysis of the prostate fossa. Dr. Calais then compares PSMA against fluciclovine, finding that PSMA has a 30% higher detection rate; and against conventional imaging, finding that PSMA has a 27% higher rate of accuracy, as well as higher sensitivity and specificity. He also compares PSMA and local staging with MRI, highlighting a study on intra-prostatic tumor detection that shows a negligible difference in detection rates, as well as two studies on PSMA PET for biopsy guidance that show PSMA PET’s effectiveness in detecting especially challenging cancer. Dr. Calais concludes that PSMA PET/CT should replace other imaging modalities for prostate cancer staging and should be used as a complement to MRI for intra-prostatic tumor detection and staging.
About The 31st Annual International Prostate Cancer Update:
The International Prostate Cancer Update (IPCU), founded in 1990, is a multi-day CME conference focused on prostate cancer treatment updates with expert, international faculty. It is led by expert physicians and is designed for urologists, medical oncologists, radiation oncologists, and other healthcare professionals involved in the diagnosis and treatment of prostate cancer. Dr. Calais delivered this educational activity during the 31st iteration of the meeting in July 2021 in Snowbird, Utah.
ABOUT THE AUTHOR
Dr. Jeremie Calais received his MD from the University of Paris-Diderot in 2010 before training in nuclear medicine and cancer imaging at the Henri Becquerel Cancer Center at the University of Rouen. He was board certified by the French Society of Nuclear Medicine in 2014. Dr. Calais is Assistant Professor and Director of the Clinical Research Program of the Ahmanson Translational Theranostics Division of the Department of Molecular and Medical Pharmacology at UCLA, where he is also a member of the Jonsson Comprehensive Cancer Center and the UCLA Institute of Urologic Oncology. Under Dr. Calais’s guidance, the clinical research program focuses on translatable radiolabeled theranostic pairs that can be used and applied for diagnosis and therapy of cancer and combines academic investigator-initiated and industry sponsored studies using targeted radionuclide imaging and therapy. Dr. Calais’s work focuses on improving the outcomes of cancer patients by applying novel diagnostic and therapeutic approaches. He uses PET/CT imaging for cancer phenotyping, radiation therapy planning, and therapy response assessment and currently serves as Principal Investigator of randomized prospective phase 2 and 3 clinical trials.
