Implications of PSMA PET Imaging for Prostate Cancer Presentation & Discussion - Oliver Sartor, and FDA approves F18 DCFPyl

[NPfisherman]

Greetings FPC folks,

First, a UroToday presentation with Drs Oliver Sartor, Neal Shore, Alicia Morgans, and Phillip Koo--RO at MD Anderson. This presentation goes into how the newer scans are "10-100X better than traditional scans". They go on to discuss OSPREY trial and the ORIOLE trial, and treatment options. As Sartor stated about the ORIOLE trial-- "In conclusion SABR, stereotactic body radiotherapy, or SBRT improves PFS in men with oligometastatic prostate cancer when using conventional imaging compared to observation alone, but total consolidation of PSMA radiotracer-avid lesions gives stronger results. And that's the punchline from this ORIOLE trial."

urotoday.com/video-lectures...

Next, the FDA approves a new and better scan--the F18 DCFPyl scan--from Onclive:

onclive.com/view/fda-approv...

With the newer scan approved, this will allow oligometastatic patients to get a better scan, and treat all lesions that can be seen giving stronger results for patients.

Incredible....that Science....

Don Pescado

[StayingOptimistic]

Thanks for posting. Does this mean I can go to MSK anytime(after scheduling ofcourse) and get one?

[NPfisherman in reply to StayingOptimistic]

I believe from the OncLive article that it stated it would be widely available by the end of the year. MSK may have been involved in the CONDOR or OSPREY trials and as such. I would expect earlier availability. The scan was just approved today. I would wait a week and call the Radiology Dept at MSK.

Fish

[NPfisherman in reply to StayingOptimistic]

Took a look at your profile and your PSA was 0.07 ( don't call yourself James Bond !!) on 4/2/21. I believe they prefer PSA to be at 0.2 or above, but talk with your MO and RO. The insurance may be agreeable although I would expect the ability to detect to be low based on your status.

Fish

[cesanon in reply to StayingOptimistic]

I would start with a teleconsultation with Sartor. He does, or at least was doing them.

If you want to get the treatment, he is the guy that can give you the right referral to the head of the line, I would expect.

[NPfisherman in reply to StayingOptimistic]

I confirmed that one of the locations for the CONDOR trial was MSK-see below:

clinicaltrials.gov/ct2/show...

There is no need to contact Dr. Sartor as he is an MO, not an RO. You will do fine at your home center.

Fish

[6357axbz]

It’s more like 0.5 or above.

My quick take is while no completed phase III trials have yet to show proof that MDT is prolonging life or slowing cancer some of these more aggressive MOs are zapping all mets visible to the new radio ligend pet-ct scans, followed by first and/or second level ADT and have been accumulating some very positive results.

[NPfisherman in reply to 6357axbz]

That was discussed by Sartor and panel in the UroToday clip. ORIOLE showed improved PFS and MFS by use of SBRT for oligometastatic disease. While some posters, bloggers, etc.. proclaim frequently that improved OS is not proven using SBRT for oligometastases, the REALITY is that proving improved OS would require TEN YEARS of f/u and that is NOT AVAILABLE !!! The fact that Sartor, Morgans, etc are using SBRT with ADT plus or minus Abi or Enza for 6 months and getting solid results speaks volumes over those that say that "zapping mets is ok". We could discuss STOMP as well, but SBRT for oligometastatic PCA patients is being done by leading Oncologists regularly tells you where this is going.

SABR COMET 10 for 4-10 lesions is a Phase III trial and if that goes as I expect it will, then SBRT will become part of standard therapy for many cancers.

Fish

[NPfisherman in reply to 6357axbz]

Here is an article on detection levels and 17/29 (59%) for PSA less than 0.5-see below:

ncbi.nlm.nih.gov/pmc/articl...

Earlier detection means earlier treatment--Will that prolong life, slow castrate resistance, improve QOL, and the list goes on. Some things are proven, but OS is not. It is being done without a Phase III and that tells us something....

Fish