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Prostate-Specific Membrane Antigen is a Biomarker for Residual Disease Following Neoadjuvant Intense Androgen Deprivation Therapy in Prostate Cancer

Authors
  • Bright, John R.1
  • Lis, Rosina T.1
  • Ku, Anson T.1
  • Terrigino, Nicholas T.1
  • Whitlock, Nichelle C.1
  • Trostel, Shana Y.1
  • Carrabba, Nicole V.1
  • Harmon, Stephanie A.2
  • Turkbey, Baris2
  • Wilkinson, Scott1
  • Sowalsky, Adam G.1
  • 1 Laboratory of Genitourinary Cancer Pathogenesis, National Cancer Institute, NIH, 37 Convent Drive, Bethesda, MD, 20892, USA
  • 2 Molecular Imaging Branch, National Cancer Institute, NIH, 10 Center Drive, Bethesda, MD, 20892, USA
Type
Published Article
Journal
The Journal of urology
Publication Date
Mar 01, 2022
Volume
208
Issue
1
Pages
90–99
Identifiers
DOI: 10.1097/JU.0000000000002492
PMID: 35227084
PMCID: PMC9187602
Source
PubMed Central
Keywords
Disciplines
  • Article
License
Unknown

Abstract

Purpose: Neoadjuvant intense androgen deprivation therapy (iADT) can exert a wide range of histologic responses, which in turn are reflected in the final prostatectomy specimen. Accurate identification and measurement of residual tumor volumes are critical for tracking and stratifying patient outcomes. Materials and Methods: The goal of this current study was to evaluate the ability of antibodies against prostate-specific membrane antigen (PSMA) to specifically detect residual tumor in a cohort of 35 patients treated with iADT plus enzalutamide for six months prior to radical prostatectomy. Results: Residual carcinoma was detected in 31 patients, and PSMA reacted positively with tumor in all cases. PSMA staining was 96% sensitive for tumor, with approximately 82% of benign regions showing no reactivity. By contrast, PSMA positively reacted with 72% of benign regions in a control cohort of 37 untreated cases, resulting in 28% specificity for tumor. PSMA further identified highly dedifferentiated prostate carcinomas including tumors with evidence of neuroendocrine differentiation. Conclusions: We propose that anti-PSMA immunostaining be a standardized marker for identifying residual cancer in the setting of neoadjuvant intense androgen deprivation therapy.

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