#TheraP
Trial presented
#GU21
published
@TheLancet
: findings demonstrate Lu-177 PSMA-617 is a potential alternative to cabazitaxel: better activity, safety, and patient-reported outcomes
@ANZUPTrials
#ProPSMA
randomised study online in
@thelancet
:
PSMA PET/CT can replace CT/bone scans in men with aggressive prostate ca:
✔Accuracy 92% v 65%
✔Management impact 28% v15%
✔Uncertain findings 7% v 23%
✔Radiation dose 8 v 19mSv
@gu_onc
@pcfa
@movember
ENZA-P in
@TheLancetOncol
Lu-177 PSMA-617 + enzalutamide vs. enza alone:
● ↑PFS: 13.0 vs 7.8, hazard radio 0.43
● PSA90 response 78% vs 37%
● PSA50 response 93% vs. 68%
● no additional side effects
Incredible work from
@drlouiseemmett
@Prof_IanD
&
@ANZUPtrials
team
Another extraordinary day at
@PeterMacCC
. We gave cycle
#17
of Lu-177 PSMA-617 to a patient with prostate cancer. Continues to benefit 4+ years. Bloods and renal function normal.
Even more extraordinary, We were both wearing the same socks.
@pros_tic
Reading the NCCN v1.2023 prostate cancer guidelines and noting this change of wording: "Ga-68 PSMA-11 or F-18 piflufolastat PSMA PET/CT or PET/MRI are preferred for bone and soft tissue (full body) imaging.". No longer an "alternative". Now preferred.
"Nonmetastatic" Castration-Resistant Prostate Cancer is now officially a misnomer. New research in patients with normal CT and bone scans, show almost 100% PSMA PET+, 55% with M1 disease.
@gu_onc
1/
#LuTectomy
#EAU23
Game Changing Session: first use of Lu-177 PSMA-617 first-line in patients with high-risk localised N0/N1 prostate cancer: 20pt. 1-2 cycles→prostatectomy. ☢36Gy. 45% PSA50-RR. Safe. Few toxicities.
@RenuEapen
@declangmurphy
@Uroweb
SUVmean > 10 on PSMA PET in the Vision trial had improved OS and PFS. It's extraordinary that we found the same cut-off in our ph2
@PeterMacCC
study and
@ANZUPtrials
#TheraP
study.
**WE HAVE A NEW BIOMARKER**
#ASCO22
@ASCO
We are officially live!
@StanfordRadOnc
is incredibly proud to deliver the first radiation treatment on a patient using the Reflexion X1 machine. Huge congratulations to our team!!
1/ Hot of the press:
#TheraP
Imaging Biomarkers presented
@asco
#GU21
. PSMA PET is a PREDICTIVE biomarker: patients randomised to Lu-PSMA-617 with very high PSMA expression on PSMA PET had a 91% PSA RESPONSE RATE (PSA decline>50%).
@ANZUPtrials
@TrialsCentre
Introducing the new PRIMARY score for reporting PSMA PET: using intra-prostatic PSMA PET/CT patterns to optimise prostate cancer DIAGNOSIS.
We feel this is MAJOR advance for interpretation of PSMA PET.
@drlouiseemmett
@JournalofNucMed
Diagnostic Accuracy of PSMA PET/CT for Initial Staging of Intermediate to High-risk Prostate Cancer: Systematic Review and Meta-analysis
"PSMA-PET should be used as a first-line approach for the initial staging of PCa."
@EUplatinum
@declangmurphy
#UpFrontPSMA
: Randomised Controlled Trial using Lu-177 PSMA first-line rather than last-line in men with newly diagnosed advanced prostate cancer (hormone-sensitive). Launched today at Peter Mac. Big milestone. Thanks
@MovemberAUS
for funding this world first trial.
@AzadOncology
📢
@ANZUPtrials
#TheraP
Lu-177 PSMA-617 is an alternative to cabazitaxel for men with metastatic castration-resistant prostate cancer: less toxicity and no difference in survival.
Hot of the press:
@TheLancetOncol
PSMA PET/CT (Ga-68 and F-18) will be reimbursed in Australia from 01 Jul 22 for staging intermediate-to-high risk and biochemical recurrence. Direct result of Australian led research
@PeterMacCC
@ANZUPtrials
#ARTnet
Australasian Assoc of Nuclear Medicine Specialists
The news that patients with prostate cancer have been waiting for: PSMA PET/CT is available through MBS as at 01 July 2022 improving patient access & enabling more accurate staging of prostate cancer, leading to appropriately targeted therapies & better outcomes for patients.
Is a PSMA PET/CT costly? Our health economics analysis in
#ProPSMA
revealed that it is not only more cost-effective but also more accurate than the combination of CT and bone scans ($1203 vs $1412). Plus, it offers a better patient experience! 💰📊👨⚕️
ViSION trial: improvements in overall survival & progression free survival with Lutetium-177 PSMA-617 ... Nice to see come through from early development to phase 3 results
@Novartis
#proPSMA
trial analysis demonstrates PSMA PET/CT is more accurate and CHEAPER than CT+bone scan (AU$1203 vs AU$1412). 1 scan instead of 2! Compelling evidence for widespread adoption. Online
@EUplatinum
🙏
@MovemberAUS
@PCFA
for funding.
@declangmurphy
LuDOTATATE vs sunitinib in pancreatic NET 1yr PFS: 80.5% vs 42%. Large difference favouring PRRT. And, much less G3/4 toxicity 44% vs 63%.
80 pt study: a lot can be achieved with small studies with effect size is large.
OCLURANDOM trial
@myESMO
Actinium-225 PSMA RLT for metastatic prostate cancer in
@TheLancetOncol
Conclusion spot on: "future prospective studies investigating the safety and efficacy of 225Ac-PSMA RLT in patients who have not responded to 177Lu-PSMA RLT are needed."
PSMA PET era highlighting the limitations of bone scanning. 167 patients: 57% of "positive" bone scans were false positive (FP). Those sticking with bone scan because of "stage migration" need to move on - FP harmful, never benefit patients.
@asco
#asco23
#VISION
&
#TheraP
Lu-PSMA-617 infographics! Combined results provide definitive results in men with prostate cancer who have progressed after docetaxel & androgen-receptor Rx: ⬆️OS/rPFS, low G3+ AEs, ⬆️ QoL.
@ASCO
@Novartis
@ANZUPtrials
Today: PSMA PET/CT funded by Medicare, enabling free access to men with prostate cancer access across Australia. Thanks to everyone who contributed to the science and policy.
@pros_tic
I'm concerned about twice-weekly RATs in Melbourne schools. Once immunity is gained (vaccination±exposure) "we need focused and fewer tests, not more testing"
"Testing asymptomatic people is tricky ... major harms obscured"
@VPrasadMDMPH
Exciting update: 200th patient enrolled in the PRIMARY2 trial! Investigating PSMA PET scans' potential to improve diagnosis of prostate cancer and reduce unnecessary biopsies.
🙏
@ButeauJames
@drlouiseemmett
@DrDanielMoon
for driving
FDG PET/CT too often ignored: a game changer for advanced disease. Enhances disease site assessment, helps in🎯personalized theranostic treatments. Say goodbye to 'one-size-fits-all'! 💥
Nice review by Dr Sutherland:
Saw another patient this week misclassified as progression on DOTATATE PET/CT when the change was likely due to commencement of long-acting octreotide therapy. "Pseudoprogression" under-recognised phenomenon:
@globeseek
@marklewismd
@OncoThor
Hot off the press. PSMA theranostics FDA approved: Lu-177 PSMA-617 (Pluvicto™) + Ga-68 kit (Locametz®) for PET imaging. First radioligand therapy for prostate cancer.
@PeterMacCC
ph2 spearheaded development. Prolongs survival & Improves quality of life
‘‘All that glitters is not gold!’’. Low volume metastatic disease on planar bone scans: high incidence of false positive results. Re-defining as benign on SPECT/CT or PSMA PET/CT is *not* stage migration or Will-Rogers effect, but simply more accurate.
We grapple with "false positives" PSMA-PET bone mets in our MDTs frequently. Usually low-grade uptake on outside PET that we read as benign. New research from
@flavell_rob
@UCSFimaging
found 23% false+ve bone mets. SUVmax>4.1 predicted true positive.
🌟Introducing PROMISE 2 for standardized evaluation of PSMA PET/CT! 📄Unlock the full potential for clinical routine & research 🔍🎯 Improve accuracy & consistency💪
#PSMA
@Uroweb
Kinetics of PSMA uptake on PET post external beam radiotherapy: super interesting data from
#MasatoshiHotta
@CalaisJeremie
@ASCO
#GU22
. Lesion uptake decreases gradually and reaches lowest at 9-12 months. Prostate response slower than bone or LN.
Any thoughts
@_ShankarSiva
?
Lu-177-PSMA-617 vs. cabazitaxel: outcomes
PSA decline >=50%: 66 vs 37%
PFS: hazard ratio 0.63
12 month PFS: 19 vs 3%
ORR: 49 vs 24%
G3-4 AEs: 33 vs 53%
"Integration of radioligand therapy (RLT) with metastasis-directed therapy (MDT) might reduce progression, including polymetastatic progression, in the setting of oligorecurrent disease."
State-of-the-Art review by
@AmarUKishan
@_ShankarSiva
@CalaisJeremie
on role of
We followed up the patients in the 2019 highly cited first description of PSMA PET/CT findings in "non-metastatic prostate cancer" to see what happened with overall survival... Polymetastatic disease [≥5 metastasis] on PSMA PET/CT** was associated with shorter survival.
**
Peter Mac has won
#ClinicalTrial
of the Year for the
#proPSMA
Study which found that a new molecular imaging technique is more accurate than conventional medical imaging, and recommends the scans be introduced into routine clinical practice. Read more:
Actinium-225 DOTATATE in
#neuroendocrinetumours
. Outcomes in 91 patients, 54 previously treated with Lutetium-177. Data looks promising: need investment in clinical trials. What does that look like? RCT of Lu-177 vs. Ac-225
@JournalofNucMed
@NECancerAus
Lutetium-177 PSMA Theranostics: Optimal Sequencing in 2023 and Future Outlook
#ASCODailyNews
@ASCO
Rapidly changing landscape: what do you think is next?
Fluciclovine (Axumin) vs PSMA PET-CT in biochemical recurrence: the results are in and there is a clear winner - 26% be 56% detection rate.
@gu_onc
proud to contribute this
@UCLATheranostic
research.
Almost all M0 pts with castration-resistant disease have PSMA-avid disease, around 50% M1. Great to contribute to this German-USA-Australian collaborative effort.
@PeterMacCC
#SUO18
#ASCO20
Metastasis-directicted ablative therapy using PSMA PET-MR/CT: ~80% were PSMA PET+ (all negative on conventional imaging). 60% had "response". Need ph3 trials: still experimental until then?
@_ShankarSiva
#APCCC22
: highlighting the alarming false-positive (FP) rate of conventional imaging (CT and bone scan). In the ProPSMA study, when equivocal imaging findings were considered positive (sensitivity analysis) the FP rate was 23% vs 7% (CI vs PSMA). This is not stage migration.
📣 Just released! Joint
@EANM_NucMed
@SNM_MI
Lu-177 PSMA guidelines. Step forward in improving the standard of care for delivery of radioligand therapy.
@ProfKHerrmann
Updated outcomes of our n=50 Phase II Lu-177 PSMA-617 cohort: 64% (95%CI 50-77) achieved PSA≥50 response. In 14 patients who subsequently progressed and were given more Lu-PSMA, high response rates were also observed.
@PeterMacCC
@ASCO
#GU19
A real honour and a testament to the collective efforts of our world-class team
@PeterMacCC
This accolade strengthens our commitment to advancing nuclear medicine, improving patient outcomes & continuing our journey of innovative healthcare solutions in Australia and beyond.
Pioneering new imaging technologies for cancer – a nuclear medicine physician‐scientist, his technologies are more accurate than standard imaging, with better outcomes compared to chemotherapy. Welcome Prof
@DrMHofman
as a new
#AAHMSFellow
.
@PeterMacCC
@Pros_TIC
What's new in oncology?
@UpToDate
updates for prostate cancer:
"For most males with PSMA-expressing mCRPC, we suggest 177-Lu [PSMA-617] rather than cabazitaxel after failure of ARPIs and docetaxel" citing
@ANZUPtrials
#TheraP
study.
Novel radiolabeled PARP PET imaging: striking images in breast cancer (ER+, TNBC and HER2+). Enables imaging of regional PARP-1 expression for the first time (= imaging tumour heterogeneity). May predict response to PARP inhibitors.
CONGRATULATIONS to the
@PCFnews
2022 TACTICAL Award recipients!! This $30 million program will support 4 cross-disciplinary research teams working to develop 21st Century therapies for the most life-threatening forms of
#ProstateCancer
! 🥳🎉
Important study: more than 6 cycles of Lu-177 PSMA is both and safe and efficacious. For patients who benefited from initial cycles, there is an urgent need to enable global access to more cycles of effective treatment.
PSMA: The Target of the Decade, from Biochemical Recurrence to Widespread Adoption. Great honour to write this piece for
@SNM_MI
JNM 60th Anniversary Special. Nuclear medicine from 1960s to 2020 and beyond
Molecular imaging prognostic markers in men undergoing Lu-PSMA therapy for prostate cancer:
high volume of FDG-avid disease unfavourable. vs high PSMA-intensity favourable.
@gu_onc
@PeterMacCC
⬆reports of
#Omicron
#COVID19
on FDG PET/CT: prominent, symmetric FDG uptake in tonsils, nasopharynx, oropharynx ± cervical LNs. No lung findings: suggesting very different disease to Alpha-Delta in-line with growing evidence.
Ga-68 FAPI-04 compared to FDG PET/CT in a case of metastatic esophageal squamous cell carcinoma. SUVmax 21 vs. 13 + additional sites of disease visualised. Nice work from Fudan University Shanghai Cancer
Center.
Predict outcomes to Lu-PSMA in late-stage mCRPC with this tool: multicenter collaboration. Hot-of-the-press published in
@TheLancetOncol
outcomes of 270 pt.
Open access paper:
Web calculator:
The era of using metabolic tumour volume (MTV) to guide patient management has arrived. An actionable PET quantitative parameter that is superior to conventional IPI. .
@SFBarringtonKCL
@GeorgeMikhaeel
A long road began in 2014 seeing early data coming from Germany inspiring us to do a
@PeterMacCC
prospective trial of Lutetium-177 PSMA-617 in metastatic prostate cancer.
Excited to witness the future of PET/CT imaging in Bologna with
@stefanofanti4
. to see the first Total Body uEXPLORER PET/CT in Europe being installed. I would like a Birthday present this too!
Great to see the rest of the team inc.
@andrea_farolfi
Triplet therapy for prostate cancer:
@Prof_IanD
commentary on PEACE-1
@TheLancet
"It is not enough to talk about PEACE-1. One must believe in it. And it is not enough to believe in it. One must work at it."
@ANZUPtrials
@AlbertoBossial
Is F-18 DCFPyL equivalent or better than Ga-68 PSMA-11? A common question.
An uncommon question: is BPL equivalent to OSEM PET reconstruction?
The technical parameters that reconstruct your PET images matter just as much as choice of radiotracer.
Congrats
@NarjessAyati
on
🌟 Now accepting applications for 3 funded 2025 registrar/fellow nuclear medicine positions at Peter MacCallum Cancer Centre 🌟
Join our team and advance your career in a leading cancer research and treatment center!
If you're passionate about nuclear medicine and making a
Is PSMA PET/CT cost-effective for disease staging in men with high-risk prostate cancer? An analysis from the proPSMA randomised controlled study
@officialEANM
2020 Virtual Meeting Next Week