Emerging Insights in Diagnosing Recurrent Prostate Cancer in Men with Low PSA Levels

Ashesh Jani, M.D., said there has been a considerable increase in referred post-prostatectomy patients with lower prostate-specific antigen (PSA) levels, making it increasingly important to have diagnostic tools that can help identify recurrent prostate cancer in this patient population.

In a presentation at the recent American Society for Radiation Oncology (ASTRO) conference, Dr. Jani discussed key research findings from a post-hoc analysis of the phase 3 SPOTLIGHT trial that looked at the use of the positron emission tomography (PET) prostate-specific membrane antigen (PSMA) agent flotufolastat F 18 (Posluma, Blue Earth Diagnostics) for patients with suspected prostate cancer recurrence and PSA levels lower than 1 ng/mL.

In a recent interview, Dr. Jani said he and his colleagues found that use of flotufolastat F 18 detected prostate cancer recurrence in 68 percent of patients with a PSA level less than 1 ng/mL and 64 percent of men with PSA levels lower than 0.5 ng/mL.

“With the advent of molecular imaging and novel radiotracers, we’re able to see the source of PSA at lower PSA levels,” noted Dr. Jani, a professor in the Department of Radiation Oncology at the Emory University School of Medicine and the James C. Kennedy Professor in Prostate Cancer at the Winship Cancer Institute of Emory University.

(Editor’s note: For related content, see “Study: PET/CT Multivariate Model Enhances Accuracy for Diagnosing Prostate Cancer,” “Emerging PET Radiotracer May Offer Multiple Advantages in Detecting Prostate Cancer” and “Could a New PSMA PET Agent Improve Detection of Distant Metastatic Lesions in Patients with Prostate Cancer?”)

The use of flotufolastat F 18 also led to the detection of extrapelvic lesions in 39 percent of patients with PSAs between 0.5 and 1 ng/mL, and 21 percent of men with PSA levels lower than 0.5 ng/mL, according to Dr. Jani.

“There was significant potential for changing management decisions based on this test,” emphasized Dr. Jani.

(Editor’s note: For related content on prostate cancer imaging, click here.)

For more insights from Dr. Jani, watch the video below.