Endocrine Abstracts

Ga-68 PSMA PET/CT is producing images with astounding tumour-to-background contrast for staging prostate cancer. Defining the extent of prostate cancer spread with imaging is of utmost importance for therapeutic decision-making. Relapse following curative-intent treatment is not uncommon despite careful selection of patients with CT, MRI and bone scintigraphy prior to surgery or radiotherapy, highlighting the limited sensitivity of conventional imaging. Imaging with PSMA-PET may improve patient outcomes by redirecting patients with metastatic disease from curative-intent local treatments destined to fail to more appropriate management. This presentation will detail the ‘ProPSMA’ multi-centre, randomised controlled trial designed to provide robust data on the diagnostic accuracy, management impact and economic benefits of using PSMA-PET for primary staging of high-risk prostate cancer.

On the other end of the spectrum, patients with established metastatic disease remain incurable. Although androgen deprivation and chemotherapy may control disease, patients relapse with limited therapeutic options. Lutetium-177 PSMA has emerged as a promising theranostic pair for patients with metastatic PSMA-avid disease. Emerging evidence suggests high response rates but the data are from single centre, retrospective studies with non-uniformity of protocols, potential selection bias and lack of robust follow-up or control arm. The early results of the first Australian prospective trial and plan for a multi-centre randomised controlled trial will be presented.