Oncology Daily Report: 01/26/2024

Prostate Cancer

A prospective multicentre single-arm phase 3 imaging trial assessed the diagnostic accuracy of 18F-DCFPyL PSMA-PET/CT compared to mpMRI for detecting prostate cancer (PCa) in patients with clinical suspicion for PCa (1). The study included 236 patients, with 184 undergoing biopsy, and found that the diagnostic accuracy of mpMRI for detecting PCa (AUC 0.76; 95% CI 0.69, 0.82) was higher than that of PSMA-PET/CT (AUC 0.63; 95% CI 0.56, 0.70, p = 0.03). However, the combination of PSMA-PET/CT and mpMRI showed excellent sensitivity (98.8%, 95% CI 93.5%, 100%) and NPV (96%, 95% CI 79.6%, 99.9%) over mpMRI alone. The study concluded that mpMRI had superior diagnostic accuracy for detecting PCa, but the combination of mpMRI and PSMA-PET/CT improved sensitivity and NPV, suggesting that PSMA-PET/CT could be considered for diagnostic use in patients unable to have mpMRI or those with negative mpMRI but concerning clinical features.

Reference

Wong LM, Sutherland T, Perry E, Tran V, Spelman T, Corcoran N, Lawrentschuk N, Woo H, Lenaghan D, Buchan N, Bax K, Symons J, Saeed Goolam A, Chalasani V, Hegarty J, Thomas L, Christov A, Ng M, Khanani H, Lee SF, Taubman K, Tarlinton L. Fluorine-18-labelled Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography or Magnetic Resonance Imaging to Diagnose and Localise Prostate Cancer. A Prospective Single-arm Paired Comparison (PEDAL). Eur Urol Oncol. 2024 Jan 27:S2588-9311(24)00026-9. doi: 10.1016/j.euo.2024.01.002. Epub ahead of print. PMID: 38281891.

Hepatocellular carcinoma

A phase II randomized study investigated the effect of neoadjuvant transcatheter arterial chemoembolization (TACE) plus surgery versus surgery alone in 60 patients with hepatocellular carcinoma >5 cm and found that the 2-year disease-free survival (DFS), overall survival, and resection rates for TACE + surgery were 56.7%, 80.0%, and 93.3%, respectively, compared to 56.1%, 89.9%, and 90.0% for surgery alone (1). The median necrosis rate by TACE was 90.0%, and in cases of 100% necrosis with TACE, 2-year DFS was 100%. The study, conducted by the Clinical Study Group of Osaka University, Hepato-Biliary-Pancreatic Group, demonstrated that neoadjuvant TACE did not significantly improve 2-year DFS but allowed for the delay of surgical treatment without increased morbidity and cancer progress. Clinical trial registration: UMIN: 000005241.

Reference

Kobayashi S, Tomokuni A, Takeda Y, Wada H, Katsura Y, Hashimoto K, Tomimaru Y, Asaoka T, Yamada T, Tsujie M, Noda T, Morita S, Nagano H, Mori M, Doki Y, Eguchi H; Clinical Study Group of Osaka University, Hepato-Biliary-Pancreatic Group. Exploratory prospective, randomized phase II study of neoadjuvant transcatheter arterial chemoembolization plus surgery versus surgery alone for large hepatocellular carcinoma (CSGO-HBP-005): Clinical Study Group of Osaka University, Hepato-Biliary-Pancreatic Group. Hepatol Res. 2024 Jan 27. doi: 10.1111/hepr.14013. Epub ahead of print. PMID: 38279693.