Comparison of 18F-DCFPyL and 68Ga-PSMA-11 for 177Lu-PSMA-617 therapy patient selection

Surekha Yadav; Sarasa T Kim; Abuzar Moradi Tuchayi; Fei Jiang; Amanda Morley; Rachelle Saelee; Yingbing Wang; Roxanna Juarez; Courtney Lawnh-Heath; Vadim S Koshkin; Thomas A Hope

doi:10.3389/fonc.2024.1382582

Comparison of ¹⁸F-DCFPyL and ⁶⁸Ga-PSMA-11 for ¹⁷⁷Lu-PSMA-617 therapy patient selection

Front Oncol. 2024 Jun 27:14:1382582. doi: 10.3389/fonc.2024.1382582. eCollection 2024.

Authors

Affiliations

¹ Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States.
² Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, United States.
³ Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States.
⁴ Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, United States.
⁵ Department of Radiology, San Francisco Veterans Affairs (VA) Medical Center, San Francisco, CA, United States.

Abstract

Purpose: ⁶⁸Ga-PSMA-11 is recommended for the selection of patients for treatment in the package insert for ¹⁷⁷Lu-PSMA-617. We aimed to compare imaging properties and post-treatment outcomes from radioligand therapy (RLT) of patients selected with ⁶⁸Ga-PSMA-11 and ¹⁸F-DCFPyL.

Methods: We retrospectively evaluated 80 patients undergoing PSMA RLT, who had pretreatment imaging using either ⁶⁸Ga-PSMA-11 or ¹⁸F-DCFPyL. For both groups, we compared the biodistribution and lesion uptake and the PSA response to treatment.

Results: Both agents had comparable biodistribution. Patients initially imaged with ¹⁸F-DCFPyL had a higher PSA response (66% vs. 42%), and more patients had a PSA50 response (72% vs. 43%) compared to patients imaged with ⁶⁸Ga-PSMA-11.

Conclusion: ¹⁸F-DCFPyL and ⁶⁸Ga-PSMA-11 had comparable biodistribution and lesion uptake. Patients imaged with ¹⁸F-DCFPyL demonstrated clinical benefit to PSMA RLT comparable to those imaged with ⁶⁸Ga-PSMA-11, and either agent can be used for screening patients.

Keywords: 177Lu-PSMA; 18F-DCFPyL-PET/CT; 68Ga-PSMA PET/CT; mCRPC; patient screening; radioligand therapy (RLT).

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This study was funded by an investigator initiated trial by Lantheus. The funder was not involved in the study design, collection, analysis, interpretation of data, the writing of this article, or the decision to submit it for publication.