Only few patients have non-metastatic castration-resistant prostate cancer after PET scan

Best Practice Nordic | Jun 2020 | ASCO20 Virtual |

Non-metastatic castration-resistant prostate cancer (nmCRPC) is characterized by an increase in prostate-specific antigen (PSA), serum testosterone at castrate level (<0.5 ng / l or 1.7 nmol / l) and no detected distant metastases in conventional imaging tests, including bone scan. NmCRPC is considered high risk in cases where the PSA doubling time is 10 months or less, as this is associated with an increased risk of developing metastases. So far, it has not been a practice to treat this group of patients, but this is now a real possibility, as several new treatments have been approved for this group of patients. One relevant question to answer is how many patients there exists. In 2018, the Danish Medical Committee estimated that there were about 100 patients in Denmark who were candidates for the new treatment options. At ASCO 2020, Martin Pitzzu et al., presented an Argentine study where a cohort of 300 prostate cancer patients were consecutively examined. 214 patients had localized disease and 86 had metastatic castration-sensitive prostate cancer. With a median of six years, 43 patients developed castration-resistant prostate cancer. Six patients met the criteria for non-metastatic castration-resistant prostate cancer and were subsequently examined with choline PET scan. However, this showed that five of the patients were PET positive and only one was PET negative at the time of the study. Read the English abstract published on Asco here.