Modelling study of long-term outcomes with PSMA-PET imaging of biochemically recurrent prostate cancer

Although prostate-specific membrane antigen positron emission tomography (PSMA-PET) has shown improved sensitity and specificity compared with conventional imaging for the the detection of biochemical recurrent (BCR) prostate cancer, the long-term outcomes of a widespread shift in imaging are unknown. A decision analytic modelling study simulated outcomes of patients with BCR following initial definitive local therapy. The model estimated that per 1000 simulated patients with BCR (assumed median age, 66 years), upfront PSMA-PET may lead to 75 fewer deaths from prostate cancer, 988 more life-years, and 824 more quality-adjusted life-year compared with conventional imaging. However, these estimates are sensitive to assumptions regarding the effectiveness of earlier treatment as well as PSA-level at imaging. The authors conclude that assuming modest benefits of earlier detection, PSMA-PET imaging could improve length and quality of life for patients with biochemical recurrent prostate cancer.