Post hoc retrospective cross-sectional analysis of PSMA-PET/CT findings in high-risk recurrent HSPC with no metastatic disease by conventional imaging

The phase 3 randomized EMBARK trial evaluated enzalutamide with or without leuprolide in patients with high-risk hormone-sensitive prostate cancer with no evidence for metastatic disease based on conventional imaging. A cross-sectional post hoc analysis of 182 patients from 4 prospective studies who were eligible for EMBARK investigated PSMA-PET/CT results. Patients’ cancers were understaged by conventional imaging. PSMA-PET results were positive in 84% of patients. PSMA-PET detected M1 disease stage in 46% of patients and found five or more lesions in 24% of patients. The authors conclude that these results challenge the interpretation of previous studies, such as EMBARK.