A Clinician's Guide to Next Generation Imaging in Patients with Advanced Prostate Cancer (RADAR III)

E. David Crawford; Phillip J. Koo; Neal Shore; Susan F. Slovin; Raoul S. Concepcion; Stephen J. Freedland; Leonard G. Gomella; Lawrence Karsh; Thomas E. Keane; Paul Maroni; David Penson; Daniel P. Petrylak; Ashley Ross; Vlad Mouraviev; Robert E. Reiter; Chaitanya Divgi; Evan Y. Yu

doi:10.1016/j.juro.2018.05.164

A Clinician's Guide to Next Generation Imaging in Patients with Advanced Prostate Cancer (RADAR III)

E. David Crawford^*, Phillip J. Koo, Neal Shore, Susan F. Slovin, Raoul S. Concepcion, Stephen J. Freedland, Leonard G. Gomella, Lawrence Karsh, Thomas E. Keane, Paul Maroni, David Penson, Daniel P. Petrylak, Ashley Ross, Vlad Mouraviev, Robert E. Reiter, Chaitanya Divgi, Evan Y. Yu

^*Corresponding author for this work

Urology

Research output: Contribution to journal › Review article › peer-review

71 Scopus citations

Abstract

Purpose:The advanced prostate cancer therapeutic landscape has changed dramatically in the last several years, resulting in improved overall survival of patients with castration naïve and castration resistant disease. The evolution and development of novel next generation imaging techniques will affect diagnostic and therapeutic decision making. Clinicians must navigate when and which next generation imaging techniques to use and how to adjust treatment strategies based on the results, often in the absence of correlative therapeutic data. Therefore, guidance is needed based on best available information and current clinical experience.Materials and Methods:The RADAR (Radiographic Assessments for Detection of Advanced Recurrence) III Group convened to offer guidance on the use of next generation imaging to stage prostate cancer based on available data and clinical experience. The group also discussed the potential impact of next generation imaging on treatment options based on earlier detection of disease.Results:The group unanimously agreed that progression to metastatic disease is a seminal event for patient treatment. Next generation imaging techniques are able to detect previously undetectable metastases, which could redefine the phases of prostate cancer progression. Thus, earlier systemic or locally directed treatment may positively alter patient outcomes.Conclusions:The RADAR III Group recommends next generation imaging techniques in select patients in whom disease progression is suspected based on laboratory (biomarker) values, comorbidities and symptoms. Currently ¹⁸F-fluciclovine and ⁶⁸Ga prostate specific membrane antigen positron emission tomography/computerized tomography are the next generation imaging agents with a favorable combination of availability, specificity and sensitivity. There is ongoing research of additional next generation imaging technologies, which may offer improved diagnostic accuracy and therapeutic options. As next generation imaging techniques evolve and presumably result in improved global accessibility, clinician ability to detect micrometastases may be enhanced for decision making and patient outcomes.

Original language	English (US)
Pages (from-to)	682-692
Number of pages	11
Journal	Journal of Urology
Volume	201
Issue number	4
DOIs	https://doi.org/10.1016/j.juro.2018.05.164
State	Published - Apr 1 2019

Funding

Supported by Amgen, Astellas, Bayer, Genentech, Janssen, Merck and Sanofi (NS), Amgen, Astellas, Bayer, Cepheid, Dendreon, Ferring, FKD, Genentech-Roche, Genomic Health, Janssen, Myovant, OPKO and Pfizer (LK, The Urology Center of Colorado), Janssen, Astellas, Progenics, GenomeDx and Movember Foundation (PM), Dendreon, Astellas, National Institutes of Health/National Cancer Institute and Agency for Healthcare Research and Quality (DP, Vanderbilt University), Oncogenix, Progenics, Johnson and Johnson, Millennium, Celgene, Dendreon, Sanofi, Agensys, Eli Lilly and Roche Laboratories (DPP), and Dendreon, Bayer, Merck and Seattle Genetics (EYY, University of Washington).

Keywords

clinical decision-making
diagnostic imaging
neoplasm metastasis
practice guideline
prostatic neoplasms

ASJC Scopus subject areas

Urology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.juro.2018.05.164

Cite this

David Crawford, E., Koo, P. J., Shore, N., Slovin, S. F., Concepcion, R. S., Freedland, S. J., Gomella, L. G., Karsh, L., Keane, T. E., Maroni, P., Penson, D., Petrylak, D. P., Ross, A., Mouraviev, V., Reiter, R. E., Divgi, C., & Yu, E. Y. (2019). A Clinician's Guide to Next Generation Imaging in Patients with Advanced Prostate Cancer (RADAR III). Journal of Urology, 201(4), 682-692. https://doi.org/10.1016/j.juro.2018.05.164

@article{21c6cbadfb8445a6a57aad42a7c164bc,

title = "A Clinician's Guide to Next Generation Imaging in Patients with Advanced Prostate Cancer (RADAR III)",

abstract = "Purpose:The advanced prostate cancer therapeutic landscape has changed dramatically in the last several years, resulting in improved overall survival of patients with castration na{\"i}ve and castration resistant disease. The evolution and development of novel next generation imaging techniques will affect diagnostic and therapeutic decision making. Clinicians must navigate when and which next generation imaging techniques to use and how to adjust treatment strategies based on the results, often in the absence of correlative therapeutic data. Therefore, guidance is needed based on best available information and current clinical experience.Materials and Methods:The RADAR (Radiographic Assessments for Detection of Advanced Recurrence) III Group convened to offer guidance on the use of next generation imaging to stage prostate cancer based on available data and clinical experience. The group also discussed the potential impact of next generation imaging on treatment options based on earlier detection of disease.Results:The group unanimously agreed that progression to metastatic disease is a seminal event for patient treatment. Next generation imaging techniques are able to detect previously undetectable metastases, which could redefine the phases of prostate cancer progression. Thus, earlier systemic or locally directed treatment may positively alter patient outcomes.Conclusions:The RADAR III Group recommends next generation imaging techniques in select patients in whom disease progression is suspected based on laboratory (biomarker) values, comorbidities and symptoms. Currently 18F-fluciclovine and 68Ga prostate specific membrane antigen positron emission tomography/computerized tomography are the next generation imaging agents with a favorable combination of availability, specificity and sensitivity. There is ongoing research of additional next generation imaging technologies, which may offer improved diagnostic accuracy and therapeutic options. As next generation imaging techniques evolve and presumably result in improved global accessibility, clinician ability to detect micrometastases may be enhanced for decision making and patient outcomes.",

keywords = "clinical decision-making, diagnostic imaging, neoplasm metastasis, practice guideline, prostatic neoplasms",

author = "{David Crawford}, E. and Koo, {Phillip J.} and Neal Shore and Slovin, {Susan F.} and Concepcion, {Raoul S.} and Freedland, {Stephen J.} and Gomella, {Leonard G.} and Lawrence Karsh and Keane, {Thomas E.} and Paul Maroni and David Penson and Petrylak, {Daniel P.} and Ashley Ross and Vlad Mouraviev and Reiter, {Robert E.} and Chaitanya Divgi and Yu, {Evan Y.}",

note = "Publisher Copyright: {\textcopyright} 2019 by American Urological Association Education and Research, Inc.",

year = "2019",

month = apr,

day = "1",

doi = "10.1016/j.juro.2018.05.164",

language = "English (US)",

volume = "201",

pages = "682--692",

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David Crawford, E, Koo, PJ, Shore, N, Slovin, SF, Concepcion, RS, Freedland, SJ, Gomella, LG, Karsh, L, Keane, TE, Maroni, P, Penson, D, Petrylak, DP, Ross, A, Mouraviev, V, Reiter, RE, Divgi, C & Yu, EY 2019, 'A Clinician's Guide to Next Generation Imaging in Patients with Advanced Prostate Cancer (RADAR III)', Journal of Urology, vol. 201, no. 4, pp. 682-692. https://doi.org/10.1016/j.juro.2018.05.164

TY - JOUR

T1 - A Clinician's Guide to Next Generation Imaging in Patients with Advanced Prostate Cancer (RADAR III)

AU - David Crawford, E.

AU - Koo, Phillip J.

AU - Shore, Neal

AU - Slovin, Susan F.

AU - Concepcion, Raoul S.

AU - Freedland, Stephen J.

AU - Gomella, Leonard G.

AU - Karsh, Lawrence

AU - Keane, Thomas E.

AU - Maroni, Paul

AU - Penson, David

AU - Petrylak, Daniel P.

AU - Ross, Ashley

AU - Mouraviev, Vlad

AU - Reiter, Robert E.

AU - Divgi, Chaitanya

AU - Yu, Evan Y.

PY - 2019/4/1

Y1 - 2019/4/1

N2 - Purpose:The advanced prostate cancer therapeutic landscape has changed dramatically in the last several years, resulting in improved overall survival of patients with castration naïve and castration resistant disease. The evolution and development of novel next generation imaging techniques will affect diagnostic and therapeutic decision making. Clinicians must navigate when and which next generation imaging techniques to use and how to adjust treatment strategies based on the results, often in the absence of correlative therapeutic data. Therefore, guidance is needed based on best available information and current clinical experience.Materials and Methods:The RADAR (Radiographic Assessments for Detection of Advanced Recurrence) III Group convened to offer guidance on the use of next generation imaging to stage prostate cancer based on available data and clinical experience. The group also discussed the potential impact of next generation imaging on treatment options based on earlier detection of disease.Results:The group unanimously agreed that progression to metastatic disease is a seminal event for patient treatment. Next generation imaging techniques are able to detect previously undetectable metastases, which could redefine the phases of prostate cancer progression. Thus, earlier systemic or locally directed treatment may positively alter patient outcomes.Conclusions:The RADAR III Group recommends next generation imaging techniques in select patients in whom disease progression is suspected based on laboratory (biomarker) values, comorbidities and symptoms. Currently 18F-fluciclovine and 68Ga prostate specific membrane antigen positron emission tomography/computerized tomography are the next generation imaging agents with a favorable combination of availability, specificity and sensitivity. There is ongoing research of additional next generation imaging technologies, which may offer improved diagnostic accuracy and therapeutic options. As next generation imaging techniques evolve and presumably result in improved global accessibility, clinician ability to detect micrometastases may be enhanced for decision making and patient outcomes.

AB - Purpose:The advanced prostate cancer therapeutic landscape has changed dramatically in the last several years, resulting in improved overall survival of patients with castration naïve and castration resistant disease. The evolution and development of novel next generation imaging techniques will affect diagnostic and therapeutic decision making. Clinicians must navigate when and which next generation imaging techniques to use and how to adjust treatment strategies based on the results, often in the absence of correlative therapeutic data. Therefore, guidance is needed based on best available information and current clinical experience.Materials and Methods:The RADAR (Radiographic Assessments for Detection of Advanced Recurrence) III Group convened to offer guidance on the use of next generation imaging to stage prostate cancer based on available data and clinical experience. The group also discussed the potential impact of next generation imaging on treatment options based on earlier detection of disease.Results:The group unanimously agreed that progression to metastatic disease is a seminal event for patient treatment. Next generation imaging techniques are able to detect previously undetectable metastases, which could redefine the phases of prostate cancer progression. Thus, earlier systemic or locally directed treatment may positively alter patient outcomes.Conclusions:The RADAR III Group recommends next generation imaging techniques in select patients in whom disease progression is suspected based on laboratory (biomarker) values, comorbidities and symptoms. Currently 18F-fluciclovine and 68Ga prostate specific membrane antigen positron emission tomography/computerized tomography are the next generation imaging agents with a favorable combination of availability, specificity and sensitivity. There is ongoing research of additional next generation imaging technologies, which may offer improved diagnostic accuracy and therapeutic options. As next generation imaging techniques evolve and presumably result in improved global accessibility, clinician ability to detect micrometastases may be enhanced for decision making and patient outcomes.

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KW - diagnostic imaging

KW - neoplasm metastasis

KW - practice guideline

KW - prostatic neoplasms

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A Clinician's Guide to Next Generation Imaging in Patients with Advanced Prostate Cancer (RADAR III)

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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