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Indium-111–Capromab Pendetide Radioimmunoscintigraphy and Prognosis for Durable Biochemical Response to Salvage Radiation Therapy in Men After Failed Prostatectomy

Cherry T. Thomas, Patrick T. Bradshaw, Brad H. Pollock, James E. Montie, Jeremy M.G. Taylor, Howard D. Thames, Patrick W. McLaughlin, David A. DeBiose, David H. Hussey, Richard L. Wahl

From the Division of Radiation Oncology, University of Cincinnati, Barrett Center for Cancer Prevention, Treatment and Research, Cincinnati, OH; Center for Epidemiology and Biostatistics, University of Texas Health Science Center at San Antonio, San Antonio; Department of Biomathematics, M.D. Anderson Cancer Center, Houston, TX; Department of Urology, University of Michigan Health Systems; Department of Biostatistics, University of Michigan; Department of Radiation Oncology, University of Michigan Health Systems, Ann Arbor, MI; and the Division of Nuclear Medicine, Department of Radiology, The Johns Hopkins Medical Institutions, Baltimore, MD.

Address reprint requests to Richard L. Wahl, MD, Department of Radiology, The Johns Hopkins Medical Institutions, The Johns Hopkins Outpatient Center, 601 North Caroline St, Room 3231A, Baltimore, MD 21287-0817; email: RWahl{at}jhmi.edu or Cherry.Thomas{at}uc.edu.

Purpose: We evaluated the prognostic significance of indium-111 (¹¹¹In)–capromab pendetide imaging for patients with prostate cancer who underwent salvage radiotherapy (RT) for recurrent disease after prostatectomy.

Patients and Methods: Records were reviewed for all men who underwent ¹¹¹In–capromab pendetide imaging at a single institution from February 1997 through December 1999. We identified 30 eligible men who were radiographically negative for metastatic disease, who had increasing serum prostate-specific antigen (PSA) after primary radical prostatectomy, and who received salvage RT. Clinical interpretations of indium monoclonal antibody (In-mab) scan results were compared with postsalvage RT PSA response.

Results: Using an American Society of Therapeutic Radiation and Oncology definition of PSA failure, in men with a positive scan in at least one location (n = 14), the cumulative 2-year PSA control after salvage RT was 0.38 ± 0.13 (± SE) compared with 0.31 ± 0.13 for men with a normal antibody scan in and outside the prostate fossa (n = 15; proportional hazard ratio [PHR] = 1.32; 95% confidence interval [CI], 0.52 to 3.36). For men with a positive antibody scan limited to the prostate fossa (n = 9), PSA control at 2 years was 0.13 ± 0.12 (PHR 1.77; 95% CI, 0.65 to 4.85). The 2-year probability of PSA control after salvage RT for men with positive scan results outside the prostate bed irrespective of In-mab findings in the prostate fossa (n = 5) was 0.60 ± 0.22 (PHR 0.81; 95% CI, 0.17 to 3.78).

Conclusion: In contrast to previous reports, for patients with postprostatectomy biochemical relapse who received salvage RT, presalvage RT In-mab scan findings outside the prostate fossa were not predictive of biochemical control after RT.

Supported in part by U.S. Government Department of Health and Human Services Public Health Service grant no. M01-RR00042 awarded by the National Institutes of Health, National Center for Research Resources, and the National Cancer Institute, Bethesda, MD; and the University of Michigan Specialized Program of Research Excellence in Prostate Cancer grant no. SPORE-1-P50-CA69568.

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Related Correspondence

• The Prognostic Significance of Indium-111–Capromab Penetide
  D.B. Sodee, P.F. Faulhaber, A.D. Nelson, and G. Bakale
  JCO 2004 22: 379-380 [Full Text]

Related Reply

• In Reply:
  Cherry T. Thomas, Parick T. Bradshaw, Brad H. Pollock, James E. Montie, Jeremy M.G. Taylor, Howard D. Thames, Patrick W. McLaughlin, David A. DeBiose, David H. Hussey, and Richard L. Wahl
  JCO 2004 22: 380-381 [Full Text]

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