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Article summary:
1. The TheraP trial showed that treatment with lutetium-177 [177Lu]Lu-PSMA-617 improved frequency of prostate-specific antigen (PSA) response rate and progression-free survival compared with cabazitaxel in men with metastatic castration-resistant prostate cancer.
2. This study aimed to analyse gallium-68 [68Ga]Ga-PSMA-11 PET (PSMA-PET) and 2-[18F]fluoro-2-deoxy-D-glucose PET (FDG-PET) imaging parameters as predictive and prognostic biomarkers in this patient population.
3. Results showed that a SUVmean of 10 or higher on PSMA-PET was associated with higher odds of PSA response to [177Lu]Lu-PSMA-617 versus cabazitaxel, while high FDG-PET MTV was associated with lower responses regardless of randomly assigned treatment.
Article analysis:
The article is generally reliable and trustworthy, as it is based on the results from the TheraP trial which is a multicentre, open label, randomised phase 2 trial that recruited men with metastatic castration resistant prostate cancer after treatment with docetaxel who were suitable for cabazitaxel from 11 hospitals in Australia. The primary study endpoint was PSA response rate, which has been analysed previously, while the prespecified tertiary study endpoint was association between total tumour quantitative parameters on PSMA PET, FDG PET, and baseline characteristics with clinical outcomes. The analysis was intention to treat using logistic regression.
The article does not appear to be biased or one sided as it presents both sides equally and provides evidence for its claims made. It also does not appear to contain any promotional content or partiality towards either side of the argument. Furthermore, possible risks are noted in the article such as quantitative PET parameters used requiring specialised software which may not be available in most clinics.
However, there are some missing points of consideration such as potential confounding factors that could have affected the results of the trial which should have been explored further by the authors. Additionally, there is no mention of any unexplored counterarguments or missing evidence for the claims made which could have strengthened the reliability of the article further if included.