Radioimmunoscintigraphy With In-111-Labeled Capromab Pendetide Predicts Prostate Cancer Response to Salvage Radiotherapy After Failed Radical Prostatectomy

J Clin Oncol 16:284-289.

By Daniel Kahn, Richard D. Williams, Michael K. Haseman, Nancy L. Reed, Sara J. Miller, and Jack Gerstbrein

Purpose: We investigated the ability of In-111-capromab pendetide to separate who have failed radical prostatectomy into categories of those who would versus those who would not respond to salvage radiotherapy.

Methods: Prostate-specific antigen (PSA) levels in 32 men with prostate cancer who had failed radical prostatectomy and had undergone a whole-body In-111-capromab pendetide scan were followed-up for 13 months (median) after salvage radiotherapy to the pelvis. A logistic regression model was used to determine whether the scan findings, as well as other clinical variables, were associated with a durable complete response (DCR), a nondurable response (NDR), or no response (NR).

Results: Sixteen of 23 (70%) men with a normal scan outside the prostatic fossa achieved a DCR after salvage radiotherapy versus two of nine (22%) who had a positive scan outside the prostate fossa and pelvis (P = .0225, Fisher's exact test). Predicted probability (95% confidence interval [CI]) that a DCR would be obtained with a normal scan was 0.88 (0.55 to 0.98); for men with a positive scan limited to the prostatic fossa it was 0.62 (0.42 to 0.79); and for men with a positive scan outside the pelvis it was 0.27 (0.09 to 0.58). No other variables before radiotherapy showed a significant association with the DCR rate.

Conclusion: Salvage radiotherapy is statistically more likely to lead to a durable complete PSA response in men with prostate cancer who have failed radical prostatectomy and have a negative In-111-capromab pendetide scan outside the pelvis as compared with those who have a positive scan.

J Clin Oncol 16:284-289.

© 1998 by American Society of Clinical Oncology.