Page 51 - ARNM-3-3

Advances in Radiotherapy &

Nuclear Medicine

ORIGINAL RESEARCH ARTICLE
Identifying lutetium-177 prostate-specific

membrane antigen-617 treatment response
patterns using a quantitative prostate-

specific membrane antigen positron emission
tomography/computed tomography traffic light

workflow within the LuPIN trial

1,2
Sarennya Pathmanandavel * , Megan Crumbaker 1,2,3,4 , Andrew Nguyen 1,4 ,
6
6
Andrew O. Yam 2,3,4,5 , Peter Wilson , Remy Niman , Maria Ayers ,
1
1
7
Shikha Sharma , Peter Eu , Andrew J. Martin 8 , Martin R. Stockler 8 ,
Anthony M. Joshua 2,3,4,9 , and Louise Emmett 1,3,4,9
1 Department of Theranostics and Nuclear Medicine, St Vincent’s Hospital, Sydney, New South
Wales, Australia
2 The Kinghorn Cancer Centre, St Vincent’s Hospital, Sydney, New South Wales, Australia
3 Garvan Institute of Medical Research, Sydney, New South Wales, Australia
4 St. Vincent’s Clinical School, University of New South Wales, Sydney, New South Wales, Australia
*Corresponding author:
Sarennya Pathmanandavel 5 School of Biotechnology and Biomolecular Sciences, Faculty of Science, University of New South
(sarennya@gmail.com) Wales, Sydney, New South Wales, Australia
Citation: Pathmanandavel S, 6 MIM Software Inc., Cleveland, Ohio, United States of America
Crumbaker M, Nguyen A, et al. 7 Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
Identifying lutetium-177 prostate- 8
specific membrane antigen-617 NHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia
treatment response patterns using 9 Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
a quantitative prostate-specific
membrane antigen positron
emission tomography/computed
tomography traffic light workflow
within the LuPIN trial. Adv Radiother Abstract
Nucl Med. 2025;3(3):43-54.
doi: 10.36922/ARNM025110011 Lutetium-177 prostate-specific membrane antigen-617 ( Lu-PSMA-617) improves
177
Received: March 14, 2025 survival in metastatic castration-resistant prostate cancer, but more optimal tools are
1st revised: April 6, 2025 needed for therapeutic response assessment and early detection of resistance. We
evaluated a quantitative imaging workflow using prostate-specific membrane antigen
2nd revised: July 8, 2025 (PSMA) positron emission tomography (PET)/computed tomography to measure
Accepted: July 22, 2025 lesional changes following Lu-PSMA-617 therapy. Pre- and post-treatment gallium-
177
Published online: August 5, 2025 68-labeled PSMA-11 PET scans from the trial were analyzed using a novel traffic light
workflow (TLW), assessing lesion-specific changes in tumor volume and maximum
Copyright: © 2025 Author(s). standardized uptake value in men treated with up to six cycles of Lu-PSMA-617
177
This is an Open-Access article
distributed under the terms of the and a radiation sensitizer (NOX66). Lesions were categorized as “reducing” (≥30%
Creative Commons Attribution volume decrease), “stable” (<30% change), or “increasing” (≥30% increase or new
License, permitting distribution, lesions). Overall response was classified as “responder” (no increasing/new lesions),
and reproduction in any medium,
provided the original work is “low-volume progressor” (<50% of total tumor volume [TTV] increasing/new lesions),
properly cited. or “high-volume progressor” (>50% of TTV increasing/new lesions). TLW response
Publisher’s Note: AccScience classifications were compared with Response Evaluation Criteria in PSMA PET (RECIP)
Publishing remains neutral with 1.0 and correlated with overall survival (OS). Among 37 men who underwent pre- and
regard to jurisdictional claims in post-treatment PET imaging, 68% (25/37) completed six cycles, 32% (12/37) received
published maps and institutional
affiliations. 2–5 cycles, and 70% (26/37) had a >50% prostate-specific antigen (PSA) decline. The

Volume 3 Issue 3 (2025) 43 doi: 10.36922/ARNM025110011