In Reply We thank Bowling and Dimitrakoff for their insightful comments on our recent prospective phase 3 imaging trial1 demonstrating a sensitivity of prostate-specific membrane antigen (PSMA) 68Ga-PSMA-11 positron emission tomographic (PET) imaging for detection of pelvic nodal metastases at the time of initial staging of 0.40. We agree with the authors that future work using PSMA PET as a response marker will be valuable, and further work should be performed to build off of the PRIMARY trial2 to better understand how to use PSMA PET and multiparametric magnetic resonance imaging in initial diagnosis. Additionally, there clearly is a relationship between disease aggressiveness and PSMA expression in the primary tumors.3
Hope TA, Calais J. PSMA PET in Prostate Cancer—A Biomarker or a Surrogate End Point?—Reply. JAMA Oncol. 2022;8(4):644–645. doi:10.1001/jamaoncol.2021.7994
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