Juan Antonio Vallejo.
A window of opportunity. For John Anthony Vallejohead of the Nuclear Medicine Service of the Reina Sofía University Hospital in Córdoba, the new techniques to diagnose prostate cancer -specifically, the PET and Computed Tomography (CT PSMA) imaging equipment– they are going to “change the physiognomy and modernize” health care of the National Health System (SNS).
Currently, PET/CT PSMA it is used in Spain within clinical trials and in routine clinical practice upon request and authorization from the Spanish Agency for Medicines and Health Products (Aemps), but It is subject to the accessibility and financing of each center. So that in 2021 it has only been used in 1,800 patients, of the more than 35,700 diagnosed.
For this reason, Vallejo declares to Medical Writing, what hopes that “in a few months” the approval of the Aemps will be obtained so that “it can be used in a healthcare manner and without having to make reports for each of the patients”, as is currently the case, and so that “the tumor committees of the centers themselves determine the usefulness” of these techniques. In this sense, it ensures that “Nuclear Medicine professionals have been working for a few years to prepare for this situationIn fact, I think that right now it is perhaps what we are working with the most intensity on prostate cancer tracers and PSMA”.
A procedure with more exact results
Likewise, it defends that according to the results of the latest clinical trials carried out in countries such as Australia, “one of the most advanced in this matter”, they show that “the performance of PET with PSMA as an entry test compared to conventional techniques such as be CT or bone scintigraphy to select patients is a short-efficient procedure, it is a more exact procedure and it is a procedure that has less disagreement and that it also selects patients better, since we would have to use it in the selection”.
In our country, it is estimated that one in three prostate cancer patients will experience a relapse of the disease after surgery or radiotherapy. This is due to the disease itself and also to the limitations of some currently used imaging techniques.
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“New cancer diagnostic techniques will modernize the SNS” |
Recently, Vallejo has participated together with other references of Nuclear Medicine in a study entitled ‘Precision imaging in the management of prostate cancer: PET/CT PSMA. Analysis of needs and opportunities in Spain’ –here you can download it-, an initiative of the Spanish Society of Nuclear Medicine and Molecular Imaging (Semnim) with the support of Oncoretos and the collaboration of Janssen. In it, it is estimated that the combination of PET and Computed Tomography (CT) technologies offers an accuracy of 92 percent for detecting the spread of prostate cancer compared to 65 percent for standard images. This high precision, together with its impact on handling, has contributed to its inclusion in the guides of the European Association of Urology (EAU, for its acronym in English) for the detection of primary and recurrent diseases.
What are the advantages of PET/CT PSMA?
In this sense, as stated by the head of the Nuclear Medicine Service of the Reina Sofía University Hospital in Córdoba, the PET/CT PSMA allows to improve “tumor staging”, as well as helping health professionals make decisions, both when offering a localized treatment (surgery or radiotherapy). It also has advantages in the use of more advanced therapies when the cancer has already spread, thus improving the management of patients with prostate cancer.
Thus, these new techniques “They open a very wide range, from what is a situation to the initial diagnosis in prostate cancer, until establishing a therapeutic process”. As he indicates, “this is what we know in Nuclear Medicine as theragnosis”, which is “using the same molecule for diagnosis as for therapy”.
“Thereforehelps us to better select the initial therapy and avoid side effects for the patient, of a therapy that is not going to contribute anything, with a loss of access time to this therapy” in what is the initial diagnosis situation. “In the rest it will allow us to better classify patients for the therapeutic processwill allow us to select patients who have a low tumor burden and separate them from those who have a high tumor burden”, Vallejo ditches.
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