Dr. Fleming on the Rationale of the SPOTLIGHT Trial in Prostate Cancer

Mark T. Fleming, MD, medical director, the US Oncology’s Genitourinary Research Committee, Virginia Oncology Associates, discusses the rationale and results from the phase 3 SPOTLIGHT trial (NCT04186845) in prostate cancer.

The multicenter, single-arm SPOTLIGHT trial evaluated the safety and diagnostic performance of ¹⁸F-rhPSMA-7.3 in PET imaging in patients with suspected recurrence of prostate cancer following curative intent therapy.

Unmet needs still exist with conventional imaging for patients with prostate cancer at risk of recurrence, and SPOTLIGHT aimed to evaluate ¹⁸F-rhPSMA-7.3 as a tool to detect recurrence with more speed and accuracy, Fleming says. By detecting recurrence earlier, more salvage therapy options will be available for patients, and it could create the chance to use PSMA targeting agents, which is promising, Fleming explains.

Detecting recurrences earlier could keep the window open for curative options for patients who failed primary curative intent therapy with radiation or a prostatectomy, Fleming says.

¹⁸F-rhPSMA-7.3 demonstrated frequent upstaging of disease in patients who were considered negative for recurrence by conventional imaging, Fleming continues. Notably, correct detection rate varied with the use of ¹⁸F-rhPSMA-7.3 based on whether patients received prior prostatectomy or radiation therapy, Fleming concludes.