Dr. Morris on Deciding Among PET Tracers in Prostate Cancer

Michael J. Morris, MD, medical oncologist, clinical director of Genitourinary Medical Oncology Service, and Prostate Cancer Section Head of the Division of Solid Tumor Oncology at Memorial Sloan Kettering Cancer Center, discusses factors to consider when deciding among PET tracers in prostate cancer.

Ultimately, all of the PSMA agents that are on track for review, such as gallium-68 PSMA-11 and F18PyL, are much better than the agents that the average practitioner is using today, says Morris. Deciding which to use may depend on factors that are unrelated to the technical aspects of the tracers; for example, it may come down to which each individual institution decides to use, Morris explains.

In terms of availability, F18PyL already has a relatively large international infrastructure that supports the production of FDG, which is now the most commonly used tracer for head imaging, Morris adds. Notably, many institutions won’t have access to gallium-68 because it requires a generator to produce, says Morris. Sometimes the decision comes down to the logistical feasibility.

However, according to Morris, when selecting a tracer, more complete studies are ultimately needed to provide elaborate comparisons between the options available. To date, the limited studies comparing gallium-68 PSMA-11 and F18PyL suggests, but do not definitively prove, that the F18PyL may have advantages over gallium-68, Morris explains. Regardless of what those subtleties are, both of these tracers are much more effective than the approaches that are often currently used in terms of bone scans, CT, and MRI. As such, either of the options would be acceptable, Morris concludes.