All I know is professor Emmet is offering and explanation that seems to imply "A significant association was found between PSMA intensity on screening and PSA response to Lu-PSMA even with the small numbers of this trial, which is reflective of the strength of the association"
Hoffmans criteria was 1.5 the level of the said study that Emmett was presenting. Thus the better response rate in his study.
"In contrast to our results, one prospective pilot study reported that 56% of men experienced a ≥ 50% PSA reduction with Lu-PSMA therapy.mce-anchor1 This was a trial with almost identical inclusion criteria to the current study. The answer to the markedly differing treatment responses lies at least in part in the screening criteria used to identify eligible patients. The study by Hofman et almce-anchor1 used 1.5 times liver intensity as an inclusion criteria for enrollment, compared to equal to or above liver intensity in this study. They had a higher percentage of men who failed screening due to low PSMA intensity and likely a resultant higher treatment response rate."
In the concluding details
"These findings indicate that there is a minimum PSMA intensity score on screening imaging below which no significant treatment response will be seen with Lu-PSMA therapy."
Her conclusion
"PSMA PET plays an important role in predicting treatment response to Lu-PSMA therapy and in identifying subsequent patterns of failure, which may aid in determining the next best treatment options."
To which radio sensitisers may be of help
It is likely that a subgroup of men undergoing Lu-PSMA therapy may also benefit from the addition of a radiation sensitizer.
But overall it is suggesting a lower threshold yields lower responses. Serious I think you should look into this more because you ann today is claiming......
"The group receiving the combination therapy started with a higher overall PSA (ProstateSpecific Antigen) level, suggesting that the cancer was more progressed in this group at the start of treatment." 88 vs 147
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