旨在评估使用 [68Ga]Ga-PSMA PET 在接受恩杂鲁胺作为一线治疗的 mCRPC 患者中监测恩杂鲁胺反应的效用。患者在开始恩杂鲁胺治疗前 8 周内和开始后 3 个月内接受 [68Ga]Ga-PSMA PET 。根据 EAU/EANM 标准，患者被分类为 PSMA 应答者 (PET-R) 或 PSMA 无应答者 (PET-NR)，而根据 PSA，他们被分类为生化应答者 (PSA-R) 或无应答者-应答者（PSA-NR）。使用Cox回归风险模型和Kaplan-Meier方法进行生存分析。69名患者被认为是完全可评估的。开始恩杂鲁胺治疗 3 个月后，我们观察到 [68Ga]Ga-PSMA PET 和 PSA 监测之间的一致性为 47.8%。对于不一致的病例，PSA 降低对 PET-NR 患者的 PFS 影响较弱，但对 OS 影响显着，而这种变化对 PET-R 患者的 PFS 和 OS 没有影响。[68Ga]Ga-PSMA PET 可以成为监测 mCRPC 患者对恩杂鲁胺反应的有用成像工具，在这种情况下比 PSA 提供更多信息，并可能更好地指导临床医生做出治疗决策。© 2024。作者。

to assess the utility of response monitoring to enzalutamide by using [68Ga]Ga-PSMA PET in mCRPC patients treated with enzalutamide as first-line therapy.patients underwent [68Ga]Ga-PSMA PET less than 8 weeks before and 3 months after starting enzalutamide. On the basis of EAU/EANM criteria, patients were categorized as PSMA responders (PET-R) or PSMA non-responders (PET-NR), whilst, based on PSA, they were classified as biochemical responders (PSA-R) or non-responders (PSA-NR). Survival analysis was performed using the Cox regression hazard model and the Kaplan-Meier method.69 patients were considered fully evaluable. We observed 47.8% of concordance between [68Ga]Ga-PSMA PET and PSA monitoring at 3 months after starting enzalutamide. For discordant cases, the PSA reduction has a weak impact on PFS and a significant impact on OS in PET-NR patients, whilst this change has no impact either for PFS and OS in PET-R ones.[68Ga]Ga-PSMA PET could be a useful imaging tool for monitoring response to enzalutamide in mCRPC patients, being more informative than PSA in this setting, and possibly better guiding clinicians in therapeutic decisions.© 2024. The Author(s).