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Updated Prostate Cancer Risk Groups by Prostate-specific Membrane Antigen Positron Emission Tomography Prostate Cancer Molecular Imaging Standardized Evaluation (PPP2): Results from an International Multicentre Registry Study - Beyond the Abstract

Over the past decade, the availability of Prostate-specific membrane antigen-directed PET (PSMA-PET) for staging and restaging of prostate cancer has expanded considerably worldwide. Compared to conventional imaging, PSMA-PET delivers superior accuracy for the assessment of disease spread in nearly all stages.1

The Prostate Cancer Molecular Imaging Standardized Evaluation (PROMISE V2), a system to standardize PSMA-PET reporting, was proposed in 2023.2 Previously, we demonstrated the ability of PSMA-PET PROMISE to predict overall survival in all stages of prostate cancer based on single-center data.3 We now report a high prognostic value of revised PSMA-PET PROMISE nomograms (PPP2) to predict overall survival and to determine low, intermediate or high risk groups.4 The updated PSMA-PET PROMISE nomograms (PPP2) were validated in an international, multicentric registry with more than 6000 patients. Robustness as well as reproducibility of the nomograms were proven across different disease stages and imaging protocols.

Updated prognostic PPP2 nomograms deliver accurate three-tier risk stratification (low/intermediate/high) and improved prediction of 3-year and 5-year overall survival in patients with prostate cancer in all stages.4

Written by: Madeleine J. Karpinski, MSc & Wolfgang P. Fendler, MD, Department of Nuclear Medicine, University Hospital Essen, Essen, Germany

References:

  1. Fendler WP, Calais J, Eiber M, Flavell RR, Mishoe A, Feng FY, et al. Assessment of 68Ga-PSMA-11 PET Accuracy in Localizing Recurrent Prostate Cancer: A Prospective Single-Arm Clinical Trial. JAMA Oncol. 2019;5(6):856-63.
  2. Seifert R, Emmett L, Rowe SP, Herrmann K, Hadaschik B, Calais J, et al. Second Version of the Prostate Cancer Molecular Imaging Standardized Evaluation Framework Including Response Evaluation for Clinical Trials (PROMISE V2). Eur Urol. 2023;83(5):405-12.
  3. Karpinski MJ, Husing J, Claassen K, Moller L, Kajuter H, Oesterling F, et al. Combining PSMA-PET and PROMISE to re-define disease stage and risk in patients with prostate cancer: a multicentre retrospective study. Lancet Oncol. 2024;25(9):1188-201.
  4. Karpinski MJ, Rahbar K, Bogemann M, Nikoukar LR, Schafers M, Hoberuck S, et al. Updated Prostate Cancer Risk Groups by Prostate-specific Membrane Antigen Positron Emission Tomography Prostate Cancer Molecular Imaging Standardized Evaluation (PPP2): Results from an International Multicentre Registry Study. Eur Urol. 2025.
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