How PSMA PET Imaging Shaped the PROTEUS Trial Results

Dr. Kalantri highlights a technical but consequential detail: the metastasis-free survival benefit only became apparent when PSMA PET was used to assess outcomes; conventional imaging alone showed no difference between arms. PSMA PET was incorporated into the protocol after enrollment had already begun, since the technology has become central to real-world GU oncology practice, meaning many patients lacked baseline PET imaging — a limitation worth noting but not one that undermines the trial's overall conclusions. Dr. Karr and Dr. Kalantri agree that PSMA PET's growing role in staging is likely to keep shaping how trials like this are read and applied.