Prostate Cancer Working Group 4 (PCWG4) is changing how advanced prostate cancer trials read response and progression. This newly developed consensus framework brings bone scintigraphy, CT/MRI, and PSMA-PET under one standardized interpretation of progression, replacing an approach that has struggled to keep pace with molecular imaging.
For over a decade, PCWG3, built on bone scintigraphy and anatomical imaging (CT/MRI), governed how advanced prostate cancer trials assessed response. But molecular imaging has moved faster than the criteria meant to interpret it. PSMA-PET has entered routine use without a clear standard for defining response or progression. Conventional imaging also cannot fully capture the metastatic disease that PSMA-PET reveals, creating real ambiguity in how new lesions are confirmed and folded into radiographic progression-free survival (rPFS) determinations.
In this webinar, MERIT walks through PCWG4 in detail and explains what it means for how these criteria get applied in clinical research going forward.
3 Key Questions We Will Explore:
- Where PCWG3 falls short: What limitations exist with PCWG3-based imaging response assessment in advanced prostate cancer clinical trials?
- What PCWG4 actually changes: What are the fundamental concepts and imaging criteria underlying PCWG4, including PSMA-PET-based response assessment?
- Putting it into practice: How can PCWG4 imaging criteria be applied to support consistent response and progression assessment in clinical trials?
Gregg Miller, MDSenior Medical Expert Radiologist
Dr. Miller is Director of Nuclear Medicine and an oncologic and body imager at Optum Health, board certified in Radiology and Nuclear Medicine. He has read several thousand PET and PET-CT scans and serves as a section lead in Nuclear Medicine and Oncologic Imaging. Over more than a decade of contract research work, he has served as an independent reviewer and adjudicator on numerous Phase I–III oncology trials for multiple CROs, applying criteria including RECIST 1.0/1.1, iRECIST, Lugano, EORTC, Choi, RANO, and PCWG-2/3. He has particularly deep experience in prostate cancer imaging, reviewing multiple metastatic castration-resistant prostate cancer trials under PCWG-2/3 criteria, including studies spanning thousands of time points, alongside broad PET expertise in FDG-PET lymphoma response assessment using Deauville, IHP, and EORTC criteria.
Veronika Matsuk, PhDOncology Clinical Scientist
Veronika’s background is in academic cancer biology and translational research. She supports oncology clinical studies by applying biological and scientific insight to imaging interpretation, response assessment frameworks, and the evaluation of clinically meaningful endpoints. Her work bridges academic research concepts with the practical and operational considerations of clinical trial design and execution.
Isabella Perez, MBAOncology Business Development Associate
Isabella Perez is a Business Development Associate at MERIT with a background in stakeholder management and an MBA specializing in supply chain and finance. She supports oncology clinical research by cultivating sponsor relationships, understanding each team’s clinical trial imaging needs, and guiding opportunities from initial engagement through contracting. By combining her relationship-building experience with a strong understanding of business operations, Isabella helps sponsors navigate imaging endpoints and identify solutions that support the successful execution of their clinical trials.