PSMA theranostics – a ‘must have’ in every prostate cancer center. 2 Case Studies and Review

PSMA theranostics – a ‘must have’ in every prostate cancer center. Illustration of two clinical cases and review of the literature (2021, Review, Full Text)

(A European study)

"Abstract

This manuscript describes the history of two patients with prostate cancer (PCa) and the role of prostate-specific membrane antigen (PSMA) theranostics in their clinical management. In the first patient PSMA-directed positron emission tomography/computed tomography (PET/CT) imaging was used for primary staging of high-risk PCa before initial therapy. Then, after biochemical relapse it was used to plan the scope of further treatment, where it allowed among others to perform precise target volume delineation for salvage radiotherapy of pathologic lymph nodes. In the second patient with metastatic castration-resistant prostate cancer (mCRPC) PSMA-guided imaging played a key role in the qualification for PSMA-directed radioligand therapy (RLT) with lutetium-177. We also present a review of the current literature concerning PSMA theranostics in the two clinical settings, i.e. primary staging of PCa and PSMA RLT of mCRPC. In the first part of the review, we report on the diagnostic efficacy of various PSMA imaging radiotracers labeled with gallium-68, fluorine-18, and technetium-99m. In the second part, we describe the limitations and future perspectives of PSMA therapeutic radiopharmaceuticals, including various beta(-) and alpha emitters."

From the Full Text:

"Introduction

A concept of ‘theranostics’

The term ‘theranostics’, which is a combination of ‘therapy’ and ‘diagnostics’, was first coined by John Funkhouser in 1998(1). In practice, it combines two radiolabeled ligands, one acting as a predictive biomarker and detecting specific features, such as receptors on cancer cells, and the other acting as a therapeutic agent, being supposed to destroy them, while sparing healthy cells. This concept helps physicians to properly select candidates most likely to benefit from targeted therapy in accordance with their ‘molecular profile’ at a given time-point, minimizing side-effects and improving their quality of life. The role of theranostics is increasingly important in delivering precision medicine to the individual patient. It provides a transition from conventional to personalized medicine, being a modern approach compared to empirical chemotherapy(2)."

(See the Full Text and References)

I will say I've been disappointed in the lack of expanding resources in the US. While this may not be the be-all and end-all for everyone, it certainly looks very promising.

Djin

That's odd. I got access to the Full Text the first few times I used the link. Now, I, too, get to just the Abstract. I wonder if you register there (at Science Direct) -- you get limited access (??).

Djin