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Theranostics for Advanced Prostate Cancer: Current Indications and Future Developments.

Andrea Farolfi1, Wolfgang Fendler1, Amir Iravani1

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Advanced prostate cancer (PCa) diagnosis and treatment are evolving with theranostics. Prostate-specific membrane antigen (PSMA)-based imaging and radioligand therapy (RLT) show promise for tailored patient care.

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LutetiumPositron emission tomographyProstate cancerProstate-specific membrane antigenRadioligand therapyTheranostics

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Area of Science:

  • Nuclear medicine
  • Oncology
  • Radiochemistry

Background:

  • Advanced prostate cancer (PCa) is a leading cause of cancer death in men.
  • Positron emission tomography (PET) imaging and radioligand therapy (RLT) are emerging strategies for advanced PCa.
  • Theranostics offers a combined diagnostic and therapeutic approach.

Purpose of the Study:

  • To review the role of theranostic processes in advanced PCa.
  • To highlight the potential of prostate-specific membrane antigen (PSMA)-based theranostics.
  • To discuss current indications, performance, limitations, and future developments.

Main Methods:

  • Nonsystematic review of current literature and expert panel consensus.
  • Focus on PSMA-based PET imaging and PSMA-directed RLT.
  • Evaluation of diagnostic and therapeutic applications in advanced PCa.

Main Results:

  • PSMA-based PET imaging is of growing interest for detecting metastases in advanced PCa.
  • PSMA-directed RLT shows initial promise for feasibility and efficacy.
  • PSMA theranostics may guide treatment strategies and monitor disease spread.

Conclusions:

  • PSMA is a promising molecule for both imaging and therapy in advanced PCa.
  • Further studies are required to define PSMA's role, side effects, and overall strategy.
  • Theranostic approaches require further investigation to determine patient risks and benefits.