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Biomarkers in Prostate-Specific Membrane Antigen Theranostics.

Panagiotis J Vlachostergios1, Ioannis Zachos2, Vassilios Tzortzis2

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Summary

Predicting treatment success for prostate cancer (PC) is crucial. This review explores imaging, clinical, and molecular markers to identify patients who will benefit most from prostate specific membrane antigen (PSMA)-targeted radionuclide therapies (TRT).

Keywords:
177LuPSA responsebiomarkermetastatic castration-resistant prostate canceroverall survivalpredictiveprognosticprogression-free survivalprostate specific membrane antigenradionuclide therapiestheranostics

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Area of Science:

  • Oncology
  • Nuclear Medicine
  • Radiopharmacology

Background:

  • Prostate cancer (PC) theranostics, particularly targeting prostate specific membrane antigen (PSMA), is a rapidly advancing field.
  • The efficacy of 177Lu-based PSMA-targeted radionuclide therapies (TRT) in metastatic castration-resistant prostate cancer (mCRPC) is promising.
  • Identifying predictive biomarkers is essential for optimizing patient selection and treatment outcomes.

Purpose of the Study:

  • To review and categorize potential predictors of efficacy for PSMA-targeted TRT.
  • To provide an overview of current and emerging surrogate markers for treatment response.
  • To guide clinical decision-making in PSMA-targeted therapy for prostate cancer.

Main Methods:

  • Literature review of studies on PSMA-targeted theranostics and radionuclide therapy.
  • Categorization of predictive markers into imaging, clinical, and molecular factors.
  • Synthesis of findings on the utility of various biomarkers in predicting treatment response.

Main Results:

  • Imaging markers, such as PSMA uptake levels and distribution, show potential in predicting response.
  • Clinical factors, including patient performance status and prior treatments, are important predictors.
  • Molecular markers, encompassing genetic and protein expression profiles, offer further insights into therapeutic efficacy.

Conclusions:

  • A combination of imaging, clinical, and molecular predictors is likely to offer the most accurate assessment of treatment response.
  • Further research is needed to validate these markers and integrate them into routine clinical practice for PSMA-TRT.
  • Personalized treatment strategies based on predictive biomarkers will enhance outcomes for prostate cancer patients undergoing PSMA-targeted therapy.