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PSMA Theranostics: Science and Practice.

Kgomotso Mokoala1, Ismaheel Lawal1,2, Thabo Lengana3

  • 1Department of Nuclear Medicine, University of Pretoria, Pretoria 0001, South Africa.

Cancers
|August 7, 2021
PubMed
Summary

Prostate-specific membrane antigen (PSMA) targeted radionuclide therapy shows promise for advanced prostate cancer. This theranostic approach offers a new treatment option for patients with metastatic castration-resistant prostate cancer (mCRPC) who have exhausted standard therapies.

Keywords:
177Lu225AcPSMAprostate cancertheranostics

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Area of Science:

  • Oncology
  • Nuclear Medicine
  • Radiopharmaceutical Chemistry

Background:

  • Prostate cancer (PCa) poses a significant global health burden, particularly advanced metastatic castration-resistant prostate cancer (mCRPC).
  • Current treatments for mCRPC are limited, necessitating novel therapeutic strategies.
  • Theranostics, combining diagnostic and therapeutic agents targeting specific biomarkers, offers a promising avenue.

Purpose of the Study:

  • To review prostate-specific membrane antigen (PSMA) labeled tracers for theranostic applications in prostate cancer.
  • To explore the progress and efficacy of PSMA-directed radionuclide therapy for mCRPC.
  • To discuss the potential benefits and challenges, including toxicities, of this emerging treatment modality.

Main Methods:

  • Review of current literature on PSMA-targeted theranostics.
  • Analysis of clinical trial data for PSMA-directed radioligand therapy.
  • Discussion of the mechanism of action for beta and alpha emitting radionuclides.

Main Results:

  • PSMA overexpression on prostate cancer cells enables targeted therapy.
  • Encouraging results from clinical trials indicate efficacy in patients with advanced mCRPC.
  • PSMA-directed radioligand therapy demonstrates effectiveness in patients who have failed standard treatments.

Conclusions:

  • PSMA-targeted radionuclide therapy is a viable and effective treatment for mCRPC.
  • Further research is needed to optimize the timing of introduction of these therapies.
  • Ongoing efforts focus on improving therapeutic outcomes while minimizing side effects like xerostomia and myelosuppression.