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Potential Targets Other Than PSMA for Prostate Cancer Theranostics: A Systematic Review
Mathieu Gauthé1, Paul Sargos2, Eric Barret3
1Department of Nuclear Medicine, Scintep, 38000 Grenoble, France.
Background:
Prostate-specific membrane antigen (PSMA) is not sufficiently overexpressed in a small proportion of prostate cancer (PCa) patients, who require other strategies for imaging and/or treatment. We reviewed potential targets other than PSMA for PCa theranostics in nuclear medicine that have already been tested in humans.
Methods:
We performed a systematic web search in the PubMed and Cochrane databases, with no time restrictions by pooling terms ("prostate cancer", "prostatic neoplasms") and ("radioligand", "radiotracer"). Included articles were clinical studies. The results were synthetized by the target type.
Results:
We included 38 studies on six different targets: gastrin-releasing peptide receptors (GRPRs) (n = 23), androgen receptor (n = 11), somatostatin receptors (n = 6), urokinase plasminogen activator surface receptor (n = 4), fibroblast activation protein (n = 2 studies) and integrin receptors (n = 1). GRPRs, the most studied target, has a lower expression in high-grade PCa, CRPC and bone metastases. Its use might be of higher interest in treating earlier stages of PCa or low-grade PCa. Radiolabeled fibroblast activation protein inhibitors were the most recent and promising molecules, but specific studies reporting their interest in PCa are needed.
Conclusion:
Theranostics in nuclear medicine will continue to develop in the future, especially for PCa patients. Targets other than PSMA exist and deserve to be promoted.
Insights
New prostate cancer (PCa) theranostic targets beyond PSMA are being explored. Research highlights gastrin-releasing peptide receptors and fibroblast activation protein as promising alternatives for PCa imaging and treatment.
Area of Science:
- Nuclear Medicine
- Oncology
- Radiopharmaceutical Therapy
Background:
- Prostate-specific membrane antigen (PSMA) is not universally overexpressed in all prostate cancer (PCa) patients.
- Alternative imaging and treatment strategies are needed for PCa patients with insufficient PSMA expression.
Purpose of the Study:
- To review and synthesize human-tested targets for PCa theranostics in nuclear medicine, excluding PSMA.
- To identify and evaluate alternative targets for PCa theranostics.
Main Methods:
- Systematic web search of PubMed and Cochrane databases.
- Inclusion of clinical studies on radioligands and radiotracers for prostate cancer.
- Synthesis of results based on target type.
Main Results:
- Six targets were identified across 38 studies: gastrin-releasing peptide receptors (GRPRs), androgen receptor, somatostatin receptors, urokinase plasminogen activator surface receptor, fibroblast activation protein, and integrin receptors.
- GRPRs are the most studied but show lower expression in high-grade/metastatic PCa, suggesting potential for earlier stages.
- Radiolabeled fibroblast activation protein inhibitors represent a recent, promising area requiring further PCa-specific investigation.
Conclusions:
- Nuclear medicine theranostics for PCa will advance, with a need to explore targets beyond PSMA.
- Alternative targets like GRPRs and fibroblast activation protein show potential and warrant further development and promotion for PCa theranostics.
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