Current status of PSMA-targeted imaging and therapy

Area of Science:

• Nuclear Medicine
• Oncology
• Radiopharmaceutical Science

Background:

• Prostate cancer incidence is rising, posing a significant threat to men's health.
• Current diagnostic methods like MRI have limitations in fully meeting patient management needs.
• Metastatic castration-resistant prostate cancer (mCRPC) often presents late, with limited treatment options and poor survival.

Purpose of the Study:

• To review current perspectives on PSMA-targeted imaging and theranostics in prostate cancer.
• To highlight the advancements in PSMA radioligands for both diagnostic and therapeutic applications.
• To emphasize the integration of nuclear medicine into multidisciplinary oncology teams for improved patient care.

Main Methods:

• Review of current literature on PSMA-targeted agents for prostate cancer.
• Analysis of approved and investigational PSMA radioligands for imaging and therapy.
• Discussion of clinical trial outcomes and the role of PSMA in patient management.

Main Results:

• Several PSMA radioligands have been developed for prostate cancer imaging and theranostics.
• ⁶⁸Ga-PSMA-11 and ¹⁸F-DCFPyL are FDA-approved for prostate cancer imaging.
• PSMA-targeted agents labeled with various isotopes (¹¹¹In, ^99mTc, ¹⁷⁷Lu, ²²⁵Ac) show promise in guiding surgery, detecting metastases, and enabling internal radiotherapy.

Conclusions:

• PSMA-targeted imaging and theranostics are becoming standard of care in prostate cancer management.
• These approaches offer improved diagnostic accuracy and novel therapeutic strategies, particularly for mCRPC.
• Integrating nuclear medicine physicians into multidisciplinary teams is crucial for optimizing the use of PSMA-targeted modalities.