Radionuclides Landscape in Prostate Cancer Theranostics

Area of Science:

• Oncology
• Nuclear Medicine
• Radiopharmaceutical Therapy

Background:

• Prostate cancer affects millions, necessitating advanced treatment strategies.
• Prostate-specific membrane antigen (PSMA) is a key molecular target for prostate cancer.
• Radiotheranostics combine diagnostic imaging and targeted radionuclide therapy.

Purpose of the Study:

• To review the molecular mechanisms of PSMA in prostate cancer.
• To explore the clinical applications of PSMA-targeted radiotheranostics.
• To examine the challenges in implementing these advanced therapies.

Main Methods:

• Review of approved and investigational PSMA-targeted radiodiagnostic and radiotherapeutic agents.
• Discussion of various radionuclides (e.g., 177Lu, 225Ac, 223Ra) and their characteristics.
• Analysis of clinical trial data and regulatory approvals.

Main Results:

• Several PSMA-targeted agents ([18F]DCFPyL, [18F]rhPSMA-7.3, [68Ga]Ga-PSMA-11, [177Lu]Lu-PSMA-617) are approved for prostate cancer.
• [177Lu]Lu-PSMA-617 (PLUVICTO®) approval marks a significant advancement for metastatic castration-resistant prostate cancer.
• Multiple radionuclides are under investigation for broader clinical implementation.

Conclusions:

• PSMA-targeted radiotheranostics represent a significant advancement in prostate cancer management.
• Further research and clinical trials are crucial to overcome implementation challenges.
• These therapies hold promise for personalized treatment of prostate cancer.