PSMA Theranostics in Prostate Cancer and Beyond: Current and Future Perspectives

Area of Science:

• Oncology
• Biomarker Discovery
• Molecular Imaging

Background:

• Prostate-specific membrane antigen (PSMA) is crucial for prostate cancer (PCa) diagnostics and therapeutics.
• PSMA expression is linked to tumor progression, angiogenesis, and treatment resistance in advanced PCa.
• Current PSMA-based theranostics face limitations with certain PCa subtypes.

Purpose of the Study:

• To review PSMA biology and its role in cancer hallmarks.
• To explore emerging biomarkers and imaging techniques complementing PSMA.
• To discuss expanding PSMA theranostics beyond PCa.

Main Methods:

• Literature review integrating PSMA biology with cancer hallmarks.
• Analysis of emerging biomarkers (genomic, circulating, exosomal microRNAs).
• Evaluation of advanced imaging (radiomics, dual-tracer PET) and PSMA's potential in other cancers (RCC, GBM).

Main Results:

• PSMA expression correlates with proliferative signaling, metabolic adaptation, and cell death evasion.
• Genomic alterations, circulating tumor markers, and exosomal microRNAs offer complementary diagnostic and prognostic information.
• PSMA-PET shows promise in renal cell carcinoma and glioblastoma, suggesting broader theranostic utility.

Conclusions:

• PSMA theranostics can be enhanced by integrating novel biomarkers and advanced imaging.
• Personalized cancer care can be advanced through predictive models and combination therapies.
• Expanding PSMA applications to non-prostate malignancies holds significant therapeutic potential.