Metropolitan Nuclear Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Metropolitan Nuclear Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Eur Urol Oncol. 2019 Mar;2(2):152-162. doi: 10.1016/j.euo.2019.01.001. Epub 2019 Jan 31.
Advanced prostate cancer (PCa) is a prominent cause of cancer death in men; positron emission tomography (PET) imaging may play a relevant role in detecting metastases and thus allowing a more tailored therapy in these patients. Radioligand therapy (RLT) may also gain relevance as a treatment strategy in advanced disease.
The aim of this review is to highlight how the recently developed theranostic processes may become a part of both the available diagnostic and the therapy arsenal in advanced PCa patients.
An expert panel of nuclear medicine physicians and a urologist, highly experienced in the fields of radionuclide imaging and RLT in advanced PCa, performed a nonsystematic review of the current indications, performance, limitations, and potential future developments of the currently available options in PCa theranostics.
Among PET radiotracers, prostate-specific membrane antigen (PSMA)-based compounds in advanced PCa are the focus of a continuously growing interest, mostly due to their potential relevance as theranostic agents. The impact of PSMA-based PET/computed tomography imaging on treatment strategies and prognosis is promising, but still not unquestionably clear. Potential applications may include a role as a gatekeeper to PSMA-directed RLT, as well as monitoring the spread of systemic disease. Currently, initial results seem to substantiate the role of PSMA-directed RLT in terms of feasibility and efficacy.
PSMA is a promising molecule for both imaging and therapy in advanced PCa patients; nevertheless, further studies are needed to investigate its role and to determine the impact of its side effects and its overall strategy outcome.
Prostate-specific membrane antigen (PSMA), a protein, is highly expressed on prostate cancer cells. The possibility to perform diagnostic imaging and subsequently administer therapies by the means of the same molecule is called "theranostics". In patients with advanced prostate cancer, PSMA might have a role in detecting disease spread through both positron emission tomography and single-photon emission computed tomography imaging, while treating prostate cancer systemic localizations with radioligand therapy. Further studies are needed to better determine patients' risks and benefits of these therapeutic approaches.
晚期前列腺癌（PCa）是男性癌症死亡的主要原因；正电子发射断层扫描（PET）成像可能在检测转移中发挥重要作用，从而使这些患者能够接受更具针对性的治疗。放射性配体治疗（RLT）也可能成为晚期疾病的一种治疗策略。
本综述旨在强调最近开发的诊断和治疗方法如何成为晚期 PCa 患者现有诊断和治疗武器库的一部分。
核医学医生和泌尿科医生组成的专家小组在放射性核素成像和晚期 PCa 的 RLT 领域具有丰富的经验，对目前 PCa 治疗学中可用选择的当前适应症、性能、局限性和潜在的未来发展进行了非系统性回顾。
在 PET 放射性示踪剂中，前列腺特异性膜抗原（PSMA）为基础的化合物在晚期 PCa 中是研究的重点，这主要是由于它们作为治疗剂的潜在相关性。PSMA 为基础的 PET/计算机断层扫描成像对治疗策略和预后的影响是有希望的，但仍然不是毫无疑问的。潜在的应用可能包括作为 PSMA 指导的 RLT 的守门员，以及监测全身性疾病的扩散。目前，初步结果似乎证实了 PSMA 指导的 RLT 在可行性和疗效方面的作用。
PSMA 是晚期 PCa 患者成像和治疗的一种很有前途的分子；然而，需要进一步的研究来探讨其作用，并确定其副作用及其整体策略结果的影响。
前列腺特异性膜抗原（PSMA）是一种在前列腺癌细胞上高度表达的蛋白质。通过同一分子进行诊断成像和随后进行治疗的可能性被称为“治疗学”。在晚期前列腺癌患者中，PSMA 可能在通过正电子发射断层扫描和单光子发射计算机断层扫描成像检测疾病扩散方面发挥作用，同时通过放射性配体治疗治疗前列腺癌的全身局部病变。需要进一步的研究来更好地确定这些治疗方法对患者的风险和益处。
