Nuclear Medicine Department, "Santa Maria Goretti" Hospital, via Canova, 04100, Latina,Italy.
Department of Biomedicine and Prevention, University Tor Vergata, Viale Oxford 81, 00133, Rome,Italy.
Curr Mol Med. 2022;22(1):25-36. doi: 10.2174/1566524021666210211112423.
Prostate cancer (PCa) represents to be the most common tumor in male and one of the most relevant causes of death in the Western countries. Androgen deprivation therapy (ADT) constitutes a widely used approach in advanced PCa. When PCa progresses in spite of ADT and castrate levels of testosterone, the severe clinical condition termed as metastatic castration-resistant prostate cancer (mCRPC) takes place. The only approach to mCRPC has been represented by chemotherapy with taxanes for many years. Nevertheless, recently introduced treatments such as 2nd generation antiandrogens (i.e., enzalutamide and abiraterone), cell immunotherapy with sipuleucel-T or targeted alpha therapy with 223Ra-dichloride, have dramatically changed mCRPC prognosis. These novel therapies call for an unmet need for imaging biomarkers suitable for patients' pre-treatment stratification and response assessment. In this scenario, nuclear medicine can provide several metabolic and molecular probes for investigating pathological processes at a cellular and sub-cellular level. The aim of this paper is to review the most relevant findings of the literature published to date on this topic, giving particular emphasis on the pros and cons of each tracer and also covering future prospects for defining personalized therapeutic approaches.
前列腺癌 (PCa) 是男性最常见的肿瘤之一，也是西方国家死亡的主要原因之一。去势治疗 (ADT) 是晚期 PCa 的常用治疗方法。尽管进行了 ADT 和去势水平的睾酮治疗，但 PCa 仍在进展，就会出现严重的临床情况，称为转移性去势抵抗性前列腺癌 (mCRPC)。多年来，mCRPC 的唯一治疗方法一直是紫杉烷类化疗。然而，近年来引入的治疗方法，如第二代抗雄激素（即恩扎鲁胺和阿比特龙）、细胞免疫疗法用 sipuleucel-T 或靶向 alpha 疗法用 223Ra-二氯化物，极大地改变了 mCRPC 的预后。这些新疗法对合适的成像生物标志物有未满足的需求，这些标志物可用于患者的治疗前分层和反应评估。在这种情况下，核医学可以提供几种代谢和分子探针，用于在细胞和亚细胞水平研究病理过程。本文的目的是回顾迄今为止发表的关于该主题的文献中最相关的发现，特别强调每个示踪剂的优缺点，并涵盖定义个性化治疗方法的未来前景。
