Department of Nuclear Medicine, Medical University of Gdańsk, Gdańsk, Poland; Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.
Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.
Clin Genitourin Cancer. 2021 Aug;19(4):e235-e247. doi: 10.1016/j.clgc.2021.03.008. Epub 2021 Mar 17.
This manuscript describes the history of 2 patients with prostate cancer (PCa) and the role of prostate-specific membrane antigen (PSMA) theranostics in their clinical management. In the first patient, PSMA-directed positron emission tomography (PET)/computed tomography (CT) imaging was used for primary staging of high-risk PCa before initial therapy. Then after biochemical relapse it was used to plan the scope of further treatment, in which it allowed among others to perform precise target volume delineation for salvage radiotherapy for pathologic lymph nodes. In the second patient with metastatic castration-resistant prostate cancer (mCRPC), PSMA-guided imaging played a key role in the qualification for PSMA-directed radioligand therapy (RLT) with lutetium-177. We also present a review of the current literature concerning PSMA theranostics in the 2 clinical settings, ie, primary staging of PCa and PSMA RLT of mCRPC. In the first part of the review, we report on the diagnostic efficacy of various PSMA imaging radiotracers labeled with gallium-68, fluorine-18, and technetium-99m. In the second part, we describe the limitations and future perspectives of PSMA therapeutic radiopharmaceuticals, including various beta(-) and alpha emitters.
这篇手稿描述了 2 例前列腺癌（PCa）患者的病史，以及前列腺特异性膜抗原（PSMA）治疗在其临床管理中的作用。在第一例患者中，PSMA 靶向正电子发射断层扫描（PET）/计算机断层扫描（CT）成像用于高危 PCa 初始治疗前的初步分期。然后在生化复发后，它被用于计划进一步治疗的范围，其中包括对病理淋巴结进行挽救性放疗的精确靶区勾画。在第二例转移性去势抵抗性前列腺癌（mCRPC）患者中，PSMA 引导成像在获得 PSMA 导向放射性配体治疗（RLT）用镥-177 的资格方面发挥了关键作用。我们还回顾了 PSMA 治疗在这 2 种临床情况下的最新文献，即 PCa 的初步分期和 mCRPC 的 PSMA RLT。在综述的第一部分，我们报告了各种用镓-68、氟-18 和锝-99m 标记的 PSMA 成像放射性示踪剂的诊断功效。在第二部分，我们描述了 PSMA 治疗性放射性药物的局限性和未来前景，包括各种β(-)和α发射器。
