Parent Ephraim E, Kase Adam M
Department of Radiology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA.
Division of Hematology Oncology, Mayo Clinic, Jacksonville, FL 32224, USA.
Cancers (Basel). 2022 Sep 1;14(17):4276. doi: 10.3390/cancers14174276.
The recent approval of Lu PSMA-617 (Pluvicto) by the United States Food and Drug Administration (FDA) is the culmination of decades of work in advancing the field of targeted radionuclide therapy for metastatic prostate cancer. Lu PSMA-617, along with the bone specific radiotherapeutic agent, RaCl (Xofigo), are now commonly used in routine clinical care as a tertiary line of therapy for men with metastatic castrate resistant prostate cancer and for osseus metastatic disease respectively. While these radiopharmaceuticals are changing how metastatic prostate cancer is classified and treated, there is relatively little guidance to the practitioner and patient as to how best utilize these therapies, especially in conjunction with other more well-established regimens including hormonal, immunologic, and chemotherapeutic agents. This review article will go into detail about the mechanism and effectiveness of these radiopharmaceuticals and less well-known classes of targeted radionuclide radiopharmaceuticals including alpha emitting prostate specific membrane antigen (PSMA)-, gastrin-releasing peptide receptor (GRPR)-, and somatostatin targeted radionuclide therapeutics. Additionally, a thorough discussion of the clinical approach of these agents is included and required futures studies.
美国食品药品监督管理局（FDA）近期批准了镥[177Lu]PSMA - 617（Pluvicto），这是转移性前列腺癌靶向放射性核素治疗领域数十年研究工作的结晶。镥[177Lu]PSMA - 617与骨特异性放射治疗剂镭[223Ra]氯化物（Xofigo），现在分别作为转移性去势抵抗性前列腺癌男性患者的三线治疗药物和骨转移性疾病的常用药物，被广泛应用于常规临床治疗中。虽然这些放射性药物正在改变转移性前列腺癌的分类和治疗方式，但对于从业者和患者而言，关于如何最佳利用这些疗法，尤其是如何与包括激素、免疫和化疗药物在内的其他更成熟治疗方案联合使用，却几乎没有相关指导。这篇综述文章将详细介绍这些放射性药物以及不太知名的靶向放射性核素放射性药物类别的作用机制和有效性，包括发射α粒子的前列腺特异性膜抗原（PSMA）、胃泌素释放肽受体（GRPR）和生长抑素靶向放射性核素疗法。此外，还将对这些药物的临床应用方法以及未来所需的研究进行全面讨论。
