Wang Hui, Li GuanNan, Zhao Jie, Eiber Matthias, Tian Rong
Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, China.
Department of Nuclear Medicine, Sanmenxia Central Hospital, Henan, China.
Front Oncol. 2024 Jan 9;13:1230251. doi: 10.3389/fonc.2023.1230251. eCollection 2023.
Currently, the incidence of prostate cancer is increasing, and it has become a great threat to men's health. The detection, staging, and follow-up of prostate cancer patients are inseparable from morphology or magnetic resonance imaging (MRI). However, these do not fully meet the needs of diagnosis and patient management. In particular, owing to the late diagnosis, metastatic castration-resistant prostate cancer (mCRPC) patients usually have poor survival and few options for further effective treatment. Prostate-specific membrane antigen (PSMA), because of its overexpression on prostate cancer cells, has gained interest due to its application in the imaging and theranostics field. Several PSMA radioligands have been developed for imaging and treating prostate cancer. Many clinical trials have assessed the efficacy and safety profiles of these radionuclide agents and show promise in patients who have exhausted other standard treatment options. To date, several small compounds for targeting PSMA have been developed, and Ga-PSMA-11 and F-DCFPyL have been approved by the United States (US) Food and Drug Administration (FDA) for imaging of prostate cancer. In- or Tc-labeled PSMA-ligand can guide surgeons searching for radioactive metastatic lymph nodes, and Lu- or Ac-labeled PSMA-ligand can be used for internal radiotherapy. Moreover, some molecules for therapeutic application are undergoing different stages of clinical trials. In this review, we present current perspectives on the use of PSMA-targeted imaging and theranostics in prostate cancer. As PSMA-targeted imaging and therapeutics are becoming the standard of care for prostate cancer patients, we emphasize the importance of integrating nuclear medicine physicians into multidisciplinary oncology teams.
目前，前列腺癌的发病率正在上升，已成为男性健康的重大威胁。前列腺癌患者的检测、分期和随访离不开形态学或磁共振成像（MRI）。然而，这些方法并不能完全满足诊断和患者管理的需求。特别是，由于诊断较晚，转移性去势抵抗性前列腺癌（mCRPC）患者的生存率通常较低，进一步有效治疗的选择也很少。前列腺特异性膜抗原（PSMA）因其在前列腺癌细胞上的过度表达，在成像和诊疗领域的应用受到关注。已经开发了几种PSMA放射性配体用于前列腺癌的成像和治疗。许多临床试验评估了这些放射性核素药物的疗效和安全性，并在其他标准治疗方案已用尽的患者中显示出前景。迄今为止，已经开发了几种靶向PSMA的小分子化合物，Ga-PSMA-11和F-DCFPyL已获得美国食品药品监督管理局（FDA）批准用于前列腺癌成像。In或Tc标记的PSMA配体可指导外科医生寻找放射性转移淋巴结，Lu或Ac标记的PSMA配体可用于内照射放疗。此外，一些用于治疗的分子正处于不同阶段的临床试验中。在本综述中，我们介绍了PSMA靶向成像和诊疗在前列腺癌中的应用现状。随着PSMA靶向成像和治疗正成为前列腺癌患者的标准治疗方法，我们强调将核医学医生纳入多学科肿瘤团队的重要性。
