Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy.
Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy.
Cancer Treat Rev. 2024 Apr;125:102699. doi: 10.1016/j.ctrv.2024.102699. Epub 2024 Feb 17.
177Lu-PSMA has been approved for the treatment of PSMA-positive metastatic castration-resistant (mCRPC) patients who progressed to androgen receptor pathway inhibitors (ARPIs) and taxane-based chemotherapy. However, a higher proportion of patients do not respond to this type of radioligand therapy (RLT). To date, there is a lack of validated prognostic and predictive biomarkers for 177Lu-PSMA therapy in prostate cancer. Several studies have investigated the prognostic and predictive role of clinical and molecular factors and also the metabolic features of PET imaging. In this review, we aim to take stock of the current scenario, focusing on new emerging data from retrospective/prospective series and clinical trials. Given the high costs and the possibility of primary resistance, it seems essential to identify clinical and molecular characteristics that could allow clinicians to choose the right patient to treat with 177Lu-PSMA. Biomarker-based clinical trials are urgently needed in this field.
177Lu-PSMA 已被批准用于治疗 PSMA 阳性转移性去势抵抗性（mCRPC）患者，这些患者已进展至雄激素受体通路抑制剂（ARPIs）和紫杉烷类化疗。然而，更高比例的患者对这种放射性配体治疗（RLT）没有反应。迄今为止，前列腺癌中缺乏针对 177Lu-PSMA 治疗的经过验证的预后和预测生物标志物。几项研究已经调查了临床和分子因素以及 PET 成像的代谢特征的预后和预测作用。在这篇综述中，我们旨在了解当前的情况，重点关注来自回顾性/前瞻性系列和临床试验的新出现的数据。鉴于高成本和可能出现原发性耐药，识别可能使临床医生能够选择合适的患者接受 177Lu-PSMA 治疗的临床和分子特征似乎至关重要。在这一领域急需基于生物标志物的临床试验。
