Department of Urology, General Hospital of Athens "G. Gennimatas", Athens, Greece.
2nd Department of Urology, School of Medicine, National and Kapodistrian University of Athens, Hospital of Athens "Sismanoglio", Athens, Greece.
Expert Opin Pharmacother. 2024 Jul;25(10):1405-1419. doi: 10.1080/14656566.2024.2385726. Epub 2024 Jul 31.
The prostate cancer (PCa) consists the most frequently diagnosed malignancy of urogenital system in males. Traditionally, treatment of localized PCa was based on surgery or radiotherapy while hormonotherapy was used in more advanced stages. However, the implementation of radiolabels has revolutionized the landscape of prostate cancer. Specifically, prostate-specific membrane antigen (PSMA) has been investigated in different aspects of PCa therapeutic era.
A literature review is presented about the implications of PSMA radiolabels on prostate cancer treatment. PSMA tracers were initially used as an imaging technique. Afterwards, PSMA labeled with isotopes presenting cytotoxic abilities, such as lutetium-117 and actinium-225, while reports exist about the use of radioligand immunotherapy. Meanwhile, ongoing trials examine the development of novel radionuclides as well as the evolution of the PSMA-targeted ligands.
Currently, PSMA radioligand treatment of prostate cancer is approved in the metastatic stage of the disease. Meanwhile, a variety of trials exist about its possible role in less advanced stages. However, plenty of parameters should be addressed before these implementations, such as PSMA dosage, dosimetry issues, and its safety profile. A future well-designed study with proper patient selection is mandatory to further explore PSMA radioligand theranostics perspectives.
前列腺癌(PCa)是男性泌尿生殖系统最常见的恶性肿瘤。传统上,局限性 PCa 的治疗基于手术或放疗,而激素治疗则用于更晚期的病例。然而,放射性标记物的应用彻底改变了前列腺癌的治疗格局。具体而言,前列腺特异性膜抗原(PSMA)在前列腺癌治疗的各个方面都得到了研究。
本文对 PSMA 放射性标记物在前列腺癌治疗中的应用进行了文献综述。PSMA 示踪剂最初被用作一种成像技术。随后,PSMA 被标记上具有细胞毒性的同位素,如镥-117 和锕-225,同时也有关于放射性配体免疫治疗的报道。此外,目前正在进行的临床试验研究了新型放射性核素的开发以及 PSMA 靶向配体的演变。
目前,PSMA 放射性配体治疗前列腺癌已在疾病的转移性阶段获得批准。与此同时,也有许多临床试验探讨了其在较早期阶段的可能作用。然而,在这些应用之前,还需要解决许多参数问题,如 PSMA 剂量、剂量学问题及其安全性概况。未来需要进行一项设计合理、患者选择适当的研究,以进一步探索 PSMA 放射性配体治疗的前景。