Kuo Phillip H, Calais Jeremie, Crosby Mike
City of Hope, Duarte, CA, USA.
University of California Los Angeles, Los Angeles, CA, USA.
Target Oncol. 2025 May 26. doi: 10.1007/s11523-025-01151-7.
Despite an evolving treatment landscape for people with metastatic castration-resistant prostate cancer, prognosis for this patient population remains poor. Prostate-specific membrane antigen positron emission tomography (PSMA PET) imaging may be used to identify patients with PSMA-positive (and no significant PSMA-negative) metastatic castration-resistant prostate cancer who could benefit from PSMA-targeted radioligand therapy. As the PSMA PET imaging and treatment landscape expands, there is a growing need for guidance and greater utilization of PSMA-targeted tracers and radioligand therapies to improve outcomes for patients with metastatic castration-resistant prostate cancer. This review discusses the current clinical considerations of PSMA PET, including the various imaging agents available and how best to identify patients eligible for PSMA PET imaging and subsequent PSMA-targeted radioligand therapy. This review also examines opportunities to mitigate discordant findings, as well as considerations around the standardization of reporting of PSMA PET imaging, key gaps in the evidence base, and guidance around the use of PSMA PET in clinical and research settings.
尽管转移性去势抵抗性前列腺癌患者的治疗格局不断演变，但该患者群体的预后仍然很差。前列腺特异性膜抗原正电子发射断层扫描（PSMA PET）成像可用于识别那些可能从PSMA靶向放射性配体治疗中获益的PSMA阳性（且无明显PSMA阴性）转移性去势抵抗性前列腺癌患者。随着PSMA PET成像和治疗领域的不断扩大，越来越需要指导以及更多地使用PSMA靶向示踪剂和放射性配体疗法，以改善转移性去势抵抗性前列腺癌患者的治疗效果。本综述讨论了PSMA PET目前的临床考量，包括可用的各种成像剂，以及如何最好地识别适合PSMA PET成像及后续PSMA靶向放射性配体治疗的患者。本综述还探讨了减少不一致结果的机会，以及关于PSMA PET成像报告标准化的考量、证据基础中的关键差距，以及在临床和研究环境中使用PSMA PET的指导。
