Jajja Salman Ayub, Sodhi Nandini, Parent Ephraim E, Singh Parminder
NYMC-Landmark Medical Center, Woonsocket, RI 02895, USA.
University of Arizona College of Medicine, Tucson, AZ 85724, USA.
Biomedicines. 2025 Jul 28;13(8):1837. doi: 10.3390/biomedicines13081837.
Following lung cancer, prostate cancer is the leading cause of cancer death in men. High-risk localized tumor burden or metastatic disease often progresses, refractory to initial treatment regimens. There is ongoing development of technology to appropriately identify high-risk patients, stage them correctly, and offer appropriate treatments to obtain the best clinical outcomes. Prostate cancer-specific membrane antigen (PSMA) is a transmembrane glutamate carboxypeptidase, which helps regulate folate absorption, and its overexpression is pathologically directly proportional and associated with prostate cancer. Increased PSMA expression is a known independent risk factor for poorer survival, and most metastatic lesions in CRPC are PSMA positive. Over the last decade, several PSMA-based PET radiopharmaceuticals have demonstrated superior sensitivities and specificities compared to traditional imaging methods. These outcomes have been demonstrated by several large clinical trials. As the data emerges, these diagnostics are being integrated into standard of care protocol to facilitate nuanced identification of malignant lesions. PSMA is also being targeted through several therapeutics, including radioligands and immunotherapies such as CAR-T, BiTEs, and ADCs. This review will discuss the landscape of PSMA-based theranostics in the context of prostate cancer.
继肺癌之后，前列腺癌是男性癌症死亡的主要原因。高危局限性肿瘤负荷或转移性疾病往往会进展，对初始治疗方案难治。目前正在不断开发技术，以适当识别高危患者，正确分期，并提供适当治疗以获得最佳临床结果。前列腺癌特异性膜抗原（PSMA）是一种跨膜谷氨酸羧肽酶，有助于调节叶酸吸收，其过表达在病理上与前列腺癌成正比并相关。PSMA表达增加是已知的生存较差的独立危险因素，去势抵抗性前列腺癌（CRPC）中的大多数转移病灶PSMA呈阳性。在过去十年中，与传统成像方法相比，几种基于PSMA的PET放射性药物已显示出更高的敏感性和特异性。这些结果已在多项大型临床试验中得到证实。随着数据的出现，这些诊断方法正被纳入护理标准方案，以促进对恶性病变的细微识别。PSMA也正通过多种治疗方法被靶向，包括放射性配体以及CAR-T、双特异性T细胞衔接器（BiTEs）和抗体药物偶联物（ADCs）等免疫疗法。本综述将在前列腺癌的背景下讨论基于PSMA的诊疗方法的情况。
