Theranostics in prostate cancer

SummaryThis review summarizes current evidence of “theranostics” for patients with prostate cancer. Prostate-specific membrane antigen (PSMA) is a glycoprotein which can be labeled with positron-emitting tomographic (PET) tracers like fluorine-18, gallium-68, or copper-64 and can be labeled with beta emitters like lutetium-177 to treat patient s with metastatic castration-resistant prostate cancer (mCRPC). PSMA PET/CT has been shown to be superior to computer tomography (CT) and bone scintigraphy in accuracy, sensitivity, and specificity in the evaluation of metastatic tumor sites and may change treatment management. However, outcome stud ies showing an improvement in progression-free survival (PFS) and/or overall survival (OS) after management change is missing. PSMA PET/CT is highly recommended in prostate cancer patients with biochemical recurrence (PSA>  0.2 ng/ml). Patients presenting with high PSMA expression in PSMA PET/CT may be favorably treated with177lutetium-617. In the TheraP study, a  multicenter phase 2 trial, patients with mCRPC were randomly assigned to receive either177lutetium-617 or cabazitaxel. The results indicate fewer treatment-related adverse events in patients treated with177lutetium-617, an improvement in PSA response, but no improvement in OS after 36  months follow-up. In the VISION trial, a phase 3 international study, patients with mCRPC were randomly assigned to receive either177lutetium-617 and standard of care (SOC) or SOC ...
Source: Memo - Magazine of European Medical Oncology - Category: Cancer & Oncology Source Type: research