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Review
. 2018 Jan-Dec:17:1536012118776068.
doi: 10.1177/1536012118776068.

PSMA Theranostics: Current Status and Future Directions

Kambiz Rahbar  1 , Ali Afshar-Oromieh  2 , Hossein Jadvar  3 , Hojjat Ahmadzadehfar  4
Affiliations
Review

PSMA Theranostics: Current Status and Future Directions

Kambiz Rahbar et al. Mol Imaging. 2018 Jan-Dec.

Abstract

Prostate-specific membrane antigen (PSMA) is a promising target for imaging diagnostics and targeted radionuclide therapy (theranostics) of prostate cancer and its metastases. There is increasing evidence of encouraging response rates and a low toxicity profile of radioligand therapy (RLT) of metastatic castration-resistant prostate cancer using 177Lu-labeled PSMA ligands. In this article, we review the current status of diagnostics and therapy using radiolabeled PSMA ligands. We also suggest protocols for patient selection criteria and conduct of PSMA-based RLT. Challenges and opportunities of PSMA theranostics are discussed.

Keywords: 177Lu-PSMA; PSMA; mCRPC; prostate cancer; radioligand therapy.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: The University of Muenster received consulting fees from ABX Advanced Biochemical Compounds, Radeberg, Germany for K.R.

Figures

Figure 1.
Figure 1.
Probability of a pathologic 68Ga-PSMA-11 PET/CT as histogram (A) and plot of the rates of pathologic scans with confidence intervals (B) depending on PSA (ng/mL) in a cohort of 971 patients. Reprinted from Afshar-Oromieh et al with the permission of the authors. Ct indicates computed tomography; PET, positron emission tomography; PSMA, prostate-specific membrane antigen.
Figure 2.
Figure 2.
A, 68Ga-PSMA11-PET images of a 66-year-old patient with castration-resistant prostate cancer pretreated with docetaxel, abiraterone, and 6 cycles of 223Radium. Maximum intensity projection (MIP) on the left side shows multiple bone and lymph node lesions. Patient was treated with 3 cycles of 177Lu-PSMA-617 radioligand therapy with a cumulative activity of 13.5 GBq (reduced activity because of single kidney). The MIP images on the right side show significant reduction in prostate-specific membrane antigen (PSMA)-positive lesions in correlation with a PSA decline of 99%. B, Fused images of 68Ga-PSMA11-positron emission tomography/computed tomography (PET/CT) images in the upper row show a significant reduction in PSMA-positive lesions. Low-dose CT images (lower row) show a significant volume reduction in soft tissue lesions (especially in the right pelvis).
See this image and copyright information in PMC

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