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Review
. 2024 Oct 16;12(10):2355.
doi: 10.3390/biomedicines12102355.

Prognostic Role of PSMA-Targeted Imaging in Metastatic Castration-Resistant Prostate Cancer: An Overview

Matteo Caracciolo  1 , Angelo Castello  2 , Massimo Castellani  2 , Mirco Bartolomei  1 , Egesta Lopci  3
Affiliations
Review

Prognostic Role of PSMA-Targeted Imaging in Metastatic Castration-Resistant Prostate Cancer: An Overview

Matteo Caracciolo et al. Biomedicines. .

Abstract

Objectives: Prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) has gained a primary role in prostate cancer (PCa) imaging, overcoming conventional imaging and prostate-specific antigen (PSA) serum levels, and has recently emerged as a promising technique for monitoring therapy response in metastatic castration-resistant prostate cancer (mCRPC) patients treated with novel hormonal therapy, taxanes, and radioligand therapy (RLT). In this review, we aim to provide an overview of the most relevant aspects under study and future prospects related to the prognostic role of PSMA PET/CT in mCRPC.

Methods: A systematic literature search was performed in the following databases: MEDLINE, PubMed, and EMBASE databases. The study focused exclusively on English-language studies, excluding papers not pertinent to the topic.

Results: PSMA PET imaging offers a higher sensitivity and specificity than conventional imaging and provides accurate staging and efficient diagnosis of distant metastases. The data presented herein highlight the usefulness of PET in risk stratification, with a prognostic potential that can have a significant impact on clinical practice. Several prospective trials are ongoing and will shortly provide more evidence supporting the prognostic potential of PET PSMA data in this clinical scenario.

Conclusions: Current evidence proves the prognostic role of PSMA PET/CT in different settings, with raising relevance also in the context of mCRPC.

Keywords: PET; PSMA; mCRPC; metastatic castration-resistant prostate cancer; prognosis; prostate cancer; prostate-specific membrane antigen.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
In the present multipanel image, we provide the correlation between PSMA tumor volume (PSMA-TV) expressed in quartiles and overall survival, expressed in months (mo.). Panel (a) depicts the boxplots of the PSMA-TV measured in ml and the corresponding quartiles 1 to 4. Panel (b) provides separate overall survival curves related to each PSMA-TV quartile. Panels (c–f) provide some exemplary patients corresponding to the different quartiles together with blood levels of prostate-specific antigen (PSA). Reproduced from Seifert, R et al. [37], published under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit: http://creativecommons.org/licenses/by/4.0/ (accessed on 19 September 2024).
See this image and copyright information in PMC

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