Lutetium-177 prostate-specific membrane antigen (PSMA) theranostics: practical nuances and intricacies
Abstract
Theranostic principles utilize a molecular biomarker specific for a tumor target, initially for imaging to assess target expression and, if deemed suitable, for targeted therapy. This presents an exciting opportunity for a highly personalized treatment strategy in the era of precision medicine. Prostate-specific membrane antigen (PSMA) theranostics has attracted increasing attention as a promising targeted treatment in metastatic prostate cancer (PC). 177 Lu-DOTA-PSMA-617 (177 Lu-PSMA-617) is a PSMA-targeted small molecule with favorable properties and is the most extensively investigated PSMA radioligand for radionuclide therapy (RNT) in PC. Since 2014 multiple retrospective studies and more recently a phase II prospective study demonstrated safety and impressive efficacy of 177 Lu-PSMA RNT. The evidence generated by these trials led to two currently underway randomized trials in metastatic castrate-resistant PC: TheraP (NCT03392428) and VISION (NCT03511664). While we wait for these pivotal trials to read out, nuclear medicine physicians, medical oncologists, radiation oncologists, and urologists are facing a steep learning curve to master the intricacies and nuances of this novel therapeutic strategy. This review article aims to share and discuss the evolving experience in practical aspects of PSMA theranostics.
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Radiolabelled PSMA ligands in prostate cancer enable accurate staging and localization of metastatic foci, facilitating tailored therapies.
“These dual-action agents enable accurate staging and localization of metastatic foci, facilitating tailored therapies that leverage radiopharmaceuticals for both diagnostic insight and targeted therapeutic intervention.”
From Radiopharmaceuticals: navigating the frontier of precision medicine and therapeutic innovation (2024) · cites this paper as [109]
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Radiopharmaceuticals: navigating the frontier of precision medicine and therapeutic innovation
Dhoundiyal, S., Srivastava, S., Kumar, S., Singh, G., Ashique, S., Pal, R., Mishra, N., & Taghizadeh-Hesary, F. (2024) · European Journal of Medical Research · doi:10.1186/s40001-023-01627-0 · Cited by 144 · see citing works
“Furthermore, theranostic paradigms, exemplified by radiolabelled prostate-specific membrane antigen (PSMA) ligands in prostate cancer, epitomize the exquisite precision of radiopharmaceuticals [109].”
BackgroundNormal-Tissue Tolerance to Radiopharmaceutical Therapies, the Knowns and the Unknowns
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- Authors
- Iravani, A., Violet, J., Azad, A., & Hofman, M. S.
- Affiliations
- The University of Melbourne (AU)
- Peter MacCallum Cancer Centre (AU)
- Corresponding author
- Hofman, Michael S.
- Venue
- Prostate Cancer and Prostatic Diseases
- Published
- 2019-10-08
- Volume
- 23
- Issue
- 1
- Pages
- 38-52
- ISSN
- 1365-7852 (ISSN-L)
- 1476-5608
- OpenAlex
- W2979774200
- Cited by
- 68
- References
- 64
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 10 · 2023: 7 · 2022: 13 · 2021: 18 · 2020: 8
- FWCI
- 1.46
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Prostate Cancer and Prostatic Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiopharmaceutical Chemistry and Applications
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Prostate Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Prostate Cancer Treatment and Research
- Keywords
- lutetium-177, prostate-specific membrane antigen, PSMA-617, radionuclide therapy, metastatic prostate cancer, castration-resistant prostate cancer, targeted therapy, PSMA imaging, clinical practice
- MeSH terms
- Theranostic Nanomedicine, Positron Emission Tomography Computed Tomography, Combined Modality Therapy, Dipeptides, Drug Administration Schedule, Follow-Up Studies, Heterocyclic Compounds, 1-Ring, Humans, Lutetium, Male, Neoplasm Staging, Prognosis, Prostatic Neoplasms, Treatment Outcome, Prostate-Specific Antigen, Patient Selection, Retreatment, Disease Management, Molecular Imaging, Molecular Targeted Therapy
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