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Wächter S, Di Fazio P, Maurer E, Manoharan J, Keber C, Pfestroff A, Librizzi D, Bartsch DK, Luster M, Eilsberger F. Prostate-Specific Membrane Antigen in Anaplastic and Poorly Differentiated Thyroid Cancer-A New Diagnostic and Therapeutic Target? Cancers (Basel) 2021; 13:cancers13225688. [PMID: 34830843 PMCID: PMC8616254 DOI: 10.3390/cancers13225688] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/01/2021] [Accepted: 11/10/2021] [Indexed: 02/07/2023] Open
Abstract
Several studies have demonstrated an expression of the prostate-specific membrane antigen (PSMA) in the cancer-related neovasculature of thyroid malignancies. Due to the poor prognosis and limited therapeutic options for patients with anaplastic (ATC) and poorly differentiated (PDTC) thyroid carcinoma, the aim of our study was to investigate the theranostic approach of PSMA expression in these patients. The PSMA uptake on Gallium-68 (68Ga)-PSMA-positron emission tomography/computed tomography (PET/CT) and glucose uptake on F-18-Fluordeoxyglucose (18F-FDG)-PET/CTs were analysed in two ATC and six PDTC patients. The PSMA expression in corresponding patients' tissue samples was detected by immunohistochemistry. In addition, various tissue sections from 22 ATC and six PDTC patients were examined concerning PSMA expression. 68Ga-PSMA-PET/CT showed heterogeneous PSMA expression among patients and lesions. Six of the eight analyzed patients (two ATC, four PDTC) showed increased glucose metabolism without increased PSMA uptake after PET/CT. In one patient (PDTC), 18F-FDG-PET/CT tracer uptake was positive and 68Ga-PSMA-PET/CT showed heterogeneous results. Another patient (PDTC) evidenced only PSMA-positive lesions and received two cycles of Lutetium-177 (177Lu)-PSMA therapy, which kept his disease stable for seven months. There was a correlation between immunohistochemical PSMA expression and uptake on 68Ga-PMSA-PET/CT in three of the examined patients. Twenty-seven of the analyzed 39 ATC and 13 of the analyzed 22 PDTC tissue sections showed a strong PSMA expression. Considering the rarity of PDTC and ATC, which is the reason for the small patient population we studied, the findings of this study confirm the high diagnostic sensitivity and superiority of 18F-FDG-PET/CT in comparison to 68Ga-PSMA-PET/CT in the diagnosis of ATC and PDTC. However, it can be suggested that 68Ga-PMSA-PET/CT can be considered as a beneficial adjunct to the well-established 18F-FDG-PET/CT for a few individual selected patients with ATC and PDTC to detect lesions not discovered by 18F-FDG-PET/CT and to determine patients' eligibility for a radioligand therapy. Radiolabelled PSMA-ligands may, in the future, represent a theranostic approach with only minor side effects for a few individual selected patients with ATC and PDTC who need alternative treatment options in case of progression when established therapies are no longer effective. However, due to the small sample size of our collective, larger studies are needed to allow for a final evaluation on the significance of PSMA-targeted diagnostic and therapy for ATC and PDTC.
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Affiliation(s)
- Sabine Wächter
- Department of Visceral, Thoracic and Vascular Surgery, University Hospital Marburg, 35043 Marburg, Germany; (P.D.F.); (E.M.); (J.M.); (D.K.B.)
- Correspondence: ; Tel.: +49-642-158-69-644; Fax: +49-642-158-63-851
| | - Pietro Di Fazio
- Department of Visceral, Thoracic and Vascular Surgery, University Hospital Marburg, 35043 Marburg, Germany; (P.D.F.); (E.M.); (J.M.); (D.K.B.)
| | - Elisabeth Maurer
- Department of Visceral, Thoracic and Vascular Surgery, University Hospital Marburg, 35043 Marburg, Germany; (P.D.F.); (E.M.); (J.M.); (D.K.B.)
| | - Jerena Manoharan
- Department of Visceral, Thoracic and Vascular Surgery, University Hospital Marburg, 35043 Marburg, Germany; (P.D.F.); (E.M.); (J.M.); (D.K.B.)
| | - Corinna Keber
- Department of Pathology, University Hospital Marburg, 35043 Marburg, Germany;
| | - Andreas Pfestroff
- Department of Nuclear Medicine, University Hospital Marburg, 35043 Marburg, Germany; (A.P.); (D.L.); (M.L.); (F.E.)
| | - Damiano Librizzi
- Department of Nuclear Medicine, University Hospital Marburg, 35043 Marburg, Germany; (A.P.); (D.L.); (M.L.); (F.E.)
| | - Detlef K. Bartsch
- Department of Visceral, Thoracic and Vascular Surgery, University Hospital Marburg, 35043 Marburg, Germany; (P.D.F.); (E.M.); (J.M.); (D.K.B.)
| | - Markus Luster
- Department of Nuclear Medicine, University Hospital Marburg, 35043 Marburg, Germany; (A.P.); (D.L.); (M.L.); (F.E.)
| | - Friederike Eilsberger
- Department of Nuclear Medicine, University Hospital Marburg, 35043 Marburg, Germany; (A.P.); (D.L.); (M.L.); (F.E.)
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Currie GM, Trifunovic M, Liu J, Kim S, Gurney H. 18F-DCFPyL PET/CT in Metastatic Renal Cell Carcinoma. J Nucl Med Technol 2021; 50:282-285. [PMID: 34750233 DOI: 10.2967/jnmt.121.262799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 09/10/2021] [Indexed: 11/16/2022] Open
Abstract
Targeted molecular imaging with positron emission tomography (PET) utilize chemical ligands is a peptide that specifically targets a receptor of interest. Prostate specific membrane antigen (PSMA) is substantially upregulated in prostate cancer but is also expressed in the neovascular tissue of several malignancies, including renal cell carcinoma (RCC). Radiolabeled peptide targets for PSMA may be helpful in detecting metastatic RCC lesions. This teaching case provides an insight incidental detection of RCC metastatic disease with PSMA targeted PET and explores potential in deliberate evaluation of RCC with PSMA targeted tracers.
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Affiliation(s)
| | - Marko Trifunovic
- Macquarie Medical Imaging, Macquarie University Hospital, Australia
| | - Jui Liu
- Macquarie Medical Imaging, Macquarie University Hospital, Australia
| | - Sang Kim
- Medical Oncology, Macquarie University, Australia
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Molecular Imaging for Radiolabeling a PSMA-Targeted Long Circulating Peptide as a Theranostic Agent in Mice Bearing a Human Prostate Tumor. J Med Biol Eng 2021. [DOI: 10.1007/s40846-021-00611-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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