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Rizzo A, Piccardo A, Treglia G. Imaging through PSMA-targeted PET in patients diagnosed with radioiodine-refractory thyroid cancer, a flash in the pan or a game changer? Endocrine 2024; 85:601-603. [PMID: 38416379 DOI: 10.1007/s12020-024-03748-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 02/13/2024] [Indexed: 02/29/2024]
Affiliation(s)
- Alessio Rizzo
- Department of Nuclear Medicine, Candiolo Cancer Institute, FPO - IRCCS, 10060, Turin, Italy.
| | - Arnoldo Piccardo
- Nuclear Medicine Department, E.O. "Ospedali Galliera", 16128, Genoa, Italy
| | - Giorgio Treglia
- Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, 6501, Bellinzona, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, 1011, Lausanne, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900, Lugano, Switzerland
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Rudd SE, Noor A, Morgan KA, Donnelly PS. Diagnostic Positron Emission Tomography Imaging with Zirconium-89 Desferrioxamine B Squaramide: From Bench to Bedside. Acc Chem Res 2024; 57:1421-1433. [PMID: 38666539 DOI: 10.1021/acs.accounts.4c00092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
Molecular imaging with antibodies radiolabeled with positron-emitting radionuclides combines the affinity and selectivity of antibodies with the sensitivity of Positron Emission Tomography (PET). PET imaging allows the visualization and quantification of the biodistribution of the injected radiolabeled antibody, which can be used to characterize specific biological interactions in individual patients. This characterization can provide information about the engagement of the antibody with a molecular target such as receptors present in elevated levels in tumors as well as providing insight into the distribution and clearance of the antibody. Potential applications of clinical PET with radiolabeled antibodies include identifying patients for targeted therapies, characterization of heterogeneous disease, and monitoring treatment response.Antibodies often take several days to clear from the blood pool and localize in tumors, so PET imaging with radiolabeled antibodies requires the use of a radionuclide with a similar radioactive half-life. Zirconium-89 is a positron-emitting radionuclide that has a radioactive half-life of 78 h and relatively low positron emission energy that is well suited to radiolabeling antibodies. It is essential that the zirconium-89 radionuclide be attached to the antibody through chemistry that provides an agent that is stable in vivo with respect to the dissociation of the radionuclide without compromising the biological activity of the antibody.This Account focuses on our research using a simple derivative of the bacterial siderophore desferrioxamine (DFO) with a squaramide ester functional group, DFO-squaramide (DFOSq), to link the chelator to antibodies. In our work, we produce conjugates with an average ∼4 chelators per antibody, and this does not compromise the binding of the antibody to the target. The resulting antibody conjugates of DFOSq are stable and can be easily radiolabeled with zirconium-89 in high radiochemical yields and purity. Automated methods for the radiolabeling of DFOSq-antibody conjugates have been developed to support multicenter clinical trials. Evaluation of several DFOSq conjugates with antibodies and low molecular weight targeting agents in tumor mouse models gave PET images with high tumor uptake and low background. The promising preclinical results supported the translation of this chemistry to human clinical trials using two different radiolabeled antibodies. The potential clinical impact of these ongoing clinical trials is discussed.The use of DFOSq to radiolabel relatively low molecular weight targeting molecules, peptides, and peptide mimetics is also presented. Low molecular weight molecules typically clear the blood pool and accumulate in target tissue more rapidly than antibodies, so they are usually radiolabeled with positron-emitting radionuclides with shorter radioactive half-lives such as fluorine-18 (t1/2 ∼ 110 min) or gallium-68 (t1/2 ∼ 68 min). Radiolabeling peptides and peptide mimetics with zirconium-89, with its longer radioactive half-life (t1/2 = 78 h), could facilitate the centralized manufacture and distribution of radiolabeled tracers. In addition, the ability to image patients at later time points with zirconium-89 based agents (e.g. 4-24 h after injection) may also allow the delineation of small or low-uptake disease sites as the delayed imaging results in increased clearance of the tracer from nontarget tissue and lower background signal.
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Affiliation(s)
- Stacey E Rudd
- School of Chemistry and Bio21 Molecular Science and Biotechnology Institute, University of Melbourne, Parkville, Melbourne 3010, Australia
| | - Asif Noor
- School of Chemistry and Bio21 Molecular Science and Biotechnology Institute, University of Melbourne, Parkville, Melbourne 3010, Australia
| | - Katherine A Morgan
- School of Chemistry and Bio21 Molecular Science and Biotechnology Institute, University of Melbourne, Parkville, Melbourne 3010, Australia
| | - Paul S Donnelly
- School of Chemistry and Bio21 Molecular Science and Biotechnology Institute, University of Melbourne, Parkville, Melbourne 3010, Australia
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Nguyen H, Hird K, Cardaci J, Smith S, Lenzo NP. Lutetium-177 Labelled Anti-PSMA Monoclonal Antibody (Lu-TLX591) Therapy for Metastatic Prostate Cancer: Treatment Toxicity and Outcomes. Mol Diagn Ther 2024; 28:291-299. [PMID: 38446353 PMCID: PMC11068829 DOI: 10.1007/s40291-024-00699-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2024] [Indexed: 03/07/2024]
Abstract
INTRODUCTION Whilst prostate cancer is the fourth most common cancer globally, effective therapies for patients with advanced disease are lacking. In recent years, interest in using theranostic agents to treat castrate-resistant prostate cancer (CRPC) and metastatic prostate cancer has emerged. Lu-TLX591 monoclonal antibody is a potential agent of significance; however, to date, reports on its toxicity and efficacy have been limited to small clinical trials in heavily pretreated patients. This retrospective study describes the real-world toxicity and efficacy profile of Lu-TLX591. METHODS Eighteen patients received Lu-TLX591 at two private oncology centres in Australia. Patients were eligible if they had CRPC or metastatic prostate cancer and prostate-specific membrane antigen (PSMA)-avid disease confirmed by PSMA-positron emission tomography (PET). Patients received two cycles of Lu-TLX591 monoclonal antibody (177 Lu-DOTA-rosopatamab) each dosed from 1.01-2.85 GBq, 14 days apart. Patient side effects, blood test results and radiology reports were recorded on the patient's electronic medical record (eMR). RESULTS Prominent side effects included fatigue (55.6%), anorexia (16.7%), nausea (11.1%), and transfusion reactions (11.1%). All-grade haematological toxicities included lymphopenia (61.1%), anaemia (22.2%), leukopenia (27.8%), neutropenia (27.8%), and thrombocytopenia (27.8%). Grade 4 toxicity included lymphopenia (6.7%) and thrombocytopenia (6.7%). Patients' prostate-specific antigen (PSA) responses were as follows; ≥ 30% PSA decline (27.8%), ≥ 50% PSA decline (11.4%) and any PSA decline (38.9%). Follow-up radiology revealed 54.5% stable disease, 45.4% disease progression and 9.1% disease regression. CONCLUSION Lu-TLX591 was safely administered at acceptable toxicity and its efficacy reflects previous clinical trials. Larger studies are required and are underway (NCT04786847; NCT05146973; NCT04876651) to determine Lu-TLX591 effectiveness amongst different prostate cancer populations and compare its efficacy against peptide-based radiopharmaceutical agents.
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Affiliation(s)
- Hanh Nguyen
- School of Medicine, Fremantle Campus, The University of Notre Dame, Fremantle, WA, Australia.
- Genesiscare, Murdoch, WA, Australia.
- Fiona Stanley Hospital, 11 Robin Warren Dr, Murdoch, Perth, WA, 6150, Australia.
| | - Kathryn Hird
- School of Medicine, Fremantle Campus, The University of Notre Dame, Fremantle, WA, Australia
| | - Joe Cardaci
- School of Medicine, Fremantle Campus, The University of Notre Dame, Fremantle, WA, Australia
- Genesiscare, Murdoch, WA, Australia
| | | | - Nat P Lenzo
- School of Medicine, Fremantle Campus, The University of Notre Dame, Fremantle, WA, Australia
- Genesiscare, Murdoch, WA, Australia
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Andryszak N, Świniuch D, Wójcik E, Ramlau R, Ruchała M, Czepczyński R. Head-to-Head Comparison of [ 18F]PSMA-1007 and [ 18F]FDG PET/CT in Patients with Triple-Negative Breast Cancer. Cancers (Basel) 2024; 16:667. [PMID: 38339419 PMCID: PMC10854516 DOI: 10.3390/cancers16030667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 01/31/2024] [Accepted: 02/02/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Triple-negative breast cancer (TNBC) exhibits high aggressiveness and a notably poorer prognosis at advanced stages. Nuclear medicine offers new possibilities, not only for diagnosis but also potentially promising therapeutic strategies. This prospective study explores the potential of prostate-specific membrane antigen (PSMA) as a diagnostic and therapeutic target in TNBC. METHODS the research investigates PSMA expression in vivo among TNBC patients using [18F]PSMA-1007 PET/CT and compares it head-to-head with the standard-of-care [18F]FDG PET/CT. RESULTS The study involves 10 TNBC patients, revealing comparable uptake of [18F]PSMA-1007 and [18F]FDG in primary and metastatic lesions. Nodal metastases were found in eight patients, showing similar SUVmax values in both modalities. Two patients had uncountable lung metastases positive in both [18F]FDG and [18F]PSMA-1007 scans. PET-positive bone metastases were identified by 18F-PSMA in four patients, while elevated [18F]FDG uptake was found only in three of them. Distant metastases displayed higher SUVmax values in the [18F]PSMA-1007 PET/CT, as compared to [18F]FDG. Additionally, brain metastases were exclusively detected using [18F]PSMA-1007. CONCLUSIONS the findings provide valuable insights into the expression of PSMA in TNBC and underscore the potential clinical significance of [18F]PSMA-1007 PET/CT in enhancing both diagnostic and therapeutic approaches for this aggressive breast cancer subtype.
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Affiliation(s)
- Natalia Andryszak
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (M.R.); (R.C.)
- Department of Nuclear Medicine, Affidea, 61-485 Poznan, Poland
| | - Daria Świniuch
- Department of Oncology, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | - Elżbieta Wójcik
- Department of Oncology Medical Center HCP Poznan, 61-485 Poznan, Poland
| | - Rodryg Ramlau
- Department of Oncology, Poznan University of Medical Sciences, 61-701 Poznan, Poland
| | - Marek Ruchała
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (M.R.); (R.C.)
| | - Rafał Czepczyński
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (M.R.); (R.C.)
- Department of Nuclear Medicine, Affidea, 61-485 Poznan, Poland
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Deshayes E, Fersing C, Thibault C, Roumiguie M, Pourquier P, Houédé N. Innovation in Radionuclide Therapy for the Treatment of Prostate Cancers: Radiochemical Perspective and Recent Therapeutic Practices. Cancers (Basel) 2023; 15:3133. [PMID: 37370743 DOI: 10.3390/cancers15123133] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/31/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
Prostate cancer represents the second cause of death by cancer in males in western countries. While early-stage diseases are accessible to surgery and/or external radiotherapy, advanced metastatic prostate cancers are primarily treated with androgen deprivation therapy, to which new generation androgen receptor antagonists or taxane-based chemotherapies are added in the case of tumor relapse. Nevertheless, patients become invariably resistant to castration with a median survival that rarely exceeds 3 years. This fostered the search for alternative strategies, independent of the androgen receptor signaling pathway. In this line, radionuclide therapies may represent an interesting option as they could target either the microenvironment of sclerotic bone metastases with the use of radiopharmaceuticals containing samarium-153, strontium-89 or radium-223 or tumor cells expressing the prostate-specific membrane antigen (PSMA), a protein found at the surface of prostate cancer cells. This review gives highlights the chemical properties of radioligands targeting prostate cancer cells and recapitulates the clinical trials evaluating the efficacy of radionuclide therapies, alone or in combination with other approved treatments, in patients with castration-resistant prostate tumors. It discusses some of the encouraging results obtained, especially the benefit on overall survival that was reported with [177Lu]-PSMA-617. It also addresses the specific requirements for the use of this particular class of drugs, both in terms of medical staff coordination and adapted infrastructures for efficient radioprotection.
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Affiliation(s)
- Emmanuel Deshayes
- INSERM U1194, Montpellier Cancer Research Institute, University of Montpellier, 34298 Montpellier, France
- Department of Nuclear Medicine, Institute du Cancer de Montpellier (ICM), 34298 Montpellier, France
| | - Cyril Fersing
- Department of Nuclear Medicine, Institute du Cancer de Montpellier (ICM), 34298 Montpellier, France
- IBMM, University Montpellier, CNRS, ENSCM, 34293 Montpellier, France
| | - Constance Thibault
- Department of Medical Oncology, Hôpital Européen Georges Pompidou, Institut du Cancer Paris CARPEM, AP-HP Centre, 75015 Paris, France
| | - Mathieu Roumiguie
- Urology Department, Andrology and Renal Transplantation, CHU Rangueil, 31059 Toulouse, France
| | - Philippe Pourquier
- INSERM U1194, Montpellier Cancer Research Institute, University of Montpellier, 34298 Montpellier, France
| | - Nadine Houédé
- INSERM U1194, Montpellier Cancer Research Institute, University of Montpellier, 34298 Montpellier, France
- Medical Oncology Department, Institute de Cancérologie du Gard-CHU Caremeau, 30009 Nîmes, France
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Flegar L, Thoduka SG, Librizzi D, Luster M, Zacharis A, Heers H, Eisenmenger N, Ahmadzadehfar H, Eiber M, Weber W, Groeben C, Huber J. Adoption of Lutetium- 177 PSMA radioligand therapy for metastatic castration resistant prostate cancer: a total population analysis in Germany from 2016 to 2020. Eur J Nucl Med Mol Imaging 2023; 50:2188-2195. [PMID: 36826478 PMCID: PMC10199877 DOI: 10.1007/s00259-023-06139-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 02/07/2023] [Indexed: 02/25/2023]
Abstract
PURPOSE This study is to investigate the adoption and current trends of Lutetium-177 PSMA RLT for mCRPC in Germany. METHODS We analyzed data from the reimbursement.INFO tool based on German hospitals' quality reports for Lutetium-177 PSMA RLT from 2016 to 2020 and from the nationwide German hospital billing database (Destatis) for general therapy with open radionuclides in combination with prostate cancer from 2006 to 2020. For validation of these billing data, we included the 177Lu-PSMA RLT cycles from two participating institutions from 2016 to 2020. For detection of trends over time we applied linear regression models. RESULTS General therapy with open radionuclides increased from 2006 to 2020. We identified a total of 12,553 177Lu-PSMA RLT cycles. The number of 177Lu-PSMA RLTs steadily increased from a total of 1026 therapies in 2016 to 3328 therapies in 2020 (+ 576 RLT/year; p < 0.005). In 2016, 25 departments of nuclear medicine offered this treatment, which increased to 44 nuclear medicine departments in 2020. In 2016, 16% of nuclear medicine departments (4/25) performed more than 100 177Lu-PSMA RLTs, which increased to 36% (16/44) in 2020 (p < 0.005). In 2016, 88% (22/25) of 177Lu-PSMA RLTs were performed at a university hospital, which decreased to 70% (31/44) in 2020. The proportion of patients older than 65 years receiving 177Lu-PSMA RLT increased from 78% in 2016 to 81% in 2020. CONCLUSION Treatment of mCRPC with 177Lu-PSMA RLT has been rapidly increasing in Germany in the recent years providing an additional therapy option. This development is remarkable, because of outstanding formal EMA approval.
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Affiliation(s)
- Luka Flegar
- Department of Urology, Philipps-University Marburg, Baldinger Street, 35043, Marburg, Germany.
| | - Smita George Thoduka
- Department of Nuclear Medicine, Philipps-University Marburg, Baldinger Street, 35043, Marburg, Germany
| | - Damiano Librizzi
- Department of Nuclear Medicine, Philipps-University Marburg, Baldinger Street, 35043, Marburg, Germany
| | - Markus Luster
- Department of Nuclear Medicine, Philipps-University Marburg, Baldinger Street, 35043, Marburg, Germany
| | - Aristeidis Zacharis
- Department of Urology, Philipps-University Marburg, Baldinger Street, 35043, Marburg, Germany
| | - Hendrik Heers
- Department of Urology, Philipps-University Marburg, Baldinger Street, 35043, Marburg, Germany
| | | | | | - Matthias Eiber
- Department of Nuclear Medicine, Technische Universität Munich, Munich, Germany
| | - Wolfgang Weber
- Department of Nuclear Medicine, Technische Universität Munich, Munich, Germany
| | - Christer Groeben
- Department of Urology, Philipps-University Marburg, Baldinger Street, 35043, Marburg, Germany
| | - Johannes Huber
- Department of Urology, Philipps-University Marburg, Baldinger Street, 35043, Marburg, Germany
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Chua WM, Lam WWC, Tong AKT, Sultana R, Kua SMY, Kanesvaran R, Wong ASC, Tay KJ, Cheng TJL, Ng DCE, Thang SP. Outcomes and prognostic predictors of Lu-177 PSMA radioligand therapy in metastatic castration-resistant prostate cancer (Asian Population Study). Asia Pac J Clin Oncol 2023. [PMID: 36999335 DOI: 10.1111/ajco.13944] [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: 09/21/2022] [Revised: 01/17/2023] [Accepted: 01/23/2023] [Indexed: 04/01/2023]
Abstract
AIM Lutetium-177 (Lu-177) prostate-specific membrane antigen radioligand therapy (PSMA-RLT) is a promising therapy for metastatic castration-resistant prostate cancer (mCRPC), but there is limited data of its efficacy and safety in Asian population. We aim to explore the clinical outcomes of Lu-177 PSMA-RLT in this population. METHODS We evaluated 84 patients with progressive mCRPC receiving Lu-177 PSMA-RLT between 9 May 2018 and 21 February 2022. Lu-177-PSMA-I&T was administered at 6-8-week intervals. Primary end point was overall survival (OS), and secondary end points included prostate-specific antigen (PSA) progression-free survival (PFS), PSA response rate, clinical response, toxicity assessment, and prognostic indicators. RESULTS The median OS and PSA PFS were 12.2 and 5.2 months, respectively. PSA decline of ≥50% was observed in 51.8% of patients. Patients achieving PSA response had longer median OS (15.0 vs. 9.5 months, p = .03) and PSA PFS (6.5 vs. 2.9 months, p < .001). Pain score improvement was seen in 19 out of 34 patients. A hematotoxicity of ≥grade 3 was observed in 13 out of 78 patients. Multivariable analyses showed that PSA velocity, alkaline phosphatase, hemoglobin (Hb), and the number of treatment cycles were independent prognostic indicators for OS. The retrospective design was the main limitation of the study. CONCLUSIONS Our study demonstrated a similar safety and efficacy of Lu-177 PSMA-RLT in Asian mCRPC patients compared to the existing literature. A PSA decline ≥50% was associated with longer OS and PSA PFS. Several prognostic indicators for patient outcomes were also identified.
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Affiliation(s)
- Wei Ming Chua
- Division of Radiological Sciences, Department of Nuclear Medicine and Molecular Imaging, Singapore General Hospital, Singapore, Singapore
| | - Winnie Wing-Chuen Lam
- Division of Radiological Sciences, Department of Nuclear Medicine and Molecular Imaging, Singapore General Hospital, Singapore, Singapore
- Radiological Sciences Academic Clinical Program, SingHealth Duke-NUS Academic Medical Centre, Singapore, Singapore
| | - Aaron Kian-Ti Tong
- Division of Radiological Sciences, Department of Nuclear Medicine and Molecular Imaging, Singapore General Hospital, Singapore, Singapore
- Radiological Sciences Academic Clinical Program, SingHealth Duke-NUS Academic Medical Centre, Singapore, Singapore
| | | | - Sandra Mei Yu Kua
- Division of Radiological Sciences, Department of Nuclear Medicine and Molecular Imaging, Singapore General Hospital, Singapore, Singapore
| | - Ravindran Kanesvaran
- Duke-NUS Graduate Medical School, Singapore, Singapore
- Department of Medical Oncology, National Cancer Centre, Singapore, Singapore
| | - Alvin Seng Cheong Wong
- Department of Hematology-Oncology, National University Cancer Institute, Singapore, Singapore
| | - Kae Jack Tay
- Duke-NUS Graduate Medical School, Singapore, Singapore
- Department of Urology, Singapore General Hospital, Singapore, Singapore
| | - Tai Jit Lenith Cheng
- Department of Diagnostic Imaging, National University Hospital, Singapore, Singapore
| | - David Chee Eng Ng
- Division of Radiological Sciences, Department of Nuclear Medicine and Molecular Imaging, Singapore General Hospital, Singapore, Singapore
- Radiological Sciences Academic Clinical Program, SingHealth Duke-NUS Academic Medical Centre, Singapore, Singapore
| | - Sue Ping Thang
- Division of Radiological Sciences, Department of Nuclear Medicine and Molecular Imaging, Singapore General Hospital, Singapore, Singapore
- Radiological Sciences Academic Clinical Program, SingHealth Duke-NUS Academic Medical Centre, Singapore, Singapore
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Rizzo A, Racca M, Dall’Armellina S, Delgado Bolton RC, Albano D, Dondi F, Bertagna F, Annunziata S, Treglia G. Potential Role of PSMA-Targeted PET in Thyroid Malignant Disease: A Systematic Review. Diagnostics (Basel) 2023; 13:diagnostics13030564. [PMID: 36766670 PMCID: PMC9914698 DOI: 10.3390/diagnostics13030564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Recently, several studies introduced the potential use of positron emission tomography/computed tomography (PET/CT) with prostate-specific membrane antigen (PSMA)-targeting radiopharmaceuticals in radioiodine-refractory thyroid cancer (TC). METHODS The authors accomplished a comprehensive literature search of original articles concerning the performance of PSMA-targeted PET/CT in TC patients. Original papers exploring this molecular imaging examination in radioiodine-refractory TC patients undergoing restaging of their disease were included. RESULTS A total of 6 documents concerning the diagnostic performance of PSMA-targeted PET/CT in TC (49 patients) were included in this systematic review. The included articles reported heterogeneous values of PSMA-targeted PET/CT detection rates in TC, ranging from 25% to 100% and overall inferior to [18F]-fluorodeoxyglucose PET/CT when the two molecular imaging examinations were compared. Two studies reported the administration of [177Lu]PSMA-radioligands with theragnostic purpose in three patients. CONCLUSIONS The available literature data in this setting are limited and heterogeneous. The employment of PET with PSMA-targeting radiopharmaceuticals in this setting did not affect patient management. Nevertheless, prospective multicentric studies are needed to properly assess its potential role in TC patients.
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Affiliation(s)
- Alessio Rizzo
- Department of Nuclear Medicine, Candiolo Cancer Institute, FPO-IRCCS, 10060 Turin, Italy
- Correspondence:
| | - Manuela Racca
- Department of Nuclear Medicine, Candiolo Cancer Institute, FPO-IRCCS, 10060 Turin, Italy
| | - Sara Dall’Armellina
- Nuclear Medicine Unit, Department of Medical Sciences, AOU Città della Salute e della Scienza, University of Turin, 10126 Turin, Italy
| | - Roberto C. Delgado Bolton
- Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, University Hospital San Pedro and Centre for Biomedical Research of La Rioja, 26006 Logroño, Spain
| | - Domenico Albano
- Division of Nuclear Medicine, Università degli Studi di Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Francesco Dondi
- Division of Nuclear Medicine, Università degli Studi di Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Francesco Bertagna
- Division of Nuclear Medicine, Università degli Studi di Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Salvatore Annunziata
- Unità di Medicina Nucleare, TracerGLab, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
| | - Giorgio Treglia
- Clinic of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, 6501 Bellinzona, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, 1011 Lausanne, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900 Lugano, Switzerland
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Chen X, Luo Z, Liu X, Li X, Li Q, Zhang W, Liu Y, Cheng Z, Yang X, Liu Y, Jin R, Zhu D, Wang F, Lu Q, Su Z, Guo H. Marsdenia tenacissima (Roxb.) Moon injection exerts a potential anti-tumor effect in prostate cancer through inhibiting ErbB2-GSK3β-HIF1α signaling axis. JOURNAL OF ETHNOPHARMACOLOGY 2022; 295:115381. [PMID: 35595220 DOI: 10.1016/j.jep.2022.115381] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/20/2022] [Accepted: 05/09/2022] [Indexed: 06/15/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Marsdenia tenacissima injection (MTE), a traditional Chinese medical injection extracted from the rattan of Marsdenia tenacissima (Roxb.) Moon, has been approved for clinical use in China as an adjuvant therapeutic agent in multiple cancers, including esophageal cancer, gastric cancer, lung cancer, and liver cancer. However, the activity and mechanism of MTE on prostate cancer (PCa) remain to be defined. AIM OF THE STUDY To investigate the activity and the underlying mechanism of MTE in the treatment of PCa. MATERIALS AND METHODS The component characterization of MTE was analyzed by HPLC-CAD-QTOF-MS/MS technology. Cell Counting Kit-8 (CCK-8) assay was used to assess PCa cell proliferation. Colony formation assay was applied to detect the clonogenic ability of the cells. MetaboAnalyst5.0 database was employed to analyze the altered metabolites of PC3 cells treated with MTE obtained by UPLC-QTOF-MS/MS. Combined with metabolomics analysis and network pharmacology, we predicted the potential targets, which further were verified by Western Blot, RT-qPCR, and Immunohistochemistry assays. Finally, SeeSAR software was applied to predict the potential active components of MTE against PCa. RESULTS A total of 21 components in MTE were confirmed by HPLC-CAD-QTOF-MS/MS analysis. MTE inhibited the proliferation and colony formation of PCa cells. A total of 20 metabolites closely related to glycerophospholipid metabolism, glycolysis/gluconeogenesis, and tricarboxylic acid (TCA) cycle were significantly changed in PC3 cells treated with MTE. The network pharmacology analysis revealed that MTE suppressed the growth of PC3 cells might by regulating the ErbB2-GSK3β-HIF1α signaling axis. Furthermore, we also confirmed that stimulation of MTE significantly inhibited the phosphorylation of ErbB2 at Tyr877 and the activities of its downstream signal transducers (GSK3β and HIF1α) in PCa, as well as the mRNA levels of critical factors (IDH2, LDHA, and HIF1A) in the tricarboxylic acid (TCA) cycle. Molecular docking further suggested that Tenacissimoside E, cryptochlorogenic acid, and scopoletin might be the active ingredients of MTE for PCa treatment. CONCLUSION This study proposed that MTE exerts a potential anti-tumor effect in PCa through inhibiting ErbB2-GSK3β-HIF1α signaling axis, which may be related to the TCA cycle.
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Affiliation(s)
- Xin Chen
- Guangxi Key Laboratory for Bioactive Molecules Research and Evaluation & College of Pharmacy, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021, China; Key Laboratory of Longevity and Aging-related Diseases of Chinese Ministry of Education & Center for Translational Medicine, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021, China
| | - Zhuo Luo
- Guangxi Key Laboratory for Bioactive Molecules Research and Evaluation & College of Pharmacy, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021, China
| | - Xi Liu
- Guangxi Key Laboratory for Bioactive Molecules Research and Evaluation & College of Pharmacy, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021, China
| | - Xiaolan Li
- Guangxi Key Laboratory for Bioactive Molecules Research and Evaluation & College of Pharmacy, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021, China; Key Laboratory of Longevity and Aging-related Diseases of Chinese Ministry of Education & Center for Translational Medicine, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021, China
| | - Qiaofeng Li
- Guangxi Key Laboratory for Bioactive Molecules Research and Evaluation & College of Pharmacy, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021, China; Key Laboratory of Longevity and Aging-related Diseases of Chinese Ministry of Education & Center for Translational Medicine, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021, China
| | - Weiquan Zhang
- Guangxi Key Laboratory for Bioactive Molecules Research and Evaluation & College of Pharmacy, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021, China; Key Laboratory of Longevity and Aging-related Diseases of Chinese Ministry of Education & Center for Translational Medicine, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021, China
| | - Ying Liu
- Key Laboratory of Longevity and Aging-related Diseases of Chinese Ministry of Education & Center for Translational Medicine, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021, China; College of Pharmacy, Guangxi University of Chinese Medicine, 179 Mingxiu Dong Road, Nanning, 530001, China
| | - Zhiping Cheng
- Guangxi Key Laboratory for Bioactive Molecules Research and Evaluation & College of Pharmacy, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021, China
| | - Xin Yang
- Key Laboratory of Longevity and Aging-related Diseases of Chinese Ministry of Education & Center for Translational Medicine, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021, China
| | - Yanying Liu
- Guangxi Key Laboratory for Bioactive Molecules Research and Evaluation & College of Pharmacy, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021, China
| | - Ronghua Jin
- Guangxi Key Laboratory for Bioactive Molecules Research and Evaluation & College of Pharmacy, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021, China
| | - Dan Zhu
- Guangxi Key Laboratory for Bioactive Molecules Research and Evaluation & College of Pharmacy, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021, China
| | - Fengmao Wang
- Guangxi Key Laboratory for Bioactive Molecules Research and Evaluation & College of Pharmacy, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021, China
| | - Qinpei Lu
- Guangxi Key Laboratory for Bioactive Molecules Research and Evaluation & College of Pharmacy, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021, China; Key Laboratory of Longevity and Aging-related Diseases of Chinese Ministry of Education & Center for Translational Medicine, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021, China.
| | - Zhiheng Su
- Guangxi Key Laboratory for Bioactive Molecules Research and Evaluation & College of Pharmacy, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021, China.
| | - Hongwei Guo
- Guangxi Key Laboratory for Bioactive Molecules Research and Evaluation & College of Pharmacy, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021, China; Key Laboratory of Longevity and Aging-related Diseases of Chinese Ministry of Education & Center for Translational Medicine, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021, China.
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10
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Wheeler TT, Cao P, Ghouri MD, Ji T, Nie G, Zhao Y. Nanotechnological strategies for prostate cancer imaging and diagnosis. Sci China Chem 2022. [DOI: 10.1007/s11426-022-1271-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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11
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Liu C, Jiang S, Xie H, Jia H, Li R, Zhang K, Wang N, Lin P, Yu X. Long non-coding RNA AC245100.4 contributes to prostate cancer migration via regulating PAR2 and activating p38-MAPK pathway. Med Oncol 2022; 39:94. [DOI: 10.1007/s12032-022-01689-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 02/21/2022] [Indexed: 12/25/2022]
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12
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Chang M, Zhu D, Chen Y, Zhang W, Liu X, Li XL, Cheng Z, Su Z, Zhang J, Lu Y, Guo H. Total Flavonoids of Litchi Seed Attenuate Prostate Cancer Progression Via Inhibiting AKT/mTOR and NF-kB Signaling Pathways. Front Pharmacol 2021; 12:758219. [PMID: 34630125 PMCID: PMC8495171 DOI: 10.3389/fphar.2021.758219] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 09/13/2021] [Indexed: 01/01/2023] Open
Abstract
Litchi seeds have been traditionally used in Chinese herbal formula for urologic neoplasms including prostate cancer (PCa). However, the effective components of Litchi seeds and the mechanisms of their actions on PCa cell growth and metastasis remain unclear. In this study, we investigated the effects and molecular mechanisms of the Total Flavonoid of Litchi Seed (TFLS) in PCa PC3 and DU145 cell lines. We found that TFLS significantly inhibited the PCa cell proliferation, induced apoptosis, and prevented cell migration and invasion. Furthermore, we observed that TFLS upregulated the expression of epithelial biomarker E-cadherin and downregulated mesenchymal biomarker Vimentin. TFLS also increased the expression of cleaved-PRAP and Bax, and decreased the expression of Bcl-2 in both PC3 and DU145 cells. Besides, TFLS inhibited AKT signaling pathway by reducing the phosphorylation of AKT and activities of downstream signal transducers including mTOR, IκBα and NF-kB. Finally, TFLS treated mice exhibited a significant decrease in tumor size without toxicity in major organs in vivo. These results indicated that TFLS could suppress PCa cell growth in vivo and inhibit PCa cell proliferation and metastasis in vitro through induction of apoptosis and phenotypic reversal of EMT, which may be achieved by inhibiting the AKT/mTOR and NF-κB signaling pathways. Taken together, our data provide new insights into the role of TFLS as a novel potent anti-cancer agent for the treatment of PCa.
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Affiliation(s)
- Ming Chang
- Key Laboratory of Longevity and Aging-Related Diseases of Chinese Ministry of Education, Center for Translational Medicine, Guangxi Medical University, Nanning, China.,School of Medicine, Southern University of Science and Technology, Shenzhen, China.,Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Shenzhen, China
| | - Dan Zhu
- Guangxi Key Laboratory of Bioactive Molecules Research and Evaluation, College of Pharmacy, Guangxi Medical University, Nanning, China
| | - Yanjiang Chen
- Department of Surgery, University of Melbourne, Parkville, VIC, Australia
| | - Weiquan Zhang
- Key Laboratory of Longevity and Aging-Related Diseases of Chinese Ministry of Education, Center for Translational Medicine, Guangxi Medical University, Nanning, China.,Guangxi Key Laboratory of Bioactive Molecules Research and Evaluation, College of Pharmacy, Guangxi Medical University, Nanning, China
| | - Xi Liu
- Guangxi Key Laboratory of Bioactive Molecules Research and Evaluation, College of Pharmacy, Guangxi Medical University, Nanning, China
| | - Xiao-Lan Li
- Key Laboratory of Longevity and Aging-Related Diseases of Chinese Ministry of Education, Center for Translational Medicine, Guangxi Medical University, Nanning, China.,Guangxi Key Laboratory of Bioactive Molecules Research and Evaluation, College of Pharmacy, Guangxi Medical University, Nanning, China
| | - Zhiping Cheng
- Guangxi Key Laboratory of Bioactive Molecules Research and Evaluation, College of Pharmacy, Guangxi Medical University, Nanning, China
| | - Zhiheng Su
- Guangxi Key Laboratory of Bioactive Molecules Research and Evaluation, College of Pharmacy, Guangxi Medical University, Nanning, China
| | - Jian Zhang
- Key Laboratory of Longevity and Aging-Related Diseases of Chinese Ministry of Education, Center for Translational Medicine, Guangxi Medical University, Nanning, China.,School of Medicine, Southern University of Science and Technology, Shenzhen, China.,Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Shenzhen, China
| | - Yi Lu
- Key Laboratory of Longevity and Aging-Related Diseases of Chinese Ministry of Education, Center for Translational Medicine, Guangxi Medical University, Nanning, China.,School of Medicine, Southern University of Science and Technology, Shenzhen, China.,Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Shenzhen, China
| | - Hongwei Guo
- Key Laboratory of Longevity and Aging-Related Diseases of Chinese Ministry of Education, Center for Translational Medicine, Guangxi Medical University, Nanning, China.,Guangxi Key Laboratory of Bioactive Molecules Research and Evaluation, College of Pharmacy, Guangxi Medical University, Nanning, China
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13
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Henríquez I, Roach M, Morgan TM, Bossi A, Gómez JA, Abuchaibe O, Couñago F. Current and Emerging Therapies for Metastatic Castration-Resistant Prostate Cancer (mCRPC). Biomedicines 2021; 9:biomedicines9091247. [PMID: 34572433 PMCID: PMC8468423 DOI: 10.3390/biomedicines9091247] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 09/06/2021] [Accepted: 09/11/2021] [Indexed: 01/05/2023] Open
Abstract
Metastatic castration-resistant prostate cancer (mCRPC) encompasses a heterogeneous wide range of molecular tumor behavior and a high risk of progression. Early detection and treatment are therefore crucial in these patients. Treatment has improved drastically in recent years and many novel therapeutic agents are currently under investigation. However, due to the rapidly changing therapeutic landscape in mCRPC, it is difficult for clinicians to keep up to date with the latest innovations in this area. In the present narrative review, we discuss the current and emerging therapies for mCRPC as well as the clinical and molecular factors that can help predict which patients are most likely to benefit from these novel agents.
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Affiliation(s)
- Iván Henríquez
- Department of Radiation Oncology, Hospital Universitario Sant Joan, 43204 Reus, Spain;
- Correspondence: ; Tel.: +34-655857839
| | - Mack Roach
- UCSF Helen Diller Family Comprehensive Cancer Center, Department of Radiation Oncology, San Francisco, CA 94143, USA;
| | - Todd M. Morgan
- Rogel Cancer Center, Department of Urology, University of Michigan, Ann Arbor, MI 48109, USA;
| | - Alberto Bossi
- Prostate Brachytherapy Unit, Department of Radiation Oncology, Genito Urinary Oncology, Goustave Roussy, 94805 Paris, France;
| | - Junior A. Gómez
- Department of Radiation Oncology, Hospital Universitario Sant Joan, 43204 Reus, Spain;
| | - Oscar Abuchaibe
- Virgilio Galvis Ramirez Cancer Centre, Department of Radiation Oncology, Bucaramanga 681004, Colombia;
| | - Felipe Couñago
- Department of Radiation Oncology, Clinical Department, Faculty of Biomedicine, Hospital Universitario Quirónsalud Madrid, Hospital La Luz, Universidad Europea, 28223 Madrid, Spain;
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14
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Target Heterogeneity in Oncology: The Best Predictor for Differential Response to Radioligand Therapy in Neuroendocrine Tumors and Prostate Cancer. Cancers (Basel) 2021; 13:cancers13143607. [PMID: 34298822 PMCID: PMC8304541 DOI: 10.3390/cancers13143607] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/04/2021] [Accepted: 07/07/2021] [Indexed: 12/27/2022] Open
Abstract
Simple Summary In the era of precision medicine, novel targets have emerged on the surface of cancer cells, which have been exploited for the purpose of radioligand therapy. However, there have been variations in the way these receptors are expressed, especially in prostate cancers and neuroendocrine tumors. This variable expression of receptors across the grades of cancers led to the concept of ‘target heterogeneity’, which has not just impacted therapeutic decisions but also their outcomes. Radiopharmaceuticals targeting receptors need to be used when there are specific indicators—either clinical, radiological, or at molecular level—warranting their use. In addition, response to these radioligands can be assessed using different techniques, whereby we can prognosticate further outcomes. We shall also discuss, in this review, the conventional as well as novel approaches of detecting heterogeneity in prostate cancers and neuroendocrine tumors. Abstract Tumor or target heterogeneity (TH) implies presence of variable cellular populations having different genomic characteristics within the same tumor, or in different tumor sites of the same patient. The challenge is to identify this heterogeneity, as it has emerged as the most common cause of ‘treatment resistance’, to current therapeutic agents. We have focused our discussion on ‘Prostate Cancer’ and ‘Neuroendocrine Tumors’, and looked at the established methods for demonstrating heterogeneity, each with its advantages and drawbacks. Also, the available theranostic radiotracers targeting PSMA and somatostatin receptors combined with targeted systemic agents, have been described. Lu-177 labeled PSMA and DOTATATE are the ‘standard of care’ radionuclide therapeutic tracers for management of progressive treatment-resistant prostate cancer and NET. These approved therapies have shown reasonable benefit in treatment outcome, with improvement in quality of life parameters. Various biomarkers and predictors of response to radionuclide therapies targeting TH which are currently available and those which can be explored have been elaborated in details. Imaging-based features using artificial intelligence (AI) need to be developed to further predict the presence of TH. Also, novel theranostic tools binding to newer targets on surface of cancer cell should be explored to overcome the treatment resistance to current treatment regimens.
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15
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Shrivastava G, Aljabali AA, Shahcheraghi SH, Lotfi M, Shastri MD, Shukla SD, Chellappan DK, Jha NK, Anand K, Dureja H, Pabari RM, Mishra V, Almutary AG, Alnuqaydan AM, Charbe N, Prasher P, Negi P, Goyal R, Dua K, Gupta G, Serrano-Aroca Á, Bahar B, Barh D, Panda PK, Takayama K, Lundstrom K, McCarron P, Bakshi H, Tambuwala MM. Targeting LIN28: a new hope in prostate cancer theranostics. Future Oncol 2021; 17:3873-3880. [PMID: 34263659 DOI: 10.2217/fon-2021-0247] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The mortality and morbidity rates for prostate cancer have recently increased to alarming levels, rising higher than lung cancer. Due to a lack of drug targets and molecular probes, existing theranostic techniques are limited. Human LIN28A and its paralog LIN28B overexpression are associated with a number of tumors resulting in a remarkable increase in cancer aggression and poor prognoses. The current review aims to highlight recent work identifying the key roles of LIN28A and LIN28B in prostate cancer, and to instigate further preclinical and clinical research in this important area.
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Affiliation(s)
- Garima Shrivastava
- Department of Biochemical Engineering & Biotechnology, Indian Institute of Technology, Delhi, Hauz Khas, New Delhi, India
| | - Alaa Aa Aljabali
- Department of Pharmaceutics & Pharmaceutical Technology, Yarmouk University, Irbid-Jordan
| | - Seyed Hossein Shahcheraghi
- Infectious Diseases Research Center, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Marzieh Lotfi
- Abortion Research Centre, Reproductive Sciences Institute, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Madhur D Shastri
- School of Pharmacy & Pharmacology, University of Tasmania, Hobart, Australia
| | - Shakti D Shukla
- Priority Research Centre for Healthy Lungs, School of Medicine & Public Health, The University of Newcastle, Callaghan, Australia
| | - Dinesh K Chellappan
- Department of Life Sciences, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia
| | - Niraj Kumar Jha
- Department of Biotechnology, School of Engineering & Technology, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Krishnan Anand
- Department of Chemical Pathology, School of Pathology, Faculty of Health Sciences & National Health Laboratory Service, University of the Free State, Bloemfontein, South Africa
| | - Harish Dureja
- Department of Chemistry, School of Science, GITAM University, Hyderabad 502329, India
| | - Ritesh M Pabari
- RCSI, University of Medicine & Health Sciences, Dublin, Ireland
| | - Vijay Mishra
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
| | - Abdulmajeed G Almutary
- Department of Medical Biotechnology, College of Applied Medical Sciences, Qassim University, Saudi Arabia
| | - Abdullah M Alnuqaydan
- Department of Medical Biotechnology, College of Applied Medical Sciences, Qassim University, Saudi Arabia
| | - Nitin Charbe
- Department of Pharmaceutical Sciences, Rangel College of Pharmacy, Texas A&M University, Kingsville, TX 78363, USA
| | - Parteek Prasher
- Department of Chemistry, University of Petroleum & Energy Studies, Dehradun 248007, India
| | - Poonam Negi
- School of Pharmaceutical Sciences, Shoolini University of Biotechnology & Management Sciences, Solan 173229, India
| | - Rohit Goyal
- School of Pharmaceutical Sciences, Shoolini University of Biotechnology & Management Sciences, Solan 173229, India
| | - Kamal Dua
- Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Ultimo NSW 2007, Australia
| | - Gaurav Gupta
- School of Pharmaceutical Sciences, Suresh Gyan Vihar University, Jaipur, India
| | - Ángel Serrano-Aroca
- Biomaterials & Bioengineering Lab, Centro de Investigación Traslacional San Alberto Magno, Universidad Católica de Valencia, San Vicente Mártir, Valencia 46001, Spain
| | - Bojlul Bahar
- International Institute of Nutritional Sciences & Food Safety Studies, University of Central Lancashire, Preston, United Kingdom
| | - Debmalya Barh
- Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Pritam Kumar Panda
- Condensed Matter Theory Group, Materials Theory Division, Department of Physics & Astronomy, Uppsala University, Uppsala 75120, Sweden
| | - Kazuo Takayama
- Center for IPS Cell Research & Application, Kyoto University, Kyoto 606-8397, Japan
| | | | - Paul McCarron
- School of Pharmacy & Pharmaceutical Sciences, Ulster University, Coleraine, County Londonderry, Northern Ireland BT52 1SA, UK
| | - Hamid Bakshi
- School of Pharmacy & Pharmaceutical Sciences, Ulster University, Coleraine, County Londonderry, Northern Ireland BT52 1SA, UK
| | - Murtaza M Tambuwala
- School of Pharmacy & Pharmaceutical Sciences, Ulster University, Coleraine, County Londonderry, Northern Ireland BT52 1SA, UK
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Vahidfar N, Aghanejad A, Ahmadzadehfar H, Farzanehfar S, Eppard E. Theranostic Advances in Breast Cancer in Nuclear Medicine. Int J Mol Sci 2021; 22:4597. [PMID: 33925632 PMCID: PMC8125561 DOI: 10.3390/ijms22094597] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/13/2021] [Accepted: 04/23/2021] [Indexed: 02/07/2023] Open
Abstract
The implication of 'theranostic' refers to targeting an identical receptor for diagnostic and therapeutic purposes, by the same radioligand, simultaneously or separately. In regard to extensive efforts, many considerable theranostic tracers have been developed in recent years. Emerging evidence strongly demonstrates the tendency of nuclear medicine towards therapies based on a diagnosis. This review is focused on the examples of targeted radiopharmaceuticals for the imaging and therapy of breast cancer.
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Affiliation(s)
- Nasim Vahidfar
- Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran 1419733141, Iran;
| | - Ayuob Aghanejad
- Research Center for Pharmaceutical Nanotechnology, Biomedicine Institute, Tabriz University of Medical Sciences, Tabriz 51368, Iran;
| | | | - Saeed Farzanehfar
- Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran 1419733141, Iran;
| | - Elisabeth Eppard
- Positronpharma SA. Rancagua 878, Santiago 7500621, Chile;
- Department of Nuclear Medicine, University Hospital Magdeburg, Leipziger Strass 44, 39120 Magdedurg, Germany
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17
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Maina T, Thakur M. SPECT Radiochemistry. Mol Imaging 2021. [DOI: 10.1016/b978-0-12-816386-3.00023-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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18
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van der Doelen MJ, Mehra N, van Oort IM, Looijen-Salamon MG, Janssen MJR, Custers JAE, Slootbeek PHJ, Kroeze LI, Bruchertseifer F, Morgenstern A, Haberkorn U, Kratochwil C, Nagarajah J, Gerritsen WR. Clinical outcomes and molecular profiling of advanced metastatic castration-resistant prostate cancer patients treated with 225Ac-PSMA-617 targeted alpha-radiation therapy. Urol Oncol 2020; 39:729.e7-729.e16. [PMID: 33353867 DOI: 10.1016/j.urolonc.2020.12.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 11/22/2020] [Accepted: 12/07/2020] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Targeted alpha-radiation therapy (TAT) with 225Ac-labeled prostate-specific membrane antigen (PSMA) ligands is a promising novel treatment option for metastatic castration-resistant prostate cancer (mCRPC) patients. However, limited data are available on efficacy, quality of life (QoL), and pretherapeutic biomarkers. The aim of this study was to evaluate the efficacy of 225Ac-PSMA TAT and impact on QoL in advanced mCRPC, and to explore predictive biomarkers on pretherapeutic metastatic tissue biopsies. METHODS Observational cohort study including consecutive patients treated with 225Ac-PSMA TAT between February 2016 and July 2018. Primary endpoint was overall survival (OS). Furthermore, prostate-specific antigen (PSA) changes, radiological response, safety, QoL, and xerostomia were evaluated. Biopsies were analyzed with immunohistochemistry and next-generation sequencing. RESULTS Thirteen patients were included. Median OS was 8.5 months for the total cohort and 12.6 months for PSMA radioligand therapy-naïve patients. PSA declines of ≥90% and ≥50% were observed in 46% and 69% of patients, respectively. Six patients were radiologically evaluable; 50% showed partial response. All patients showed >90% total tumor volume reduction on PET imaging. Patients experienced clinically relevant decrease of pain and QoL improvement in physical and role functioning domains. Xerostomia persisted during follow-up. Patients with high baseline immunohistochemical PSMA expression or DNA damage repair alterations tended to have longer OS. CONCLUSIONS TAT with 225Ac-PSMA resulted in remarkable survival and biochemical responses in advanced mCRPC patients. Patients experienced clinically relevant QoL improvement, although xerostomia was found to be nontransient. Baseline immunohistochemical PSMA expression and DNA damage repair status are potential predictive biomarkers of response to 225Ac-PSMA TAT.
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Affiliation(s)
- Maarten J van der Doelen
- Radboud University Medical Center, Department of Medical Oncology, Nijmegen, The Netherlands; Radboud University Medical Center, Department of Urology, Nijmegen, The Netherlands.
| | - Niven Mehra
- Radboud University Medical Center, Department of Medical Oncology, Nijmegen, The Netherlands
| | - Inge M van Oort
- Radboud University Medical Center, Department of Urology, Nijmegen, The Netherlands
| | | | - Marcel J R Janssen
- Radboud University Medical Center, Department of Radiology and Nuclear Medicine, Nijmegen, The Netherlands
| | - José A E Custers
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Medical Psychology, Nijmegen, The Netherlands
| | - Peter H J Slootbeek
- Radboud University Medical Center, Department of Medical Oncology, Nijmegen, The Netherlands
| | - Leonie I Kroeze
- Radboud University Medical Center, Department of Pathology, Nijmegen, The Netherlands
| | - Frank Bruchertseifer
- European Commission, Joint Research Centre, Nuclear Safety and Security, Karlsruhe, Germany
| | - Alfred Morgenstern
- European Commission, Joint Research Centre, Nuclear Safety and Security, Karlsruhe, Germany
| | - Uwe Haberkorn
- University Hospital Heidelberg, Department of Nuclear Medicine, Germany
| | | | - James Nagarajah
- Radboud University Medical Center, Department of Radiology and Nuclear Medicine, Nijmegen, The Netherlands; Technical University Munich, Klinikum rechts der Isar, Department of Nuclear Medicine, Munich, Germany
| | - Winald R Gerritsen
- Radboud University Medical Center, Department of Medical Oncology, Nijmegen, The Netherlands
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PSMA Expression in the Neovasculature Associated With Rectal Adenocarcinoma: A Potential Stromal Target for Nuclear Theranostics. Clin Nucl Med 2020; 45:e309-e310. [PMID: 32404709 DOI: 10.1097/rlu.0000000000003066] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
We report the case of a 63-year-old man who underwent MRI and Ga-PSMA-11 PET/CT for biochemical recurrence localization after radical prostatectomy (serum PSA, 0.25 ng/mL) and describe the incidental discovery of a rectal adenocarcinoma. Immunohistochemical analysis showed PSMA staining in the tumor-associated neovasculature, but not in normal vasculature, or tumor cells. After surgical removal, he was treated with salvage radiotherapy to the postoperative prostate bed. This case example has several implications: the findings confirm the expression of PSMA in the tumor-associated neovasculature of a rectal cancer, nonprostate cancers' stroma may represent a potentially relevant target for nuclear theranostics.
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20
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Mayor N, Sathianathen NJ, Buteau J, Koschel S, Antón Juanilla M, Kapoor J, Azad A, Hofman MS, Murphy DG. Prostate-specific membrane antigen theranostics in advanced prostate cancer: an evolving option. BJU Int 2020; 126:525-535. [PMID: 32559353 DOI: 10.1111/bju.15143] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To review current data for the role of prostate specific membrane antigen (PSMA) radioligand therapy (RLT) for patients with advanced prostate cancer. This review provides an update for multidisciplinary teams on the current and potential future applications of theranostics in prostate cancer. METHODS Narrative review focussing on PSMA as a target for RLT, and data using RESULTS: RLT with PSMA is an exciting therapeutic alternative to the existing management options already in use for patients with metastatic castrate-resistant prostate cancer (mCRPC). To date, most evidence exists regarding small-molecule PSMA inhibitors bound to beta-emitting radioisotopes such as 177Lu (Lu-PSMA). Prospective phase II data supports the safety and efficacy of Lu-PSMA in men with heavily pre-treated progressive mCRPC, and several late-phase randomised trials of Lu-PSMA are underway, with many more in the pipeline. Early results are encouraging, indicating that the theranostic approach may play a vital role in management of advanced prostate cancer and perhaps even in much earlier disease states. CONCLUSIONS PSMA RLT is a promising new treatment option for men with mCPRC, and may also have utility in less advanced prostate cancer.
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Affiliation(s)
- Nikhil Mayor
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | | | - James Buteau
- Molecular Imaging and Nuclear Medicine Therapeutics, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Samantha Koschel
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Marta Antón Juanilla
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Jada Kapoor
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Arun Azad
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC, Australia
| | - Michael S Hofman
- Molecular Imaging and Nuclear Medicine Therapeutics, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC, Australia
| | - Declan G Murphy
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, VIC, Australia
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21
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A rare case of polyostotic fibrous dysplasia detected on 18F-rhPSMA-7 PET/CT. Eur J Nucl Med Mol Imaging 2020; 47:2927-2929. [PMID: 32300833 PMCID: PMC7567679 DOI: 10.1007/s00259-020-04751-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 03/03/2020] [Indexed: 11/11/2022]
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22
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Herlan C, Bräse S. Lanthanide conjugates as versatile instruments for therapy and diagnostics. Dalton Trans 2020; 49:2397-2402. [PMID: 32030383 DOI: 10.1039/c9dt04851k] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Lanthanides have demonstrated outstanding properties in many fields of research including biology and medicinal chemistry. Their unique luminescence and magnetic properties make them the metals of choice for next generation theranostics that efficiently combine the two central pillars of medicine - diagnostics and therapy. Attached to targeting units, lanthanide complexes pave the way for real-time imaging of drug uptake and distribution as well as specific regulation of subcellular processes with few side effects. This enables individualized treatment options for severe diseases characterized by altered cell expression. The highly diverse results achieved as well as insights into the challenges that research in this area has to face in the upcoming years will be summarized in the present review.
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Affiliation(s)
- Claudine Herlan
- Institute of Organic Chemistry, Karlsruhe Institute of Technology, Fritz-Haber-Weg 6, 76131 Karlsruhe, Germany.
| | - Stefan Bräse
- Institute of Organic Chemistry, Karlsruhe Institute of Technology, Fritz-Haber-Weg 6, 76131 Karlsruhe, Germany. and Institute of Biological and Chemical Systems (IBCS-FMS), Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
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23
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Yao X, Zha Z, Ploessl K, Choi SR, Zhao R, Alexoff D, Zhu L, Kung HF. Synthesis and evaluation of novel radioiodinated PSMA targeting ligands for potential radiotherapy of prostate cancer. Bioorg Med Chem 2020; 28:115319. [PMID: 32001090 DOI: 10.1016/j.bmc.2020.115319] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 01/03/2020] [Accepted: 01/08/2020] [Indexed: 12/19/2022]
Abstract
Radioligand therapy (RLT) using prostate-specific membrane antigen (PSMA) targeting ligands is an attractive option for the treatment of Prostate cancer (PCa) and its metastases. We report herein a series of radioiodinated glutamate-urea-lysine-phenylalanine derivatives as new PSMA ligands in which l-tyrosine and l-glutamic acid moieties were added to increase hydrophilicity concomitant with improvement of in vivo targeting properties. Compounds 8, 15, 19a/19b and 23a/23b were synthesized and radiolabeled with 125I by iododestannylation. All iodinated compounds displayed high binding affinities toward PSMA (IC50 = 1-13 nM). In vitro cell uptake studies demonstrated that compounds containing an l-tyrosine linker moiety (8, 15 and 19a/19b) showed higher internalization than MIP-1095 and 23a/23b, both without the l-tyrosine linker moiety. Biodistribution studies in mice bearing PC3-PIP and PC3 xenografts showed that [125I]8 and [125I]15 with higher lipophilicity exhibited higher nonspecific accumulations in the liver and intestinal tract, whereas [125I]19a/19b and [125I]23a/23b containing additional glutamic acid moieties showed higher accumulations in the kidney and implanted PC3-PIP (PSMA+) tumors. [125I]23b displayed a promising biodistribution profile with favorable tumor retention, fast clearance from the kidney, and 2-3-fold lower uptake in the liver and blood than that observed for [125I]MIP-1095. [125/131I]23b may serve as an optimal PSMA ligand for radiotherapy treatment of prostate cancer over-expressing PSMA.
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Affiliation(s)
- Xinyue Yao
- College of Chemistry, Beijing Normal University, Beijing 100875, PR China; Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Zhihao Zha
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Karl Ploessl
- Five Eleven Pharma Inc., Philadelphia, PA 19104, USA
| | - Seok Rye Choi
- Five Eleven Pharma Inc., Philadelphia, PA 19104, USA
| | - Ruiyue Zhao
- College of Chemistry, Beijing Normal University, Beijing 100875, PR China; Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - David Alexoff
- Five Eleven Pharma Inc., Philadelphia, PA 19104, USA
| | - Lin Zhu
- College of Chemistry, Beijing Normal University, Beijing 100875, PR China.
| | - Hank F Kung
- Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA; Five Eleven Pharma Inc., Philadelphia, PA 19104, USA.
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24
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Ulaner GA, Landgren CO. Current and potential applications of positron emission tomography for multiple myeloma and plasma cell disorders. Best Pract Res Clin Haematol 2020; 33:101148. [PMID: 32139013 DOI: 10.1016/j.beha.2020.101148] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 01/13/2020] [Indexed: 11/19/2022]
Abstract
Fluorine-18 (18F)-fluorodeoxyglucose (FDG) positron emission tomography (PET) allows evaluation of elevated glucose metabolism in malignancies. There has been increasing interest in FDG PET/CT for plasma cell disorders since the International Myeloma Working Group outlined multiple applications of this imaging modality, including distinguishing smoldering myeloma from active multiple myeloma, confirmation of solitary plasmacytoma, and multiple indications in patients with known multiple myeloma, including determining extent of initial disease, monitoring therapy response, and detection of residual disease following therapy. The field of molecular imaging is now shifting focus from evaluation of metabolism to targeted evaluation of specific tumor markers. Targeted PET imaging targeted of CXCR4 and CD38 has advanced into translational clinical trials, bringing us closer to powerful imaging options for myeloma. In this review we discuss the current applications of FDG PET/CT in plasma cell disorders, as well as advances in targeted PET imaging.
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Affiliation(s)
- Gary A Ulaner
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA; Weill Cornell Medical College, New York, NY, 10065, USA.
| | - C Ola Landgren
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA; Weill Cornell Medical College, New York, NY, 10065, USA.
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25
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Schreiber H, Hänze J, Nimphius W, Verburg FA, Luster M, Hofmann R, Hegele A. Prostate specific membrane antigen (PSMA) in urothelial cell carcinoma (UCC) is associated with tumor grading and staging. J Cancer Res Clin Oncol 2020; 146:305-313. [PMID: 31897687 DOI: 10.1007/s00432-019-03113-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 12/13/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Prostate specific membrane antigen (PSMA) has become a target for radionuclide imaging and therapy. Previous studies have shown that the expression of PSMA is not specific to prostate tissue. In this study we examine the expression of PSMA in urothelial cell carcinoma (UCC). METHODS Immunhistochemical PSMA-staining was performed in 89 UCC samples. PSMA expression in tumor tissue, adjacent healthy tissue and blood vessels was examined. We furthermore analyzed PSMA-mRNA expression in nine human UCC cell lines. We correlated our findings with clinical data regarding recurrence and progression of UCC. RESULTS UCC tissue showed a significantly higher PSMA expression compared to healthy urothelial tissue (p < 0.001). Non muscle invasive bladder cancer revealed significantly higher PSMA expression compared to muscle invasive bladder cancer (p < 0.05). PSMA expression significantly differed between various T-stages (p < 0.05) and tumor differentiation (p < 0.001). In four human UCC cell lines PSMA-mRNA was detectable. Those patients who suffered recurrence showed a higher rate of PSMA expression but no correlation to recurrence-free survival was evident. Progression of disease correlated significantly with a higher PSMA expression (p = 0.036). CONCLUSIONS Both UCC tissue and healthy urothelial tissue express PSMA, with significantly higher levels in UCC. We confirmed these findings in human UCC cell lines. In this small first cohort expression of PSMA correlates significant with progression of disease but not with recurrence and recurrence-free survival. These first results make PSMA a promising target for future diagnosis and therapy of UCC.
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Affiliation(s)
- Henner Schreiber
- Department of Urology and Pediatric Urology, University Hospital Marburg, Marburg, Germany.
| | - Jörg Hänze
- Department of Urology and Pediatric Urology, University Hospital Marburg, Marburg, Germany
| | - Wilhelm Nimphius
- Department of Pathology, University Hospital Marburg, Marburg, Germany
| | | | - Markus Luster
- Department of Nuclear Medicine, University Hospital Marburg, Marburg, Germany
| | - Rainer Hofmann
- Department of Urology and Pediatric Urology, University Hospital Marburg, Marburg, Germany
| | - Axel Hegele
- Department of Urology and Pediatric Urology, University Hospital Marburg, Marburg, Germany
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26
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Violet J, Sandhu S, Iravani A, Ferdinandus J, Thang SP, Kong G, Kumar AR, Akhurst T, Pattison DA, Beaulieu A, Mooi J, Tran B, Guo C, Kalff V, Murphy DG, Jackson P, Eu P, Scalzo M, Williams S, Hicks RJ, Hofman MS. Long-Term Follow-up and Outcomes of Retreatment in an Expanded 50-Patient Single-Center Phase II Prospective Trial of 177Lu-PSMA-617 Theranostics in Metastatic Castration-Resistant Prostate Cancer. J Nucl Med 2019; 61:857-865. [PMID: 31732676 DOI: 10.2967/jnumed.119.236414] [Citation(s) in RCA: 181] [Impact Index Per Article: 36.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 10/22/2019] [Indexed: 01/19/2023] Open
Abstract
177Lu-PSMA-617 is a radioligand with high affinity for prostate-specific membrane antigen (PSMA), enabling targeted β-irradiation of prostate cancer. We have previously reported favorable activity with low toxicity in a prospective phase II trial involving 30 men with metastatic castration-resistant prostate cancer. We now report their longer-term outcomes, including a 20-patient extension cohort and outcomes of subsequent systemic treatments after completion of trial therapy. Methods: Fifty patients with PSMA-avid metastatic castration-resistant prostate cancer who had progressed after standard therapies received up to 4 cycles of 177Lu-PSMA every 6 wk. Endpoints included prostate-specific antigen (PSA) response (Prostate Cancer Working Group 2), toxicity (Common Terminology Criteria for Adverse Events, version 4.03), imaging response, patient-reported health-related quality of life, progression-free survival, and overall survival. We also describe, as a novel finding, outcomes of men who subsequently progressed and had further systemic therapies, including 177Lu-PSMA. Results: Seventy-five men were screened to identify 50 patients eligible for treatment. Adverse prognostic features of the cohort included short median PSA doubling time (2.3 mo) and extensive prior treatment, including prior docetaxel (84%), cabazitaxel (48%), and abiraterone or enzalutamide (92%). The mean administered radioactivity was 7.5 GBq/cycle. A PSA decline of at least 50% was achieved in 32 of 50 patients (64%; 95% confidence interval [CI], 50%-77%), including 22 patients (44%; 95% CI, 30%-59%) with at least an 80% decrease. Of 27 patients with measurable soft-tissue disease, 15 (56%) achieved an objective response by RECIST 1.1. The most common toxicities attributed to 177Lu-PSMA were self-limiting G1-G2 dry mouth (66%), transient G1-G2 nausea (48%), G3-G4 thrombocytopenia (10%), and G3 anemia (10%). Brief Pain Inventory severity and interference scores decreased at all time points, including at the 3-mo follow-up, with a decrease of -1.2 (95% CI, -0.5 to -1.9; P = 0.001) and -1.0 (95% CI, -0.2 to -0.18; P = 0.013), respectively. At a median follow-up of 31.4 mo, median overall survival was 13.3 mo (95% CI, 10.5-18.7 mo), with a significantly longer survival of 18.4 mo (95% CI, 13.8-23.8 mo) in patients achieving a PSA decline of at least 50%. At progression after prior response, further 177Lu-PSMA was administered to 15 (30%) patients (median of 2 cycles commencing 359 d from enrollment), with a PSA decline of at least 50% in 11 patients (73%). Four of 21 patients (19%) receiving other systemic therapies on progression experienced a PSA decline of at least 50%. There were no unexpected adverse events with 177Lu-PSMA retreatment. Conclusion: This expanded 50-patient cohort of men with extensive prior therapy confirms our earlier report of high response rates, low toxicity, and improved quality of life with 177Lu-PSMA radioligand therapy. On progression, rechallenge 177Lu-PSMA demonstrated higher response rates than other systemic therapies.
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Affiliation(s)
- John Violet
- Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Shahneen Sandhu
- Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Amir Iravani
- Sir Peter MacCallum Department of Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Justin Ferdinandus
- Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Sue-Ping Thang
- Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Grace Kong
- Sir Peter MacCallum Department of Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Aravind Ravi Kumar
- Sir Peter MacCallum Department of Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Tim Akhurst
- Sir Peter MacCallum Department of Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - David A Pattison
- Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Alexis Beaulieu
- Sir Peter MacCallum Department of Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Jennifer Mooi
- Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Ben Tran
- Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Christina Guo
- Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Victor Kalff
- Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Declan G Murphy
- Sir Peter MacCallum Department of Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; and
| | - Price Jackson
- Medical Physics, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Peter Eu
- Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Mark Scalzo
- Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Scott Williams
- Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Rodney J Hicks
- Sir Peter MacCallum Department of Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Michael S Hofman
- Sir Peter MacCallum Department of Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia .,Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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27
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Xu KM, Chen RC, Schuster DM, Jani AB. Role of novel imaging in the management of prostate cancer. Urol Oncol 2019; 37:611-618. [PMID: 31072791 DOI: 10.1016/j.urolonc.2019.04.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 03/13/2019] [Accepted: 04/09/2019] [Indexed: 12/12/2022]
Abstract
This review summarizes novel imaging in the management of prostate cancer including multiparametric MRI, PET-CT scans with different radiotracers including 11C-acetate, 11C-choline, 18F-choline, 18F sodium fluoride, prostate-specific membrane antigen, and anti-1-amino-3-[18F] fluorocyclobutane-1-carboxylic acid (fluciclovine).
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Affiliation(s)
- Karen M Xu
- Department of Radiation Oncology and Winship Cancer Institute of Emory University, Emory University, Atlanta, GA
| | - Ronald C Chen
- Department of Radiation Oncology, University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, NC
| | - David M Schuster
- Department of Radiology and Imaging Sciences, Division of Nuclear Medicine and Molecular Imaging, Emory University Hospital, Atlanta, GA
| | - Ashesh B Jani
- Department of Radiation Oncology and Winship Cancer Institute of Emory University, Emory University, Atlanta, GA.
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28
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Murphy DG, Sathianathen N, Hofman MS, Azad A, Lawrentschuk N. Where to Next for Theranostics in Prostate Cancer? Eur Urol Oncol 2019; 2:163-165. [PMID: 31017092 DOI: 10.1016/j.euo.2019.03.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 03/12/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Declan G Murphy
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia.
| | | | - Michael S Hofman
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia; Molecular Imaging and Nuclear Medicine Therapeutics, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Arun Azad
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia; Division of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Nathan Lawrentschuk
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Department of Surgery, University of Melbourne, Austin Hospital, Heidelberg, Australia
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