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Guidotti A, Lombardo R, De Nunzio C. Re: James P. Buteau, Daniel Moon, Michael T. Fahey, et al. Clinical Trial Protocol for PRIMARY2: A Multicentre, Phase 3, Randomised Controlled Trial Investigating the Additive Diagnostic Value of [ 68Ga]Ga-PSMA-11 Positron Emission Tomography/Computed Tomography in Men with Negative or Equivocal Multiparametric Magnetic Resonance Imaging for the Diagnosis of Clinically Significant Prostate Cancer. Eur Urol Oncol. In press. https://doi.org/ 10.1016/j.euo.2023.11.008. Eur Urol Oncol 2024; 7:1156-1157. [PMID: 38570238 DOI: 10.1016/j.euo.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 02/16/2024] [Indexed: 04/05/2024]
Affiliation(s)
- Alessio Guidotti
- Department of Urology, Ospedale Sant'Andrea, Sapienza University, Rome, Italy.
| | - Riccardo Lombardo
- Department of Urology, Ospedale Sant'Andrea, Sapienza University, Rome, Italy
| | - Cosimo De Nunzio
- Department of Urology, Ospedale Sant'Andrea, Sapienza University, Rome, Italy
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Udovicich C, Jia AY, Loblaw A, Eapen R, Hofman MS, Siva S. Evolving Paradigms in Prostate Cancer: The Integral Role of Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography in Primary Staging and Therapeutic Decision-Making. Int J Radiat Oncol Biol Phys 2024:S0360-3016(24)03387-X. [PMID: 39278417 DOI: 10.1016/j.ijrobp.2024.08.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 08/13/2024] [Accepted: 08/30/2024] [Indexed: 09/18/2024]
Abstract
Prostate-specific membrane antigen (PSMA) positron emission tomography or computed tomography (PET/CT) has emerged as a superior imaging option to conventional imaging for prostate cancer. The majority of early evidence and prospective trials evaluated PSMA PET/CT in the biochemical recurrence or metastatic setting. However, there has been an increasing number of prospective trials in the primary setting. The purpose of this narrative review was to describe the role of PSMA PET/CT in localized primary prostate cancer. This narrative review focuses on the prospective evidence available in this setting. We detail the current practice and future potential for PSMA PET/CT to be used in multiple stages of localized primary prostate cancer. The most common practice currently for PSMA PET/CT is in the primary nodal and metastatic staging of high-risk prostate cancer. We describe other roles of PSMA PET/CT, including in intermediate-risk prostate cancer as well as local staging and the impact on radiation therapy and surgical management. We also discuss the potential future roles of PSMA PET/CT in prediagnosis such as risk stratification for biopsy, prognosis, and specific surgical roles. Potential pitfalls of PSMA PET/CT are also addressed. PSMA PET/CT has already had a significant influence on prostate cancer, and there will continue to be a greater role for this imaging modality in localized primary prostate cancer.
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Affiliation(s)
- Cristian Udovicich
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia; The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia; Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Canada
| | - Angela Y Jia
- Department of Radiation Oncology, University Hospitals Seidman Cancer Center and Case Western Reserve University, Cleveland, Ohio
| | - Andrew Loblaw
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Canada; Department of Health Policy, Measurement and Evaluation, University of Toronto, Toronto, Canada
| | - Renu Eapen
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia; Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Prostate Cancer Theranostics and Imaging Centre of Excellence (ProsTIC), Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Michael S Hofman
- The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia; Prostate Cancer Theranostics and Imaging Centre of Excellence (ProsTIC), Molecular Imaging and Therapeutic Nuclear Medicine, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
| | - Shankar Siva
- Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia; The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
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Thomson A, Castillo C, Graefen H, Perera S, Lawrentschuk N, Perera M, Eapen R, Murphy DG. Re: First-in-Human Safety, Imaging, and Dosimetry of a Carbonic Anhydrase IX-Targeting Peptide, [ 68Ga]Ga-DPI-4452, in Patients with Clear Cell Renal Cell Carcinoma. Eur Urol 2024; 86:284-285. [PMID: 38631995 DOI: 10.1016/j.eururo.2024.03.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 03/28/2024] [Indexed: 04/19/2024]
Affiliation(s)
- Alice Thomson
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Carlotta Castillo
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Department of Urology, Santiago Clinic Hospital, Santiago de Compostela, Spain
| | - Henrike Graefen
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Medical School Hamburg, Hamburg, Germany
| | - Sachin Perera
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Nathan Lawrentschuk
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Department of Urology, Royal Melbourne Hospital, Melbourne, Australia
| | - Marlon Perera
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Renu Eapen
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Declan G Murphy
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Australia.
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Stamatakos PV, Fragkoulis C, Leventi A, Gklinos K, Kontolatis N, Papatsoris A, Dellis A. PSMA-based therapeutics for prostate cancer. Expert Opin Pharmacother 2024; 25:1405-1419. [PMID: 39054909 DOI: 10.1080/14656566.2024.2385726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 07/11/2024] [Accepted: 07/24/2024] [Indexed: 07/27/2024]
Abstract
INTRODUCTION The prostate cancer (PCa) consists the most frequently diagnosed malignancy of urogenital system in males. Traditionally, treatment of localized PCa was based on surgery or radiotherapy while hormonotherapy was used in more advanced stages. However, the implementation of radiolabels has revolutionized the landscape of prostate cancer. Specifically, prostate-specific membrane antigen (PSMA) has been investigated in different aspects of PCa therapeutic era. AREAS COVERED A literature review is presented about the implications of PSMA radiolabels on prostate cancer treatment. PSMA tracers were initially used as an imaging technique. Afterwards, PSMA labeled with isotopes presenting cytotoxic abilities, such as lutetium-117 and actinium-225, while reports exist about the use of radioligand immunotherapy. Meanwhile, ongoing trials examine the development of novel radionuclides as well as the evolution of the PSMA-targeted ligands. EXPERT OPINION Currently, PSMA radioligand treatment of prostate cancer is approved in the metastatic stage of the disease. Meanwhile, a variety of trials exist about its possible role in less advanced stages. However, plenty of parameters should be addressed before these implementations, such as PSMA dosage, dosimetry issues, and its safety profile. A future well-designed study with proper patient selection is mandatory to further explore PSMA radioligand theranostics perspectives.
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Affiliation(s)
| | | | - Aggeliki Leventi
- Department of Urology, General Hospital of Athens "G. Gennimatas", Athens, Greece
| | - Konstantinos Gklinos
- Department of Urology, General Hospital of Athens "G. Gennimatas", Athens, Greece
| | - Nikolaos Kontolatis
- Department of Urology, General Hospital of Athens "G. Gennimatas", Athens, Greece
| | - Athanasios Papatsoris
- 2nd Department of Urology, School of Medicine, National and Kapodistrian University of Athens, Hospital of Athens "Sismanoglio", Athens, Greece
| | - Athanasios Dellis
- 1st Department of Urology, School of Medicine, National and Kapodistrian University of Athens, Hospital of Athens "Aretaieion", Athens, Greece
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