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Prostate-Specific Membrane Antigen as Target for Neuroimaging of Central Nervous System Tumors. Mol Imaging 2022; 2022:5358545. [PMID: 35517711 PMCID: PMC9042374 DOI: 10.1155/2022/5358545] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 03/24/2022] [Indexed: 12/18/2022] Open
Abstract
Introduction. Positron emission tomography (PET) imaging with prostate-specific membrane antigen- (PSMA-) binding tracers has been found incidentally to demonstrate uptake in CNS tumors. Following the encouraging findings of several such case reports, there is a growing interest in the potential application of PSMA-targeted PET imaging for diagnostics, theranostics, and monitoring of CNS tumors. This is a systematic literature review on PSMA-binding tracers in CNS tumors. Methods. A PubMed search was conducted, including preclinical and clinical reports. One hundred and twelve records were identified, and after screening, 56 were included in the final report. Results. Tissue studies demonstrated PSMA expression in tumor vascular endothelial cells, without expression in normal brain tissue, though the extent and intensity of staining varied by anti-PSMA antibody and methodology. Most included studies reported on gliomas, which showed strong PSMA ligand uptake and more favorable tumor to background ratios than other PET tracers. There are also case reports demonstrating PSMA ligand uptake in prostate cancer brain metastases, nonprostate cancer brain metastases, and meningiomas. We also review the properties of the various PSMA-binding radiotracers available. Therapeutic and theranostic applications of PSMA-binding tracers have been studied, including labeled alpha- and beta-ray emitting isotopes, as well as PSMA targeting in directing MRI-guided focused ultrasound. Conclusions. There is a potential application for PSMA-targeted PET in neuro-oncology as a combination of diagnostic and therapeutic use, as a theranostic modality for managing CNS tumors. Further research is needed regarding the mechanism(s) of PSMA expression in CNS tumors and its differential performance by tumor type.
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Maluf FC, Pereira FMT, Serrano Uson PL, Bastos DA, Rodrigues da Rosa DA, Wiermann EG, Schutz FA, Kater FR, de Oliveira FNG, Marques Monteiro FS, de Pádua FV, Orlandi FJ, de Almeida Saito HP, Ayadi M, Boghikian PS, Kopp RM, de Carvalho RS, de Fogace RN, de Araújo Cavallero SR, Aguiar S, Souza VC, Sommer SG. Consensus for Treatment of Metastatic Castration-Sensitive Prostate Cancer: Report From the First Global Prostate Cancer Consensus Conference for Developing Countries (PCCCDC). JCO Glob Oncol 2021; 7:550-558. [PMID: 33856896 PMCID: PMC8162577 DOI: 10.1200/go.20.00505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
PURPOSE International guideline recommendations may not always be extrapolated to developing countries where access to resources is limited. In metastatic castration-sensitive prostate cancer (mCSPC), there have been successful drug and imaging advancements that were addressed in the Prostate Cancer Consensus Conference for Developing Countries for best-practice and limited-resource scenarios. METHODS A total of 24 out of 300 questions addressed staging, treatment, and follow-up for patients with mCSPC both in best-practice settings and resource-limited settings. Responses were compiled and presented in percentage of clinicians supporting each response. Questions had 4-8 options for response. RESULTS Recommendations for staging in mCSPC were split but there was consensus that chest x-ray, abdominal and pelvic computed tomography, and bone scan should be used where resources are limited. In both de novo and relapsed low-volume mCSPC, orchiectomy alone in limited resources was favored and in relapsed high-volume disease, androgen deprivation therapy plus docetaxel in limited resources and androgen deprivation therapy plus abiraterone in high-resource settings were consensus. A 3-weekly regimen of docetaxel was consensus among voters. When using abiraterone, a regimen of 1,000 mg plus prednisone 5 mg/d is optimal, but in limited-resource settings, half the panel agreed that abiraterone 250 mg with fatty foods plus prednisone 5 mg/d is acceptable. The panel recommended against the use of osteoclast-targeted therapy to prevent osseous complications. There was consensus that monitoring of patients undergoing systemic treatment should only be conducted in case of prostate-specific antigen elevation or progression-suggestive symptoms. CONCLUSION The treatment recommendations for most topics addressed differed between the best-practice setting and resource-limited setting, accentuating the need for high-quality evidence that contemplates the effect of limited resources on the management of mCSPC.
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Affiliation(s)
- Fernando Cotait Maluf
- Hospital Israelita Albert Einstein, São Paulo, Brazil.,Beneficência Portuguesa de São Paulo, São Paulo, Brazil.,Latin American Oncology Group (LACOG), Rio Grande do Sul, Brazil
| | | | | | - Diogo Assed Bastos
- Latin American Oncology Group (LACOG), Rio Grande do Sul, Brazil.,Hospital Sirio-Libanês, São Paulo, Brazil.,Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, Brazil
| | | | - Evanius Garcia Wiermann
- Latin American Oncology Group (LACOG), Rio Grande do Sul, Brazil.,Instituto de Oncologia do Paraná, Curitiba, Brazil
| | - Fábio A Schutz
- Beneficência Portuguesa de São Paulo, São Paulo, Brazil.,Latin American Oncology Group (LACOG), Rio Grande do Sul, Brazil
| | - Fábio Roberto Kater
- Beneficência Portuguesa de São Paulo, São Paulo, Brazil.,Latin American Oncology Group (LACOG), Rio Grande do Sul, Brazil
| | | | - Fernando Sabino Marques Monteiro
- Latin American Oncology Group (LACOG), Rio Grande do Sul, Brazil.,Hospital Santa Lucia, Brasília, Brazil.,Hospital Universitário de Brasília, Brasília, Brazil
| | - Fernando Vidigal de Pádua
- Latin American Oncology Group (LACOG), Rio Grande do Sul, Brazil.,Hospital Sírio Libanês, Brasília, Brazil
| | | | | | - Mouna Ayadi
- Institut Salah-Azaïz de Cancerologie, Tunis.,Faculté de Médecine, Tunis, Tunisia
| | | | - Ray Manneh Kopp
- Latin American Oncology Group (LACOG), Rio Grande do Sul, Brazil.,Clínica Porto Azul, Barranquilla, Colombia.,Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Ricardo Saraiva de Carvalho
- Beneficência Portuguesa de São Paulo, São Paulo, Brazil.,Latin American Oncology Group (LACOG), Rio Grande do Sul, Brazil
| | - Rodrigo Nogueira de Fogace
- Hospital Israelita Albert Einstein, São Paulo, Brazil.,Latin American Oncology Group (LACOG), Rio Grande do Sul, Brazil
| | | | | | - Vinicius Carreira Souza
- Latin American Oncology Group (LACOG), Rio Grande do Sul, Brazil.,Grupo de oncologia D'Or, Rio de Janeiro, Brazil
| | - Silke Gillessen Sommer
- Oncology Institute of Southern Switzerland (IOSI), Bellinzona and Università della Svizzera Italiana, Lugano, Switzerland.,Manchester Cancer Research Centre, Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
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