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Shirke AA, Wang J, Ramamurthy G, Mahanty A, Walker E, Zhang L, Panigrahi A, Wang X, Basilion JP. Prostate Specific Membrane Antigen Expression in a Syngeneic Breast Cancer Mouse Model. Mol Imaging Biol 2024:10.1007/s11307-024-01920-2. [PMID: 38760621 DOI: 10.1007/s11307-024-01920-2] [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: 12/18/2023] [Revised: 04/09/2024] [Accepted: 04/22/2024] [Indexed: 05/19/2024]
Abstract
PURPOSE Prostate specific membrane antigen (PSMA) has been studied in human breast cancer (BCa) biopsies, however, lack of data on PSMA expression in mouse models impedes development of PSMA-targeted therapies, particularly in improving breast conserving surgery (BCS) margins. This study aimed to validate and characterize the expression of PSMA in murine BCa models, demonstrating that PSMA can be utilized to improve therapies and imaging techniques. METHODS Murine triple negative breast cancer 4T1 cells, and human cell lines, MDA-MB-231, MDA-MB-468, implanted into the mammary fat pads of BALB/c mice, were imaged by our PSMA targeted theranostic agent, PSMA-1-Pc413, and tumor to background ratios (TBR) were calculated to validate selective uptake. Immunohistochemistry was used to correlate PSMA expression in relation to CD31, an endothelial cell biomarker highlighting neovasculature. PSMA expression was also quantified by Reverse Transcriptase Polymerase Chain Reaction (RT-PCR). RESULTS Accumulation of PSMA-1-Pc413 was observed in 4T1 primary tumors and associated metastases. Average TBR of 4T1 tumors were calculated to be greater than 1.5-ratio at which tumor tissues can be distinguished from normal structures-at peak accumulation with the signal intensity in 4T1 tumors comparable to that in high PSMA expressing PC3-pip tumors. Extraction of 4T1 tumors and lung metastases followed by RT-PCR analysis and PSMA-CD31 co-staining shows that PSMA is consistently localized on tumor neovasculature with no expression in tumor cells and surrounding normal tissues. CONCLUSION The selective uptake of PSMA-1-Pc413 in these cancer tissues as well as the characterization and validation of PSMA expression on neovasculature in this syngeneic 4T1 model emphasizes their potential for advancements in targeted therapies and imaging techniques for BCa. PSMA holds great promise as an oncogenic target for BCa and its associated metastases.
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Affiliation(s)
- Aditi A Shirke
- Department of Biomedical Engineering, Case Western Reserve University, 11100 Euclid Ave, Wearn Building B-49, Cleveland, OH, 44106, USA.
| | - Jing Wang
- Department of Radiology, Case Western Reserve University, 11100 Euclid Ave, Wearn Building B-49, Cleveland, OH, 44106, USA
| | - Gopolakrishnan Ramamurthy
- Department of Radiology, Case Western Reserve University, 11100 Euclid Ave, Wearn Building B-49, Cleveland, OH, 44106, USA
| | - Arpan Mahanty
- Department of Radiology, Case Western Reserve University, 11100 Euclid Ave, Wearn Building B-49, Cleveland, OH, 44106, USA
| | - Ethan Walker
- Department of Biomedical Engineering, Case Western Reserve University, 11100 Euclid Ave, Wearn Building B-49, Cleveland, OH, 44106, USA
| | - Lifang Zhang
- Department of Radiology, Case Western Reserve University, 11100 Euclid Ave, Wearn Building B-49, Cleveland, OH, 44106, USA
| | - Abhiram Panigrahi
- Department of Radiology, Case Western Reserve University, 11100 Euclid Ave, Wearn Building B-49, Cleveland, OH, 44106, USA
| | - Xinning Wang
- Department of Biomedical Engineering, Case Western Reserve University, 11100 Euclid Ave, Wearn Building B-49, Cleveland, OH, 44106, USA.
| | - James P Basilion
- Department of Biomedical Engineering, Case Western Reserve University, 11100 Euclid Ave, Wearn Building B-49, Cleveland, OH, 44106, USA.
- Department of Radiology, Case Western Reserve University, 11100 Euclid Ave, Wearn Building B-49, Cleveland, OH, 44106, USA.
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Moran S, Cheng HH, Weg E, Kim EH, Chen DL, Iravani A, Ippolito JE. Prostate-specific membrane antigen-positron emission tomography (PSMA-PET) of prostate cancer: current and emerging applications. Abdom Radiol (NY) 2024; 49:1288-1305. [PMID: 38386156 DOI: 10.1007/s00261-024-04188-w] [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: 02/11/2023] [Revised: 01/03/2024] [Accepted: 01/07/2024] [Indexed: 02/23/2024]
Abstract
Prostate-specific membrane antigen-positron emission tomography (PSMA-PET) is transforming the management of patients with prostate cancer. In appropriately selected patients, PSMA-PET offers superior sensitivity and specificity compared to conventional imaging (e.g., computed tomography and bone scintigraphy) as well as choline and fluciclovine PET, with the added benefit of consolidating bone and soft tissue evaluation into a single study. Despite being a newly available imaging tool, PSMA-PET has established indications, interpretation guidelines, and reporting criteria, which will be reviewed. The prostate cancer care team, from imaging specialists to those delivering treatment, should have knowledge of physiologic PSMA radiotracer uptake, patterns of disease spread, and the strengths and limitations of PSMA-PET. In this review, current and emerging applications of PSMA-PET, including appropriateness use criteria as well as image interpretation and pitfalls, will be provided with an emphasis on clinical implications.
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Affiliation(s)
- Shamus Moran
- Department of Radiology, University of Washington School of Medicine, Seattle, WA, USA
| | - Heather H Cheng
- Division of Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Emily Weg
- Department of Radiation Oncology, University of Washington School of Medicine, Seattle, WA, USA
| | - Eric H Kim
- Division of Urologic Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Delphine L Chen
- Division of Nuclear Medicine, Department of Radiology, University of Washington School of Medicine, Seattle, WA, USA
- Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Amir Iravani
- Division of Nuclear Medicine, Department of Radiology, University of Washington School of Medicine, Seattle, WA, USA
- Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Joseph E Ippolito
- Mallinckrodt Institute of Radiology, Washington University School of Medicine in St. Louis, 4559 Scott Ave., Mail Stop Code: 8131, St. Louis, MO, 63110, USA.
- Department of Biochemistry and Molecular Biophysics, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
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Xu F, Liu F. Intense 18 F-Prostate-Specific Membrane Antigen Uptake and Mild 18 F-FDG Uptake in a Biopsy-Proven Pulmonary Hemangioma. Clin Nucl Med 2024; 49:375-376. [PMID: 38377395 DOI: 10.1097/rlu.0000000000005117] [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: 02/22/2024]
Abstract
ABSTRACT We present intense radiotracer activity in a soft tissue density abutting the aortic arch of the left lung on 18 F-prostate-specific membrane antigen PET/CT scan in a patient with prostate cancer, mimicking metastatic disease from prostate cancer versus primary lung malignancy. 18 F-FDG PET/CT scan, however, shows no elevated FDG activity. The results of pathology examination from resected specimen are consistent with pulmonary hemangioma.
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Affiliation(s)
- Feng Xu
- From the Department of Radiology, Washington DC VA Medical Center, Washington, DC
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Bunnag N, Wongwijitsook J, Vachatimanont S. Synchronous Pulmonary Malignancy Detected During PSMA Ligand PET/CT for Initial Staging of Prostate Cancer: a Case Report. Nucl Med Mol Imaging 2023; 57:287-290. [PMID: 37982101 PMCID: PMC10654289 DOI: 10.1007/s13139-023-00798-2] [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: 01/27/2023] [Revised: 03/15/2023] [Accepted: 03/18/2023] [Indexed: 04/08/2023] Open
Abstract
We present a case of an 83-year-old man with underlying colorectal cancer who underwent a gallium-68 prostate specific membrane antigen-11 positron emission tomography/computed tomography (68 Ga-PSMA-11 PET/CT) for the initial staging of prostate cancer. PET / CT revealed two mildly PSMA-avid lung nodules without evidence of PSMA-avid nodal or bony metastasis. Subsequently, a wedge pulmonary resection was performed and the histopathology and immunohistochemistry of the nodules were consistent with synchronous primary lung cancer. Because differentiating synchronous primary lung cancer from pulmonary metastasis of prostate cancer can significantly affect treatment strategies and pulmonary metastasis rarely presents during initial staging of prostate cancer, synchronous primary lung cancer should be included in the differential diagnosis of pulmonary lesions in initial staging of 68 Ga-PSMA-11 PET/CT regardless of PSMA avidity. The lack of nodal or bony metastases also decreases the likelihood of lung metastasis, and a tissue diagnosis may be required.
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Affiliation(s)
- Napisa Bunnag
- Department of Radiology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Jirarot Wongwijitsook
- Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Nuclear Medicine Unit, King Chulalongkorn Memorial Hospital, 1873 Rama 4 Road, Pathum Wan, Bangkok, Thailand
| | - Sira Vachatimanont
- Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Nuclear Medicine Unit, King Chulalongkorn Memorial Hospital, 1873 Rama 4 Road, Pathum Wan, Bangkok, Thailand
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5
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Zhu W, Li X, Zheng G, Bai C, Ji Z, Zhang H, Xing H, Zhang Y, Huo L. Preclinical and pilot clinical evaluation of a small-molecule carbonic anhydrase IX targeting PET tracer in clear cell renal cell carcinoma. Eur J Nucl Med Mol Imaging 2023; 50:3116-3125. [PMID: 37246998 DOI: 10.1007/s00259-023-06248-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 04/24/2023] [Indexed: 05/30/2023]
Abstract
PURPOSE Clear cell renal cell carcinoma (ccRCC) highly expresses carbonic anhydrase IX (CAIX). The purpose of this study was to evaluate 68Ga-NY104, a small-molecule CAIX-targeting PET agent, in tumor models of ccRCC and patients diagnosed with confirmed, or suspicious, ccRCC. METHODS The in vivo and ex vivo biodistribution of 68Ga-NY104 was investigated in CAIX-positive OS-RC-2 xenograft-bearing models. The binding of the tracer was further validated using autoradiography for human ccRCC samples. In addition, three patients with confirmed or suspicious ccRCC were studied. RESULTS NY104 can be labeled with high radiochemical yield and purity. It quickly cleared through kidney with α-half-life of 0.15 h. Discernible uptake is noted in the heart, lung, liver, stomach, and kidney. The OS-RC-2 xenograft demonstrated intense uptake 5 min after injection and gradually increased until 3 h after injection with ID%/g of 29.29 ± 6.82. Significant binding was detected using autoradiography on sections of human ccRCC tumor. In the three patients studied, 68Ga-NY104 was well-tolerated and no adverse events were reported. Substantial accumulation was observed in both primary and metastatic lesions in patient 1 and 2 with SUVmax of 42.3. Uptake in the stomach, pancreas, intestine, and choroid plexus was noted. The lesion in third patient was correctly diagnosed as non-metastatic for negative 68Ga-NY104 uptake. CONCLUSION 68Ga-NY104 can efficiently and specifically bind to CAIX. Given the pilot nature of our study, future clinical studies are warranted to evaluate 68Ga-NY104 for detection of CAIX-positive lesions in patients with ccRCC. TRIAL REGISTRATION The clinical evaluation part of this study was retrospectively registered at ClinicalTrial.gov (NCT05728515) as NYPILOT on 6 Feb, 2023.
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Affiliation(s)
- Wenjia Zhu
- Department of Nuclear Medicine, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China
| | - Xiaoyuan Li
- Department of Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Guoyang Zheng
- Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Chunmei Bai
- Department of Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Zhigang Ji
- Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Haiqiong Zhang
- Department of Nuclear Medicine, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China
| | - Haiqun Xing
- Department of Nuclear Medicine, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China
| | - Yushi Zhang
- Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
| | - Li Huo
- Department of Nuclear Medicine, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
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6
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Lu Q, Long Y, Gai Y, Liu Q, Jiang D, Lan X. [ 177Lu]Lu-PSMA-617 theranostic probe for hepatocellular carcinoma imaging and therapy. Eur J Nucl Med Mol Imaging 2023; 50:2342-2352. [PMID: 36877233 DOI: 10.1007/s00259-023-06155-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 02/13/2023] [Indexed: 03/07/2023]
Abstract
PURPOSE This study aimed to explore the feasibility of using [177Lu]Lu-prostate-specific membrane antigen (PSMA)-617 and [177Lu]Lu-Evans blue (EB)-PSMA-617 for in vivo radioligand therapy by single-dose administration in a PSMA-positive hepatocellular carcinoma (HCC) xenograft mouse model. METHODS [177Lu]Lu-PSMA-617 and [177Lu]Lu-EB-PSMA-617 were prepared, and labelling efficiency and radiochemical purity were determined. A HepG2 human HCC subcutaneous xenograft mouse model was established. After intravenous injection of [177Lu]Lu-PSMA-617 or [177Lu]Lu-EB-PSMA-617 (37 MBq) into the mouse model, single-photon emission computed tomography/computed tomography (SPECT/CT) was performed. Biodistribution studies were conducted to verify targeting specificity and pharmacokinetics. In the radioligand therapy study, mice were randomized into 4 groups: 37 MBq [177Lu]Lu-PSMA-617, 18.5 MBq [177Lu]Lu-PSMA-617, 7.4 MBq [177Lu]Lu-EB-PSMA-617, and saline (control). A single-dose administration was applied at the beginning of therapy studies. Tumor volume, body weight, and survival were monitored every 2 days. After the end of therapy, mice were euthanized. Tumors were then weighed, and systemic toxicity was evaluated via blood testing and histological examination of healthy organs. RESULTS [177Lu]Lu-PSMA-617 and [177Lu]Lu-EB-PSMA-617 were successfully prepared with high purity and stability. SPECT/CT and biodistribution showed that tumor uptake was higher and persisted longer for [177Lu]Lu-EB-PSMA-617 compared with [177Lu]Lu-PSMA-617. [177Lu]Lu-PSMA-617 was rapidly cleared from the blood, while [177Lu]Lu-EB-PSMA-617 persisted for significantly longer. In radioligand therapy studies, tumor growth was significantly suppressed in the 37 MBq [177Lu]Lu-PSMA-617, 18.5 MBq [177Lu]Lu-PSMA-617, and 7.4 MBq [177Lu]Lu-EB-PSMA-617 groups compared to the saline group. Median survival was 40, 44, 43, and 30 days, respectively. No healthy organ toxicity was observed in safety and tolerability evaluation. CONCLUSIONS Radioligand therapy using [177Lu]Lu-PSMA-617 and [177Lu]Lu-EB-PSMA-617 significantly suppressed tumor growth and prolonged survival time in PSMA-positive HCC xenograft mice without obvious toxicity. These radioligands appear promising for clinical use in humans, and future studies are warranted.
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Affiliation(s)
- Qiaomiao Lu
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Wuhan, Hubei, 430022, China
| | - Yu Long
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Wuhan, Hubei, 430022, China
| | - Yongkang Gai
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Wuhan, Hubei, 430022, China
- Key Laboratory of Biological Targeted Therapy of the Ministry of Education, Wuhan, 430022, China
| | - Qingyao Liu
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Wuhan, Hubei, 430022, China
- Key Laboratory of Biological Targeted Therapy of the Ministry of Education, Wuhan, 430022, China
| | - Dawei Jiang
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Wuhan, Hubei, 430022, China
- Key Laboratory of Biological Targeted Therapy of the Ministry of Education, Wuhan, 430022, China
| | - Xiaoli Lan
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China.
- Hubei Key Laboratory of Molecular Imaging, Wuhan, Hubei, 430022, China.
- Key Laboratory of Biological Targeted Therapy of the Ministry of Education, Wuhan, 430022, China.
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7
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Hu Y, Wang P, Dai W. Heterogeneous uptake of 18F-FDG and 18F-PSMA-1007 PET/CT in lung cancer and lymph node metastasis. BMC Pulm Med 2023; 23:73. [PMID: 36882747 PMCID: PMC9993722 DOI: 10.1186/s12890-023-02377-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 03/02/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND PSMA PET/CT has shown excellent results in imaging of prostate cancer. However, some nonprostatic malignancies can also demonstrate 18 F-PSMA uptake, including primary lung cancer. 18 F-FDG PET/CT is widely employed in initial staging, response to therapy and follow-up assessment for lung cancer. Here we present an interesting case report on the different patterns of PSMA and FDG uptake between primary lung cancer and metastatic intrathoracic lymph node metastases in a patient with concurrent metastatic prostate cancer. CASE PRESENTATION A 70-year-old male underwent 18 F-FDG PET/CT and 18 F-PSMA-1007 PET/CT imaging due to suspicion primary lung cancer and prostate cancer. The patient eventually was diagnosed with non-small cell lung cancer (NSCLC) with mediastinal lymph node metastases and prostate cancer with left iliac lymph node and multiple bone metastases. Interestingly, our imaging revealed different patterns of tumor uptake detected on 18 F-FDG and 18 F-PSMA-1007 PET/CT in primary lung cancer and lymph node metastases. The primary lung lesion showed intense FDG uptake, and mild uptake with 18 F-PSMA-1007. Whereas the mediastinal lymph node metastases showed both intense FDG and PSMA uptake. The prostate lesion, left iliac lymph node, and multiple bone lesions showed significant PSMA uptake and negative FDG uptake. CONCLUSION In this case, there was a homogeneity of 18 F-FDG intense uptake between LC and metastatic lymph nodes, but a heterogeneity in 18 F-PSMA-1007 uptake. It illustrated that these molecular probes reflect the diversity of tumor microenvironments, which may help us understand the differences of the tumor response to treatment.
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Affiliation(s)
- Yuan Hu
- Department of Nuclear Medicine, The First College of Clinical Medical Science, China Three Gorges University, Yichang, 443003, Hubei, China
| | - Peng Wang
- Department of Nuclear Medicine, The First College of Clinical Medical Science, China Three Gorges University, Yichang, 443003, Hubei, China
| | - Wenli Dai
- Department of Nuclear Medicine, The First College of Clinical Medical Science, China Three Gorges University, Yichang, 443003, Hubei, China.
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8
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Cegla P, Wojewodzka-Mirocha M, Chalewska W, Dedecjus M. [68Ga]Ga-PSMA-11 uptake in planepitheliale lung cancer: a pitfall in prostate cancer imaging. Nuklearmedizin 2023; 62:220-221. [PMID: 36720240 DOI: 10.1055/a-2000-5589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Paulina Cegla
- Department of Endocrine Oncology and Nuclear Medicine, Maria Sklodowska-Curie National Research Institute of Oncology in Warsaw, Warszawa, Poland
| | - Marta Wojewodzka-Mirocha
- Department of Endocrine Oncology and Nuclear Medicine, Maria Sklodowska-Curie National Research Institute of Oncology in Warsaw, Warszawa, Poland
| | - Wioletta Chalewska
- Department of Endocrine Oncology and Nuclear Medicine, Maria Sklodowska-Curie National Research Institute of Oncology in Warsaw, Warszawa, Poland
| | - Marek Dedecjus
- Department of Endocrine Oncology and Nuclear Medicine, Maria Sklodowska-Curie National Research Institute of Oncology in Warsaw, Warszawa, Poland
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9
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PSMA Expression in Solid Tumors beyond the Prostate Gland: Ready for Theranostic Applications? J Clin Med 2022; 11:jcm11216590. [PMID: 36362824 PMCID: PMC9657217 DOI: 10.3390/jcm11216590] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 11/02/2022] [Accepted: 11/04/2022] [Indexed: 11/09/2022] Open
Abstract
In the past decades, the expanding use of prostate-specific membrane antigen (PSMA) imaging for prostate cancer has led to the incidental detection of a lot of extra-prostatic malignancies showing an increased uptake of PSMA. Due to these incidental findings, the increasing amount of immunohistochemistry studies and the deeper knowledge of the mechanisms of expression of this antigen, it is now clear that “PSMA” is a misnomer, since it is not specific to the prostate gland. Nevertheless, this lack of specificity could represent an interesting opportunity to bring new insights on the biology of PSMA and its sites of expression to image and treat new conditions, particularly several cancers. In this review, we will describe the main extra-prostatic cancers that exhibit PSMA expression and that can be studied with PSMA-based positron emission tomography–computed tomography (PET/CT) as an additional or alternative tool to conventional imaging. In particular, we will focus on cancers in which a radioligand therapy with 177lutetium has been attempted, aiming to provide an overview of the possible future theragnostic applications of PSMA.
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10
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Man YG, Mannion C, Jewett A, Hsiao YH, Liu A, Semczuk A, Zarogoulidis P, Gapeev AB, Cimadamore A, Lee P, Lopez-Beltran A, Montironi R, Massari F, Lu X, Cheng L. The most effective but largely ignored target for prostate cancer early detection and intervention. J Cancer 2022; 13:3463-3475. [PMID: 36313040 PMCID: PMC9608211 DOI: 10.7150/jca.72973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 10/01/2022] [Indexed: 11/05/2022] Open
Abstract
Over the past two decades, the global efforts for the early detection and intervention of prostate cancer seem to have made significant progresses in the basic researches, but the clinic outcomes have been disappointing: (1) prostate cancer is still the most common non-cutaneous cancer in Europe in men, (2) the age-standardized prostate cancer rate has increased in nearly all Asian and African countries, (3) the proportion of advanced cancers at the diagnosis has increased to 8.2% from 3.9% in the USA, (4) the worldwide use of PSA testing and digital rectal examination have failed to reduce the prostate cancer mortality, and (5) there is still no effective preventive method to significantly reduce the development, invasion, and metastasis of prostate cancer… Together, these facts strongly suggest that the global efforts during the past appear to be not in a correlated target with markedly inconsistent basic research and clinic outcomes. The most likely cause for the inconsistence appears due to the fact that basic scientific studies are traditionally conducted on the cell lines and animal models, where it is impossible to completely reflect or replicate the in vivo status. Thus, we would like to propose the human prostate basal cell layer (PBCL) as “the most effective target for the early detection and intervention of prostate cancer”. Our proposal is based on the morphologic, immunohistochemical and molecular evidence from our recent studies of normal and cancerous human prostate tissues with detailed clinic follow-up data. We believe that the human tissue-derived basic research data may provide a more realistic roadmap to guide the clinic practice and to avoid the potential misleading from in vitro and animal studies.
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Affiliation(s)
- Yan-gao Man
- Department of Pathology, Hackensack Meridian School of Medicine, Nutley, NJ, USA,✉ Corresponding authors: Yan-gao Man., MD., PhD. E-mail: or or Liang Cheng., MD. E-mail: or
| | - Ciaran Mannion
- Department of Pathology, Hackensack Meridian School of Medicine, Nutley, NJ, USA
| | - Anahid Jewett
- Tumor Immunology Laboratory, Jonsson Comprehensive Cancer Center, UCLA School of Dentistry and Medicine, Los Angeles, CA, USA
| | - Yi-Hsuan Hsiao
- Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan
| | - Aijun Liu
- Department of Pathology, Chinese PLA General Hospital 7 th Medical Center, Beijing, China
| | - Andrzej Semczuk
- II ND Department of Gynecology, Lublin Medical University, Lublin, Poland
| | - Paul Zarogoulidis
- Pulmonary-Oncology Department, "Theageneio" Cancer Hospital, Thessaloniki, Greece
| | - Andrei B. Gapeev
- Laboratory of Biological Effects of Non-Ionizing Radiation, Institute of Cell Biophysics, Russian Academy of Sciences, Russian Federation
| | - Alessia Cimadamore
- Section of Pathological Anatomy, Polytechnic University of the Marche Region, School of Medicine, United Hospitals, Ancona, Italy
| | - Peng Lee
- Department of Pathology, New York University School of Medicine, New York, NY, USA.,Department of Pathology, New York Harbor Healthcare System, New York, NY, USA
| | - Antonio Lopez-Beltran
- Department of Morphological Sciences, Cordoba University Medical School, Cordoba, Spain
| | - Rodolfo Montironi
- Molecular Medicine and Cell Therapy Foundation, Department of Clinical & Molecular Sciences, Polytechnic University of the Marche Region, Ancona, Italy
| | - Francesco Massari
- Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Xin Lu
- Department of Biological Sciences, Boler-Parseghian Center for Rare and Neglected Diseases, Harper Cancer Research Institute, University of Notre Dame, Notre Dame, IN, USA.,Tumor Microenvironment and Metastasis Program, Indiana University Melvin and Bren Simon Comprehensive Cancer Center, Indianapolis, IN, USA
| | - Liang Cheng
- Department of Pathology and Laboratory Medicine, Brown University Medical School
- Lifespan Academic Medical Center, RI, USA.,✉ Corresponding authors: Yan-gao Man., MD., PhD. E-mail: or or Liang Cheng., MD. E-mail: or
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11
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Lu Q, Long Y, Fan K, Shen Z, Gai Y, Liu Q, Jiang D, Cai W, Wan C, Lan X. PET imaging of hepatocellular carcinoma by targeting tumor-associated endothelium using [ 68Ga]Ga-PSMA-617. Eur J Nucl Med Mol Imaging 2022; 49:4000-4013. [PMID: 35763056 PMCID: PMC9529836 DOI: 10.1007/s00259-022-05884-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 06/16/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Hepatocellular carcinoma (HCC) is a malignant tumor associated with high morbidity and mortality rates. In many non-prostate solid tumors such as HCC, prostate-specific membrane antigens (PSMA) are overexpressed in tumor-associated endothelial cells. Therefore, the aim of this study was to evaluate the performance of [68Ga]Ga-PSMA-617 PET imaging on HCC with different animal models, including cell line-derived xenografts (CDX) and patient-derived xenografts (PDX), and to explore its mechanisms of function. METHODS [68Ga]Ga-PSMA-617 was prepared. The expression level of PSMA in two human hepatocellular cancer cells (HepG2 and HuH-7) was evaluated, and the cellular uptakes of [68Ga]Ga-PSMA-617 were assayed. HepG2 and HuH-7 subcutaneous xenograft models, HepG2 orthotopic xenograft models, and four different groups of PDX models were prepared. Preclinical pharmacokinetics and performance of [68Ga]Ga-PSMA-617 were evaluated in different types of HCC xenografts models using small animal PET and biodistribution studies. RESULTS Low PSMA expression level of HepG2 and HuH-7 cells was observed, and the cellular uptake and blocking study confirmed the non-specificity of the PSMA-targeted probe binding to HepG2 and HuH-7 cells. In the subcutaneous xenograft models, the tumor uptakes at 0.5 h were 0.76 ± 0.12%ID/g (HepG2 tumors) and 0.78 ± 0.08%ID/g (HuH-7 tumors), respectively, which were significantly higher than those of the blocking groups (0.23 ± 0.04%ID/g and 0.20 ± 0.04%ID/g, respectively). In the orthotopic xenograft models, PET images clearly displayed the tumor locations based on the preferential accumulation of [68Ga]Ga-PSMA-617 in tumor tissue versus normal liver tissue, suggesting the possibility of using [68Ga]Ga-PSMA-617 PET imaging to detect primary HCC lesions in deep tissue. In the four different groups of HCC PDX models, PET imaging with [68Ga]Ga-PSMA-617 provided clear tumor uptakes with prominent tumor-to-background contrast, further demonstrating its potential for the clinical imaging of PSMA-positive HCC lesions. The staining of tumor tissue sections with CD31- and PSMA-specific antibodies visualized the tumor-associated blood vessels and PSMA expression on endothelial cells in subcutaneous, orthotopic tissues, and PDX tissues, confirming the imaging with [68Ga]Ga-PSMA-617 might be mediated by targeting tumor associated endothelium. CONCLUSION In this study, in vivo PET on different types of HCC xenograft models illustrated high uptake within tumors, which confirmed that [68Ga]Ga-PSMA-617 PET may be a promising imaging modality for HCC by targeting tumor associated endothelium.
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Affiliation(s)
- Qiaomiao Lu
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, Wuhan, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Hubei, Wuhan, 430022, China
| | - Yu Long
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, Wuhan, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Hubei, Wuhan, 430022, China
| | - Kevin Fan
- Department of Radiology and Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, 53705, USA
| | - Zhiwen Shen
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China
| | - Yongkang Gai
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, Wuhan, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Hubei, Wuhan, 430022, China
- Key Laboratory of Biological Targeted Therapy of the Ministry of Education, Hubei, Wuhan, 430022, China
| | - Qingyao Liu
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, Wuhan, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Hubei, Wuhan, 430022, China
- Key Laboratory of Biological Targeted Therapy of the Ministry of Education, Hubei, Wuhan, 430022, China
| | - Dawei Jiang
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, Wuhan, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Hubei, Wuhan, 430022, China
- Key Laboratory of Biological Targeted Therapy of the Ministry of Education, Hubei, Wuhan, 430022, China
| | - Weibo Cai
- Department of Radiology and Department of Medical Physics, University of Wisconsin-Madison, Madison, WI, 53705, USA
| | - Chidan Wan
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, China.
| | - Xiaoli Lan
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, Wuhan, 430022, China.
- Hubei Key Laboratory of Molecular Imaging, Hubei, Wuhan, 430022, China.
- Key Laboratory of Biological Targeted Therapy of the Ministry of Education, Hubei, Wuhan, 430022, China.
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12
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Abstract
ABSTRACT A 69-year-old man with a known history of gastric and prostate adenocarcinoma was referred to 68Ga-prostate-specific membrane antigen (PSMA) PET/CT for restaging due to biochemical recurrence of prostate cancer. 68Ga-PSMA PET/CT revealed tracer accumulation in the primary prostatic lesion, lymph node, bone metastases, and brain lesion, which was later confirmed on biopsy to be metastasis of gastric carcinoma. This case reminds us of the variable spectrum of 68Ga-PSMA uptake in prostatic and nonprostatic metastatic lesions, the potential pitfalls on PET/CT images in the workup of patients with concomitant malignancies.
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Affiliation(s)
- Selin Kesim
- From the Department of Nuclear Medicine, Marmara University Istanbul Pendik Training and Research Hospital, Istanbul, Turkey
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13
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Wang G, Zhou M, Zang J, Jiang Y, Chen X, Zhu Z, Chen X. A pilot study of 68 Ga-PSMA-617 PET/CT imaging and 177Lu-EB-PSMA-617 radioligand therapy in patients with adenoid cystic carcinoma. EJNMMI Res 2022; 12:52. [PMID: 35984529 PMCID: PMC9390098 DOI: 10.1186/s13550-022-00922-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 08/04/2022] [Indexed: 11/29/2022] Open
Abstract
Background This pilot study was designed to evaluate the diagnostic value of 68 Ga-PSMA-617 and 18F-FDG PET/CT in adenoid cystic carcinoma (ACC) and to assess the safety and therapeutic response to PSMA radioligand therapy (RLT) in ACC patients. Methods Thirty patients pathologically diagnosed with ACC were recruited into the cohort. Each patient underwent 68 Ga-PSMA-617 and 18F-FDG PET/CT within 1 week. The number and SUVmax of PET-positive lesions were recorded and compared. Four patients accepted RLT using 177Lu-EB-PSMA-617, in a dosage of approximately 1.85 GBq (50 mCi) per cycle for up to 3 cycles. Results Compared with 18F-FDG, 68 Ga-PSMA-617 revealed more PET-positive extrapulmonary tumors (157 vs. 141, P = 0.016) and higher SUVmax (8.8 ± 3.6 vs. 6.4 ± 4.2, P = 0.027). However, 68 Ga-PSMA-617 revealed less PET-positive pulmonary lesions (202 vs. 301, P < 0.001) and lower SUVmax of tumors (3.1 ± 3.0 vs. 4.2 ± 3.9, P < 0.001) than 18F-FDG. The combination of 68 Ga-PSMA-617 and 18F-FDG can detect 469 PET-positive lesions, which was superior to each alone (469 vs. 359 vs. 442, P < 0.001). Two patients achieved remarkable response after PSMA RLT, while the other two patients showed reduced tumor uptake of recurrent foci, lung and liver metastases, whereas increased SUVmax of bone metastases. Conclusions 68 Ga-PSMA-617 PET/CT is a valuable imaging modality for the detection of ACC and combining with 18F-FDG PET/CT will achieve a higher detection efficiency. PSMA RLT may be a promising treatment for ACC and is worth of further investigation. Trial registration: Diagnosis of Adenoid Cystic Carcinoma on 68 Ga-PSMA-617 PET-CT and Therapy With 177Lu-EB-PSMA-617 (NCT04801264, Registered 16 March 2021, retrospectively registered). URL of registry: https://clinicaltrials.gov/ct2/show/NCT04801264.
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Affiliation(s)
- Guochang Wang
- Department of Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China
| | - Mengjiao Zhou
- Department of Otolaryngology Head and Neck Surgery, Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otolaryngology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
| | - Jie Zang
- Department of Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China
| | - Yuanyuan Jiang
- Department of Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China
| | - Xiaohong Chen
- Department of Otolaryngology Head and Neck Surgery, Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Beijing Institute of Otolaryngology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China.
| | - Zhaohui Zhu
- Department of Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, China.
| | - Xiaoyuan Chen
- Departments of Diagnostic Radiology, Surgery, Chemical and Biomolecular Engineering, and Biomedical Engineering, Yong Loo Lin School of Medicine and Faculty of Engineering, National University of Singapore, Singapore, 119074, Singapore. .,Clinical Imaging Research Centre, Centre for Translational Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117599, Singapore. .,Nanomedicine Translational Research Program, NUS Center for Nanomedicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore.
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14
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CAR-T Cells for the Treatment of Lung Cancer. Life (Basel) 2022; 12:life12040561. [PMID: 35455052 PMCID: PMC9028981 DOI: 10.3390/life12040561] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 12/16/2022] Open
Abstract
Adoptive cell therapy with genetically modified T lymphocytes that express chimeric antigen receptors (CAR-T) is one of the most promising advanced therapies for the treatment of cancer, with unprecedented outcomes in hematological malignancies. However, the efficacy of CAR-T cells in solid tumors is still very unsatisfactory, because of the strong immunosuppressive tumor microenvironment that hinders immune responses. The development of next-generation personalized CAR-T cells against solid tumors is a clinical necessity. The identification of therapeutic targets for new CAR-T therapies to increase the efficacy, survival, persistence, and safety in solid tumors remains a critical frontier in cancer immunotherapy. Here, we summarize basic, translational, and clinical results of CAR-T cell immunotherapies in lung cancer, from their molecular engineering and mechanistic studies to preclinical and clinical development.
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15
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Kennedy GT, Azari FS, Bernstein E, Nadeem B, Chang AE, Segil A, Sullivan N, Marfatia I, Din A, Desphande C, Kucharczuk JC, Low PS, Singhal S. A Prostate-Specific Membrane Antigen-Targeted Near-Infrared Conjugate for Identifying Pulmonary Squamous Cell Carcinoma during Resection. Mol Cancer Ther 2022; 21:546-554. [PMID: 35149546 PMCID: PMC8983600 DOI: 10.1158/1535-7163.mct-21-0821] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 12/13/2021] [Accepted: 01/24/2022] [Indexed: 11/16/2022]
Abstract
Pulmonary squamous cell carcinoma is the second most common lung cancer subtype and has a low 5-year survival rate at 17.6%. Complete resection with negative margins can be curative, but a high number of patients suffer early postoperative recurrence due to inadequate disease clearance at the index operation. Intraoperative molecular imaging (IMI) with tumor-targeted optical contrast agents is effective in improving resection completeness for other tumor types, but there are no IMI tracers targeted to pulmonary squamous cell carcinoma. In this report, we describe the use of a novel prostate-specific membrane antigen (PSMA)-targeted near-infrared conjugate (OTL78) to identify pulmonary squamous cell carcinoma. We identified PSMA as a viable target by examining its expression in human lung tumor specimens from a surgical cohort. Ninety-four percent of tumors expressed PSMA in either the pulmonary squamous cells or the tumor neovasculature. Using in vitro and in vivo models, we found that OTL78 reliably localized pulmonary squamous cell carcinoma in a PSMA-dependent manner. Finally, we found that IMI with OTL78 markedly improved surgeons' ability to identify residual disease after surgery in a preclinical model. Ultimately, this novel optical tracer may aid surgical resection of pulmonary squamous cell carcinoma and potentially improve long-term outcomes.
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Affiliation(s)
- Gregory T Kennedy
- Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - Feredun S Azari
- Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - Elizabeth Bernstein
- Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - Bilal Nadeem
- Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - Ashley E Chang
- Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - Alix Segil
- Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - Neil Sullivan
- Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - Isvita Marfatia
- Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - Azra Din
- Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - Charuhas Desphande
- Department of Pathology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - John C Kucharczuk
- Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - Philip S Low
- Department of Chemistry, Purdue University, West Lafayette, Indiana
| | - Sunil Singhal
- Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
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16
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Palameta S, Manrique-Rincón AJ, Toscaro JM, Semionatto IF, Fonseca MC, Rosa RS, Ruas LP, Oliveira PS, Bajgelman MC. Boosting antitumor response with PSMA-targeted immunomodulatory VLPs, harboring costimulatory TNFSF ligands and GM-CSF cytokine. Mol Ther Oncolytics 2022; 24:650-662. [PMID: 35284623 PMCID: PMC8898762 DOI: 10.1016/j.omto.2022.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 02/11/2022] [Indexed: 11/29/2022] Open
Abstract
Therapeutic strategies based on immunomodulation have improved cancer therapy. Most approaches target co-stimulatory pathways or the inhibition of immunosuppressive mechanisms, to enhance immune response and overcome the immune tolerance of tumors. Here, we propose a novel platform to deliver targeted immunomodulatory signaling, enhancing antitumor response. The platform is based on virus-like particles derived from lentiviral capsids. These particles may be engineered to harbor multifunctional ligands on the surface that drive tropism to the tumor site and deliver immunomodulatory signaling, boosting the antitumor response. We generated virus-like particles harboring a PSMA-ligand, TNFSF co-stimulatory ligands 4-1BBL or OX40L, and a membrane-anchored GM-CSF cytokine. The virus-like particles are driven to PSMA-expressing tumors and deliver immunomodulatory signaling from the TNFSF surface ligands and the anchored GM-CSF, inducing T cell proliferation, inhibition of regulatory T cells, and potentiating elimination of tumor cells. The PSMA-targeted particles harboring immunomodulators enhanced antitumor activity in immunocompetent challenged mice and may be explored as a potential tool for cancer immunotherapy.
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17
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Piek MW, de Vries LH, Donswijk ML, de Keizer B, de Boer JP, Lodewijk L, van Leeuwaarde RS, Vriens MR, Hartemink KJ, van der Ploeg IMC. Retrospective analysis of PSMA PET/CT thyroid incidental uptake in adults: incidence, diagnosis, and treatment/outcome in a tertiary cancer referral center and University Medical Center. Eur J Nucl Med Mol Imaging 2022; 49:2392-2400. [PMID: 35031811 DOI: 10.1007/s00259-022-05679-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 01/09/2022] [Indexed: 12/21/2022]
Abstract
PURPOSE A prostate-specific membrane antigen (PSMA) thyroid incidentaloma (PTI) is an unexpected, PSMA-avid thyroid lesion, newly detected during the investigation of an unrelated condition using PSMA PET/CT. The aim of this study is to examine the incidence and clinical significance of PTI and the associated management strategies since the implementation of the PSMA PET/CT scan. METHODS This study involves a retrospective cohort study of 61 PTI cases depicted on PSMA PET/CT scans performed between January 2016 and July 2021, almost exclusively for (re)staging prostate cancer. The medical records of the included cases were retrospectively reviewed and data of the PSMA PET/CT scans, primary malignancy, thyroid diagnostics, treatment, and follow-up were collected. RESULTS PTI was reported in 1.1% of the patients who underwent oncologic PSMA PET/CT scans included in this study. Two PTI cases had a histologically proven thyroid cancer: one a benign thyroid lesion and one a metastasis of a renal cell carcinoma. In none of the cases in whom any form of further thyroid workup was withheld, the PTI became clinically relevant during follow-up (median 1.8 years (1.1-3.3)). Six patients (10%) died due to their primary cancer. CONCLUSION The incidence of thyroid incidentalomas on PSMA PET/CT was low (1.1%) in this large, two-center experience. Less than half of the PTI cases were analyzed and the risk of malignancy, despite being low, was not negligible. The clinical outcome was good using a standard diagnostic workup for PTI, while the prognosis of the patient was determined by the primary malignancy. The consideration to analyze and treat PTI cases should be part of the shared decision-making in cancer patients.
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Affiliation(s)
- Marceline W Piek
- Departments of Surgical Oncology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, NL-1066 CX, Amsterdam, The Netherlands
| | - Lisa H de Vries
- Departments of Surgery, University Medical Center of Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Maarten L Donswijk
- Departments of Nuclear Medicine, Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, NL-1066 CX, Amsterdam, The Netherlands
| | - Bart de Keizer
- Departments of Nuclear Medicine, University Medical Center of Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Jan Paul de Boer
- Departments of Internal Medicine, Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, NL-1066 CX, Amsterdam, The Netherlands
| | - Lutske Lodewijk
- Departments of Surgery, University Medical Center of Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Rachel S van Leeuwaarde
- Departments of Endocrine Oncology, University Medical Center of Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Menno R Vriens
- Departments of Surgery, University Medical Center of Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Koen J Hartemink
- Departments of Surgical Oncology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, NL-1066 CX, Amsterdam, The Netherlands
| | - Iris M C van der Ploeg
- Departments of Surgical Oncology, Netherlands Cancer Institute-Antoni Van Leeuwenhoek Hospital, Plesmanlaan 121, NL-1066 CX, Amsterdam, The Netherlands.
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18
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Unger C, Bronsert P, Michalski K, Bicker A, Juhasz-Böss I. Expression of Prostate Specific Membrane Antigen (PSMA) in Breast Cancer. Geburtshilfe Frauenheilkd 2022; 82:50-58. [PMID: 35027860 PMCID: PMC8747897 DOI: 10.1055/a-1638-9429] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 09/06/2021] [Indexed: 10/28/2022] Open
Abstract
Background Prostate specific membrane antigen (PSMA) is a promising protein for breast cancer patients. It has not only been detected in prostate cancer but is also expressed by tumor cells and the endothelial cells of tumor vessels in breast cancer patients. PSMA plays a role in tumor progression and tumor angiogenesis. For this reason, a number of diagnostic and therapeutic methods to target PSMA have been developed. Method This paper provides a general structured overview of PSMA and its oncogenic potential, with a special focus on its role in breast cancer. This narrative review is based on a selective literature search carried out in PubMed and the library of Freiburg University Clinical Center. The following key words were used for the search: "PSMA", "PSMA and breast cancer", "PSMA PET/CT", "PSMA tumor progression". Relevant articles were explicitly read through, processed, and summarized. Conclusion PSMA could be a new diagnostic and therapeutic alternative, particularly for triple-negative breast cancer. It appears to be a potential predictive and prognostic marker.
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Affiliation(s)
- Clara Unger
- Klinik für Frauenheilkunde, Universitätsklinikum Freiburg, Freiburg, Germany
| | - Peter Bronsert
- Institut für Klinische Pathologie, Universitätsklinikum Freiburg, Freiburg, Germany
| | - Kerstin Michalski
- Klinik für Nuklearmedizin, Universitätsklinikum Freiburg, Freiburg, Germany
| | - Anna Bicker
- Klinik für Gynäkologie und Geburtshilfe in den St. Vincentius Kliniken, Karslruhe, Germany
| | - Ingolf Juhasz-Böss
- Klinik für Frauenheilkunde, Universitätsklinikum Freiburg, Freiburg, Germany
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19
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Li Y, Zhang K, Yang F, Jiao D, Li M, Zhao X, Xu C, Liu S, Li H, Shi S, Yang B, Yang L, Han D, Wen W, Qin W. Prognostic Value of Vascular-Expressed PSMA and CD248 in Urothelial Carcinoma of the Bladder. Front Oncol 2021; 11:771036. [PMID: 34869004 PMCID: PMC8635966 DOI: 10.3389/fonc.2021.771036] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 10/27/2021] [Indexed: 11/22/2022] Open
Abstract
Background Urothelial carcinoma of the bladder (UCB) is a common cancer of the urinary system. Despite substantial improvements in available treatment options, the survival outcome of patients with advanced UCB is unsatisfactory. Therefore, it is necessary to identify new prognostic biomarkers for monitoring and therapy guidance of UCB. In recent years, prostate-specific membrane antigen (PSMA) and CD248 have been identified promising candidate bio7markers. Methods In this study, we first examined PSMA and CD248 expression in tissues from 124 patients with UCB using immunohistochemical and immunofluorescent staining. We then analyzed the association between the expression of the two biomarkers and other clinicopathological features and prognosis. Finally, we performed bioinformatic analysis of CD248 and FOLH 1 (PSMA) using the TCGA-BLCA dataset to explore the underlying mechanism of PSMA and CD248 in the progression of UCB. Results Among the 124 cases, PSMA and CD248 were confirmed to be expressed in tumor-associated vessels. Vascular PSMA and CD248 expression levels were associated significantly with several deteriorated clinicopathological features. Furthermore, using univariate and multivariate Cox analyses, high vascular PSMA and CD248 expression levels were observed to be associated significantly with poor prognosis in patients with UCB. As risk factors, both PSMA and CD248 expression showed good performance to predict prognosis. Furthermore, combining these vascular molecules with other clinical risk factors generated a risk score that could promote predictive performance. Bioinformatic analysis showed that both PSMA and CD248 might contribute to angiogenesis and promote further progression of UCB. Conclusion Both PSMA and CD248 are specifically expressed in the tumor-associated vasculature of UCB. These two molecules might be used as novel prognostic biomarkers and vascular therapeutic targets for UCB.
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Affiliation(s)
- Yu Li
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Keying Zhang
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Fa Yang
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Dian Jiao
- Department of Urology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Mingyang Li
- Department of Pathology, Fourth Military Medical University, Xi'an, China
| | - Xiaolong Zhao
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Chao Xu
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Shaojie Liu
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Hongji Li
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Shengjia Shi
- Assisted Reproduction Center, Northwest Women's and Children's Hospital, Xi'an, China
| | - Bo Yang
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Lijun Yang
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Donghui Han
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Weihong Wen
- Institute of Medical Research, Northwestern Polytechnical University, Xi'an, China
| | - Weijun Qin
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
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20
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Shahrokhi P, Masteri Farahani A, Tamaddondar M, Rezazadeh F. The utility of radiolabeled PSMA ligands for tumor imaging. Chem Biol Drug Des 2021; 99:136-161. [PMID: 34472217 DOI: 10.1111/cbdd.13946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/06/2021] [Accepted: 08/16/2021] [Indexed: 01/19/2023]
Abstract
Prostate-specific membrane antigen (PSMA) is a glycosylated type-II transmembrane protein expressed in prostatic tissue and significantly overexpressed in several prostate cancer cells. Despite its name, PSMA has also been reported to be overexpressed in endothelial cells of benign and malignant non-prostate disease. So its clinical use was extended to detection, staging, and therapy of various tumor types. Recently small molecules targeting PSMA have been developed as imaging probes for diagnosis of several malignancies. Preliminary studies are emerging improved diagnostic sensitivity and specificity of PSMA imaging, leading to a change in patient management. In this review, we evaluated the first preclinical and clinical studies on PSMA ligands resulting future perspectives radiolabeled PSMA in staging and molecular characterization, based on histopathologic examinations of PSMA expression.
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Affiliation(s)
- Pejman Shahrokhi
- Nuclear Medicine Center, Payambar Azam Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Hormozgan, Iran
| | - Arezou Masteri Farahani
- Nuclear Medicine Center, Payambar Azam Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Hormozgan, Iran
| | - Mohammad Tamaddondar
- Nephrology Department, Payambar Azam Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Hormozgan, Iran
| | - Farzaneh Rezazadeh
- Department of Radiopharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
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21
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PSMA radioligand therapy for solid tumors other than prostate cancer: background, opportunities, challenges, and first clinical reports. Eur J Nucl Med Mol Imaging 2021; 48:4350-4368. [PMID: 34120192 PMCID: PMC8566635 DOI: 10.1007/s00259-021-05433-w] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/24/2021] [Indexed: 12/11/2022]
Abstract
In the past decade, a growing body of literature has reported promising results for prostate-specific membrane antigen (PSMA)-targeted radionuclide imaging and therapy in prostate cancer. First clinical studies evaluating the efficacy of [177Lu]Lu-PSMA radioligand therapy (PSMA-RLT) demonstrated favorable results in prostate cancer patients. [177Lu]Lu-PSMA is generally well tolerated due to its limited side effects. While PSMA is highly overexpressed in prostate cancer cells, varying degrees of PSMA expression have been reported in other malignancies as well, particularly in the tumor-associated neovasculature. Hence, it is anticipated that PSMA-RLT could be explored for other solid cancers. Here, we describe the current knowledge of PSMA expression in other solid cancers and define a perspective towards broader clinical implementation of PSMA-RLT. This review focuses specifically on salivary gland cancer, glioblastoma, thyroid cancer, renal cell carcinoma, hepatocellular carcinoma, lung cancer, and breast cancer. An overview of the (pre)clinical data on PSMA immunohistochemistry and PSMA PET/CT imaging is provided and summarized. Furthermore, the first clinical reports of non-prostate cancer patients treated with PSMA-RLT are described.
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Mao K, Luo P, Geng W, Xu J, Liao Y, Zhong H, Ma P, Tan Q, Xia H, Duan L, Song S, Long D, Liu Y, Yang T, Wu Y, Jin Y. An Integrative Transcriptomic and Metabolomic Study Revealed That Melatonin Plays a Protective Role in Chronic Lung Inflammation by Reducing Necroptosis. Front Immunol 2021; 12:668002. [PMID: 34017341 PMCID: PMC8129533 DOI: 10.3389/fimmu.2021.668002] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 04/12/2021] [Indexed: 11/17/2022] Open
Abstract
It has been reported that melatonin can relieve the symptoms of chronic obstructive pulmonary disease (COPD) by improving sleep quality, that is to say, the pineal secreted hormone melatonin has a protective effect in the pathogenesis of COPD, but its underlying mechanism remains unclear. In this study, we recruited 73 people into control (n = 22), stable COPD (n = 20), and acute exacerbation of COPD (n = 31) groups to detect the serum melatonin levels. Then, through the mouse model, we employed a systematic study based on the metabolomic and transcriptomic analyses to investigate the molecular mechanisms involved in the progression of the disease. Circulating melatonin in acute exacerbation of COPD patients was decreased compared with that in healthy donors and stable COPD patients. The serum melatonin level was positively correlated with lung function parameters, such as FEV1, FEV1/FVC, and FEV1% predicted in acute exacerbation of COPD patients. Animal experiments showed that melatonin can not only alleviate chronic lipopolysaccharide (LPS)-induced mouse lung destruction and chronic lung inflammation but also reduce necroptosis (RIP1/RIP3/MLKL), a programmed cell death process in bronchial epithelial cells. The protective effect of melatonin on chronic lung inflammation was further suggested to be dependent on targeting its membrane receptor MT1/MT2. In addition, transcriptomic and metabolomic profiling in the lungs of mice indicated that LPS can induce perturbations of the mainstream metabolites associated with amino acid and energy metabolism. Melatonin may reduce the necroptosis by modifying the disordered pathways of alanine, aspartate, and glutamate metabolism caused by LPS. This study suggests that melatonin may act as a potential therapeutic agent for alleviating the chronic inflammation associated with COPD.
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Affiliation(s)
- Kaimin Mao
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of the National Health Commission Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Critical Care Medicine, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Ping Luo
- Center for Translational Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Geng
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of the National Health Commission Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Juanjuan Xu
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of the National Health Commission Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuhan Liao
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of the National Health Commission Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hua Zhong
- College of Life Sciences, Wuhan University, Wuhan, China
| | - Pei Ma
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of the National Health Commission Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qi Tan
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of the National Health Commission Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hui Xia
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of the National Health Commission Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Limin Duan
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of the National Health Commission Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Siwei Song
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of the National Health Commission Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Danling Long
- Department of Stomatology, Taihe Hospital, Hubei University of Medicine, Shiyan, China
| | - Yuqi Liu
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tinglin Yang
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of the National Health Commission Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yali Wu
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of the National Health Commission Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yang Jin
- Department of Respiratory and Critical Care Medicine, Key Laboratory of Pulmonary Diseases of the National Health Commission Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Zha Z, Choi SR, Ploessl K, Alexoff D, Zhao R, Zhu L, Kung HF. Radiolabeling Optimization and Preclinical Evaluation of the New PSMA Imaging Agent [ 18F]AlF-P16-093. Bioconjug Chem 2021; 32:1017-1026. [PMID: 33872489 DOI: 10.1021/acs.bioconjchem.1c00177] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Prostate-specific membrane antigen (PSMA)-targeted radioligands have played an increasing role in the diagnosis of prostate cancer. [68Ga]Ga-P16-093 is a PSMA-targeting agent for positron emission tomography imaging, currently under a Phase 2 clinical trial. In the present study, P16-093 was labeled with 18F via [18F]AlF2+ complex formation, and the biological properties of [18F]AlF-P16-093 were evaluated. Optimization of radiolabeling efficiency was performed by testing a series of parameters, including the amount of free ligand; the amount of Al3+; and the influence of solvent, pH, temperature, reaction time, and reaction volume. Optimal labeling results were achieved at pH 5 by reacting at 60 °C for 15 min in a vial containing 74-370 MBq of [18F]fluoride, 46 nmol of P16-093, 40 nmol of AlCl3·6 H2O, and 50% EtOH. [18F]AlF-P16-093 was prepared with a non-decay-corrected radiochemical yield of 54.4 ± 4.4% (n = 9) within 30 min (final radiochemical purity ≥95%). In vitro, [18F]AlF-P16-093 showed PSMA-specific high uptakes in PIP-PC3 cells. The binding affinity of [18F]AlF-P16-093 to PSMA was determined as Kd of 12.4 ± 2.0 nM. The tumor uptake in mice with a xenografted PSMA-expressing PIP-PC3 tumor was high (18.8 ± 5.14% ID/g at 1 h postinjection) and retained without washout for 2 h. In addition, tumor uptake was almost completely blocked by coinjecting a PSMA inhibitor, 2-PMPA. The bone activity at 1 h post injection was higher with [18F]AlF-P16-093 (2.83 ± 0.49% ID/g) in comparison to that of [68Ga]Ga-P16-093 (0.26 ± 0.07% ID/g). In summary, an efficient and simple radiosynthesis of [18F]AlF-P16-093 was achieved. [18F]AlF-P16-093 showed desirable in vivo pharmacokinetics and excellent PSMA-targeting properties for imaging PSMA expression in prostate cancer.
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Affiliation(s)
- Zhihao Zha
- Five Eleven Pharma Inc., Philadelphia, Pennsylvania 19104, United States
| | - Seok Rye Choi
- Five Eleven Pharma Inc., Philadelphia, Pennsylvania 19104, United States
| | - Karl Ploessl
- Five Eleven Pharma Inc., Philadelphia, Pennsylvania 19104, United States
| | - David Alexoff
- Five Eleven Pharma Inc., Philadelphia, Pennsylvania 19104, United States
| | - Ruiyue Zhao
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Lin Zhu
- College of Chemistry, Beijing Normal University, Beijing 100875, PR China
| | - Hank F Kung
- Five Eleven Pharma Inc., Philadelphia, Pennsylvania 19104, United States.,Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
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Holzgreve A, Biczok A, Ruf VC, Liesche-Starnecker F, Steiger K, Kirchner MA, Unterrainer M, Mittlmeier L, Herms J, Schlegel J, Bartenstein P, Tonn JC, Albert NL, Suchorska B. PSMA Expression in Glioblastoma as a Basis for Theranostic Approaches: A Retrospective, Correlational Panel Study Including Immunohistochemistry, Clinical Parameters and PET Imaging. Front Oncol 2021; 11:646387. [PMID: 33859946 PMCID: PMC8042319 DOI: 10.3389/fonc.2021.646387] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 03/03/2021] [Indexed: 12/13/2022] Open
Abstract
Aim The aim of the current study was to enlighten the evolution of prostate-specific membrane antigen (PSMA) expression in glioblastoma between initial diagnosis and recurrence in order to provide preliminary insight for further clinical investigations into innovative PSMA-directed treatment concepts in neuro-oncology. Methods Patients who underwent resection for de-novo glioblastoma (GBM) and had a re-resection in case of a recurrent tumor following radiochemotherapy and subsequent chemotherapy were included (n = 16). Histological and immunohistochemical stainings were performed at initial diagnosis and at recurrence (n = 96 tissue specimens). Levels of PSMA expression both in endothelial and non-endothelial cells as well as vascular density (CD34) were quantified via immunohistochemistry and changes between initial diagnosis and recurrence were determined. Immunohistochemical findings were correlated with survival and established clinical parameters. Results PSMA expression was found to be present in all GBM tissue samples at initial diagnosis as well as in all but one case of recurrent tumor samples. The level of PSMA expression in glioblastoma varied inter-individually both in endothelial and non-endothelial cells. Likewise, the temporal evolution of PSMA expression highly varied in between patients. The level of vascular PSMA expression at recurrence and its change between initial diagnosis and recurrence was associated with post recurrence survival time: Patients with high vascular PSMA expression at recurrence as well as patients with increasing PSMA expression throughout the disease course survived shorter than patients with low vascular PSMA expression or decreasing vascular PSMA expression. There was no significant correlation of PSMA expression with MGMT promoter methylation status or Ki-67 labelling index. Conclusion PSMA is expressed in glioblastoma both at initial diagnosis and at recurrence. High vascular PSMA expression at recurrence seems to be a negative prognostic marker. Thus, PSMA expression in GBM might present a promising target for theranostic approaches in recurrent glioblastoma. Especially PSMA PET imaging and PSMA-directed radioligand therapy warrant further studies in brain tumor patients.
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Affiliation(s)
- Adrien Holzgreve
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Annamaria Biczok
- Department of Neurosurgery, University Hospital, LMU Munich, Munich, Germany
| | - Viktoria C Ruf
- Department of Neuropathology, University of Munich (LMU), Munich, Germany
| | | | - Katja Steiger
- Institute of Pathology, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | | | - Marcus Unterrainer
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Lena Mittlmeier
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Jochen Herms
- Department of Neuropathology, University of Munich (LMU), Munich, Germany
| | - Jürgen Schlegel
- Institute of Pathology, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Peter Bartenstein
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Jörg-Christian Tonn
- Department of Neurosurgery, University Hospital, LMU Munich, Munich, Germany
| | - Nathalie L Albert
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Bogdana Suchorska
- Department of Neurosurgery, University Hospital, LMU Munich, Munich, Germany
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Targeting Toxins toward Tumors. Molecules 2021; 26:molecules26051292. [PMID: 33673582 PMCID: PMC7956858 DOI: 10.3390/molecules26051292] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 02/20/2021] [Accepted: 02/22/2021] [Indexed: 12/21/2022] Open
Abstract
Many cancer diseases, e.g., prostate cancer and lung cancer, develop very slowly. Common chemotherapeutics like vincristine, vinblastine and taxol target cancer cells in their proliferating states. In slowly developing cancer diseases only a minor part of the malignant cells will be in a proliferative state, and consequently these drugs will exert a concomitant damage on rapidly proliferating benign tissue as well. A number of toxins possess an ability to kill cells in all states independently of whether they are benign or malignant. Such toxins can only be used as chemotherapeutics if they can be targeted selectively against the tumors. Examples of such toxins are mertansine, calicheamicins and thapsigargins, which all kill cells at low micromolar or nanomolar concentrations. Advanced prodrug concepts enabling targeting of these toxins to cancer tissue comprise antibody-directed enzyme prodrug therapy (ADEPT), gene-directed enzyme prodrug therapy (GDEPT), lectin-directed enzyme-activated prodrug therapy (LEAPT), and antibody-drug conjugated therapy (ADC), which will be discussed in the present review. The review also includes recent examples of protease-targeting chimera (PROTAC) for knockdown of receptors essential for development of tumors. In addition, targeting of toxins relying on tumor-overexpressed enzymes with unique substrate specificity will be mentioned.
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Zekri L, Vogt F, Osburg L, Müller S, Kauer J, Manz T, Pflügler M, Maurer A, Heitmann JS, Hagelstein I, Märklin M, Hörner S, Todenhöfer T, Calaminus C, Stenzl A, Pichler B, la Fougère C, Schneider MA, Rammensee H, Zender L, Sipos B, Salih HR, Jung G. An IgG-based bispecific antibody for improved dual targeting in PSMA-positive cancer. EMBO Mol Med 2021; 13:e11902. [PMID: 33372710 PMCID: PMC7863392 DOI: 10.15252/emmm.201911902] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 11/26/2020] [Accepted: 12/01/2020] [Indexed: 12/14/2022] Open
Abstract
The prostate-specific membrane antigen (PSMA) has been demonstrated in numerous studies to be expressed specifically on prostate carcinoma cells and on the neovasculature of several other cancer entities. However, the simultaneous expression of PSMA on both, tumor cells as well as tumor vessels remains unclear, even if such "dual" expression would constitute an important asset to facilitate sufficient influx of effector cells to a given tumor site. We report here on the generation of a PSMA antibody, termed 10B3, which exerts superior dual reactivity on sections of prostate carcinoma and squamous cell carcinoma of the lung. 10B3 was used for the construction of T-cell recruiting bispecific PSMAxCD3 antibodies in Fab- and IgG-based formats, designated Fabsc and IgGsc, respectively. In vitro, both molecules exhibited comparable activity. In contrast, only the larger IgGsc molecule induced complete and durable elimination of established tumors in humanized mice due to favorable pharmacokinetic properties. Upon treatment of three patients with metastasized prostate carcinoma with the IgGsc reagent, marked activation of T cells and rapid reduction of elevated PSA levels were observed.
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Christensen SB, Simonsen HT, Engedal N, Nissen P, Møller JV, Denmeade SR, Isaacs JT. From Plant to Patient: Thapsigargin, a Tool for Understanding Natural Product Chemistry, Total Syntheses, Biosynthesis, Taxonomy, ATPases, Cell Death, and Drug Development. PROGRESS IN THE CHEMISTRY OF ORGANIC NATURAL PRODUCTS 2021; 115:59-114. [PMID: 33797641 DOI: 10.1007/978-3-030-64853-4_2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Thapsigargin, the first representative of the hexaoxygenated guaianolides, was isolated 40 years ago in order to understand the skin-irritant principles of the resin of the umbelliferous plant Thapsia garganica. The pronounced cytotoxicity of thapsigargin is caused by highly selective inhibition of the intracellular sarco-endoplasmic Ca2+-ATPase (SERCA) situated on the membrane of the endo- or sarcoplasmic reticulum. Thapsigargin is selective to the SERCA pump and to a minor extent the secretory pathway Ca2+/Mn2+ ATPase (SPCA) pump. Thapsigargin has become a tool for investigation of the importance of SERCA in intracellular calcium homeostasis. In addition, complex formation of thapsigargin with SERCA has enabled crystallization and structure determination of calcium-free states by X-ray crystallography. These results led to descriptions of the mechanism of action and kinetic properties of SERCA and other ATPases. Inhibition of SERCA depletes Ca2+ from the sarco- and endoplasmic reticulum provoking the unfolded protein response, and thereby has enabled new studies on the mechanism of cell death. Development of protocols for selective transformation of thapsigargin disclosed the chemistry and facilitated total synthesis of the molecule. Conversion of trilobolide into thapsigargin offered an economically feasible sustainable source of thapsigargin, which enables a future drug production. Principles for prodrug development were used by conjugating a payload derived from thapsigargin with a hydrophilic peptide selectively cleaved by proteases in the tumor. Mipsagargin was developed in order to obtain a drug for treatment of cancer diseases characterized by the presence of prostate specific membrane antigen (PSMA) in the neovascular tissue of the tumors. Even though mipsagargin showed interesting clinical effects the results did not encourage funding and consequently the attempt to register the drug has been abandoned. In spite of this disappointing fact, the research performed to develop the drug has resulted in important scientific discoveries concerning the chemistry, biosynthesis and biochemistry of sesquiterpene lactones, the mechanism of action of ATPases including SERCA, mechanisms for cell death caused by the unfolded protein response, and the use of prodrugs for cancer-targeting cytotoxins. The presence of toxins in only some species belonging to Thapsia also led to a major revision of the taxonomy of the genus.
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Affiliation(s)
- Søren Brøgger Christensen
- Department of Drug Design and Pharmacology, University of Copenhagen, Universitetsparken 2, 2100, Copenhagen Ø, Denmark.
| | - Henrik Toft Simonsen
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Søltofts Plads, Bld 223, 2800, Kgs. Lyngby, Denmark
| | - Nikolai Engedal
- Department of Tumor Biology, Institute for Cancer Research, University Hospital, Montebello, 0379, Oslo, Norway
| | - Poul Nissen
- Department of Molecular Biology and Genetics, Danish Research Institute of Translational Neuroscience - DANDRITE, Nordic EMBL Partnership for Molecular Medicine, Aarhus University, Gustav Wieds Vej 10C, 8000, Aarhus C, Denmark
| | - Jesper Vuust Møller
- Department of Biomedicine, Aarhus University, Ole Worms Allé 3, Bld 1182, Room 114, 8000, Aarhus C, Denmark
| | - Samuel R Denmeade
- Department of Oncology, Prostate Cancer Program, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Maryland, The Johns Hopkins University School of Medicine, Baltimore, The Bunting-Blaustein Cancer Research Building, 1650 Orleans Street, Baltimore, MD, 21231, USA
| | - John T Isaacs
- Department of Oncology, Prostate Cancer Program, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Maryland, The Johns Hopkins University School of Medicine, Baltimore, The Bunting-Blaustein Cancer Research Building, 1650 Orleans Street, Baltimore, MD, 21231, USA
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Lawhn-Heath C, Yom SS, Liu C, Villanueva-Meyer JE, Aslam M, Smith R, Narwal M, Juarez R, Behr SC, Pampaloni MH, Chan JW, Glastonbury CM, Hope TA, Flavell RR. Gallium-68 prostate-specific membrane antigen ([ 68Ga]Ga-PSMA-11) PET for imaging of thyroid cancer: a feasibility study. EJNMMI Res 2020; 10:128. [PMID: 33090273 PMCID: PMC7581659 DOI: 10.1186/s13550-020-00720-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 10/16/2020] [Indexed: 11/17/2022] Open
Abstract
Background Prostate-specific membrane antigen (PSMA) is expressed in the microvasculature of thyroid cancer. This suggests the potential use of PSMA as a diagnostic agent in patients with aggressive forms of thyroid cancer. The purpose of the current study was to determine the feasibility and utility of [68Ga]Ga-PSMA-11 PET/MRI in thyroid cancer patients. Methods Eligible patients for this prospective pilot study were adults with a history of pathology-proven thyroid cancer who had abnormal radiotracer uptake on an 2-[18F]FDG PET and/or 131I scintigraphy performed in the 12 months prior to study enrollment. Patients underwent a [68Ga]Ga-PSMA-11 PET/MRI, and comparison was made to the prior qualifying 2-[18F]FDG PET CT/MRI for lesion location and relative intensity. Results Twelve patients underwent [68Ga]Ga-PSMA-11 PET/MRI, one of which was excluded from analysis due to debulking surgery prior to the PSMA PET. Of the remaining patients, 7/11 had differentiated disease (3 papillary, 2 follicular, 2 Hurthle cell) and 4/11 had dedifferentiated disease (2 poorly differentiated papillary, 2 anaplastic). Out of 43 lesions, 41 were visually 2-[18F]FDG positive (uptake greater than background, detection rate 95.3%) and 28 were PSMA positive (uptake greater than background, detection rate 65.1%). Uptake was heterogeneous between patients, and in some cases within patients. 3/11 patients (1 poorly differentiated papillary, 2 follicular) had PSMA uptake which was greater than FDG uptake. For the remaining 8 patients, 2-[18F]FDG uptake was greater than PSMA. Using one eligibility guideline in the prostate cancer literature for PSMA radioligand therapy (RLT), 8/11 could be considered eligible for possible future PSMA RLT. This was not predictable based on thyroid cancer subtype. Conclusions [68Ga]Ga-PSMA-11 PET demonstrated lower detection rate when compared to 2-[18F]FDG PET for thyroid cancer lesion visualization. Thyroid cancer subtype alone may not be sufficient to predict PSMA uptake, and radiotracer uptake may vary between patients and even within patients.
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Affiliation(s)
- Courtney Lawhn-Heath
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, Lobby 6, Box 0946, San Francisco, CA, 94143, USA
| | - Sue S Yom
- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, USA
| | - Chienying Liu
- Department of Medicine, Division of Endocrinology, University of California San Francisco, San Francisco, CA, USA
| | - Javier E Villanueva-Meyer
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, Lobby 6, Box 0946, San Francisco, CA, 94143, USA
| | - Maya Aslam
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, Lobby 6, Box 0946, San Francisco, CA, 94143, USA
| | - Raven Smith
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, Lobby 6, Box 0946, San Francisco, CA, 94143, USA
| | - Manpreet Narwal
- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, USA
| | - Roxanna Juarez
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, Lobby 6, Box 0946, San Francisco, CA, 94143, USA
| | - Spencer C Behr
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, Lobby 6, Box 0946, San Francisco, CA, 94143, USA
| | - Miguel Hernandez Pampaloni
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, Lobby 6, Box 0946, San Francisco, CA, 94143, USA
| | - Jason W Chan
- Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, USA
| | - Christine M Glastonbury
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, Lobby 6, Box 0946, San Francisco, CA, 94143, USA
| | - Thomas A Hope
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, Lobby 6, Box 0946, San Francisco, CA, 94143, USA
| | - Robert R Flavell
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, Lobby 6, Box 0946, San Francisco, CA, 94143, USA. .,Department of Pharmaceutical Chemistry, University of California San Francisco, San Francisco, CA, USA.
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68Ga-PSMA-Avid Small Cell Lung Cancer on PET/CT: Incidental Second Malignancy in Treated Prostate Cancer. Clin Nucl Med 2020; 45:1016-1017. [PMID: 32956110 DOI: 10.1097/rlu.0000000000003270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Ga-prostate-specific membrane antigen (Ga-PSMA) PET/CT has shown excellent results in imaging of prostate cancer. Some nonprostatic malignancies can also demonstrate Ga-PSMA uptake, including primary lung adenocarcinoma. However, no such data are present for small cell lung cancer. We present the case of a 59-year-old man, where a second primary metastatic small cell lung cancer was discovered on Ga-PSMA PET/CT done for suspected recurrence of prostate cancer.
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30
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Jafari E, Ahmadzadehfar H, Dadgar H, Assadi M. An overview on prostate-specific membrane antigen uptake in malignancies other than prostate cancer: A pictorial essay. World J Nucl Med 2020; 19:260-265. [PMID: 33354182 PMCID: PMC7745855 DOI: 10.4103/wjnm.wjnm_78_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 12/28/2019] [Indexed: 01/10/2023] Open
Abstract
Prostate-specific membrane antigen (PSMA) is a Type II transmembrane glycoprotein which is extremely overexpressed in prostate cancer epithelial cells. Recently, PSMA-targeted small molecule labeled with 68Ga and 99mTc allowed precise molecular imaging of prostate cancer and PSMA-targeted small molecule labeled with 177Lu leads to the development of radionuclide-targeted therapy of prostate cancer. Despite its name, it has been shown that PSMA has been expressed in several malignancies which can be due to significant neovascularization. Present pictorial assay reports the nonspecific tracer uptake in some malignancies during 68Ga-PSMA positron-emission tomography/computed tomography imaging and 99mTc-PSMA scintigraphy.
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Affiliation(s)
- Esmail Jafari
- Department of Molecular Imaging and Radionuclide Therapy, The Persian Gulf Nuclear Medicine Research Center, Bushehr Medical University Hospital, Bushehr University of Medical Sciences, Bushehr, Iran
| | | | - Habibollah Dadgar
- Cancer Research Center, RAZAVI Hospital, Imam Reza International University, Mashhad, Iran
| | - Majid Assadi
- Department of Molecular Imaging and Radionuclide Therapy, The Persian Gulf Nuclear Medicine Research Center, Bushehr Medical University Hospital, Bushehr University of Medical Sciences, Bushehr, Iran
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31
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Impact of PSMA PET/CT in prostate cancer patient’s clinical management: a pictorial essay of interesting cases with histologic confirmation. Clin Transl Imaging 2020. [DOI: 10.1007/s40336-020-00372-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Ahn T, Roberts MJ, Abduljabar A, Joshi A, Perera M, Rhee H, Wood S, Vela I. A Review of Prostate-Specific Membrane Antigen (PSMA) Positron Emission Tomography (PET) in Renal Cell Carcinoma (RCC). Mol Imaging Biol 2020; 21:799-807. [PMID: 30617728 DOI: 10.1007/s11307-018-01307-0] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Metastatic renal cell carcinoma (mRCC) is a disease that portends poor prognosis despite an increasing number of novel systemic treatment options including new targeted therapies and immunotherapy. Ablative intervention directed at oligometastatic RCC has demonstrated survival benefit. Consequently, developing techniques for improved staging of mRCC on contemporary imaging modalities including X-ray computed tomography (CT), magnetic resonance imaging (MRI) and/or bone scan (BS) is a clinical priority. This is relevant for metastatic deposits too small to characterize or lymph nodes within physiological normality. Prostate-specific membrane antigen (PSMA) is a type II transmembrane glycoprotein highly expressed on prostate cancer epithelial cells. Recently, small molecules targeting the PSMA receptor, linked to radioactive isotopes have been developed for use with positron emission tomography (PET). Despite its nomenclature, PSMA has also been found to be expressed in the neovasculature of non-prostate cancers such as renal cell carcinoma (RCC) and hence PSMA PET/CT imaging has been proposed as an alternative staging modality. Preliminary small studies involving the use of PSMA PET/CT imaging in mRCC have been encouraging with evidence of improved staging sensitivity which has directly led to change in management in some cases. Given these early encouraging reports, we performed a comprehensive narrative review on the available evidence, including the scientific basis for PSMA expression in RCC, the role of PSMA PET/CT imaging with potential clinical implications in mRCC, its limitations and future opportunities.
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Affiliation(s)
- Thomas Ahn
- Department of Urology, Greenslopes Private Hospital, Brisbane, Queensland, Australia. .,Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
| | - Matthew J Roberts
- Department of Urology, Greenslopes Private Hospital, Brisbane, Queensland, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.,Department of Urology, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Aous Abduljabar
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Andre Joshi
- Department of Urology, Townsville Hospital, Brisbane, Queensland, Australia.,Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia.,Centre for Kidney Disease Research, Translational Research Institute, Brisbane, Australia
| | - Marlon Perera
- Department of Urology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,Department of Surgery, Austin Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Handoo Rhee
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.,Department of Urology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Simon Wood
- Department of Urology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,Centre for Kidney Disease Research, Translational Research Institute, Brisbane, Australia
| | - Ian Vela
- Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.,Department of Urology, Princess Alexandra Hospital, Brisbane, Queensland, Australia.,Australian Prostate Cancer Research Center Queensland, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
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Tanjore Ramanathan J, Lehtipuro S, Sihto H, Tóvári J, Reiniger L, Téglási V, Moldvay J, Nykter M, Haapasalo H, Le Joncour V, Laakkonen P. Prostate-specific membrane antigen expression in the vasculature of primary lung carcinomas associates with faster metastatic dissemination to the brain. J Cell Mol Med 2020; 24:6916-6927. [PMID: 32390293 PMCID: PMC7299712 DOI: 10.1111/jcmm.15350] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 01/10/2020] [Accepted: 03/01/2020] [Indexed: 01/10/2023] Open
Abstract
Glioblastomas and brain metastases (BM) of solid tumours are the most common central nervous system neoplasms associated with very unfavourable prognosis. In this study, we report the association of prostate‐specific membrane antigen (PSMA) with various clinical parameters in a large cohort of primary and secondary brain tumours. A tissue microarray containing 371 cases of ascending grades of gliomas pertaining to astrocytic origin and samples of 52 cases of primary lung carcinomas with matching BM with follow‐up time accounting to 10.4 years was evaluated for PSMA expression using immunohistochemistry. In addition, PSMA expression was studied in BM arising from melanomas and breast carcinomas. Neovascular expression of PSMA was evident alongside with high expression in the proliferating microvasculature of glioblastomas when compared to the tumour cell expression. This result correlated with the results obtained from the in silico (cancer genome databases) analyses. In gliomas, only the vascular expression of PSMA associated with poor overall survival but not the tumour cell expression. In the matched primary lung cancers and their BM (n = 52), vascular PSMA expression in primary tumours associated with significantly accelerated metastatic dissemination to the brain with a tendency towards poor overall survival. Taken together, we report that the vascular expression of PSMA in the primary and secondary brain tumours globally associates with the malignant progression and poor outcome of the patients.
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Affiliation(s)
| | - Suvi Lehtipuro
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Harri Sihto
- Translational Cancer Medicine Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - József Tóvári
- Department of Experimental Pharmacology, National Institute of Oncology, Budapest, Hungary
| | - Lilla Reiniger
- SE-NAP Brain Metastasis Research group, 2nd Department of Pathology, Semmelweis University, Budapest, Hungary.,1st Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Vanda Téglási
- 1st Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Judit Moldvay
- SE-NAP Brain Metastasis Research group, 2nd Department of Pathology, Semmelweis University, Budapest, Hungary.,Department of Tumor Biology, National Korányi Institute of Pulmonology-Semmelweis University, Budapest, Hungary
| | - Matti Nykter
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Science Center, Tampere University Hospital, Tampere, Finland
| | - Hannu Haapasalo
- Department of Pathology, University of Tampere and Fimlab laboratories, Tampere, Finland
| | - Vadim Le Joncour
- Translational Cancer Medicine Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Pirjo Laakkonen
- Translational Cancer Medicine Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Laboratory Animal Centre, HiLIFE - Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
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Van de Wiele C, Sathekge M, de Spiegeleer B, De Jonghe PJ, Debruyne PR, Borms M, Beels L, Maes A. PSMA expression on neovasculature of solid tumors. Histol Histopathol 2020; 35:919-927. [PMID: 32282924 DOI: 10.14670/hh-18-215] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The use of prostate specific membrane antigen (PSMA) binding agents, labelled with diagnostic and therapeutic radio-isotopes is opening the potential for a new era of personalized management of prostate carcinoma. A wide variety of immunohistochemistry studies have shown PSMA also to be upregulated on the endothelial cells of the neovasculature of a wide variety of other solid tumors where it may facilitate endothelial cell sprouting and invasion through its regulation of lytic proteases that have the ability to cleave the extracellular matrix. Similar to the introduction of PSMA-targeting theranostics in prostate carcinoma, overexpression of PSMA on newly formed tumor vessels may serve as a target for imaging and subsequent treatment of cancer through the use of agents that are capable of blocking PSMA in its function or through PSMA-mediated delivery of chemotherapeutics or radiation agents. In this review, the available data on PSMA expression on tumor neovasculature in human solid tumors assessed by using immunohistochemistry are discussed.
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Affiliation(s)
- Christophe Van de Wiele
- Department of Nuclear Medicine, AZ Groeninge, Kortrijk, Belgium.,Department of Nuclear Medicine and Radiology, Ghent University, Ghent, Belgium.
| | - Mike Sathekge
- Department of Nuclear Medicine, University of Pretoria, Pretoria, South-Africa
| | - Bart de Spiegeleer
- Laboratory of Drug Quality and Registration, Ghent University, Ghent, Belgium
| | | | - Philip R Debruyne
- Department of Radiotherapy and Medical Oncology, AZ Groeninge, Kortrijk, Belgium
| | - Marleen Borms
- Department of Radiotherapy and Medical Oncology, AZ Groeninge, Kortrijk, Belgium
| | - Laurence Beels
- Department of Nuclear Medicine, AZ Groeninge, Kortrijk, Belgium.,Department of Imaging and Pathology @ KULAK, KU Leuven campus Kulak, Kortrijk, Belgium
| | - Alex Maes
- Department of Nuclear Medicine, AZ Groeninge, Kortrijk, Belgium.,Department of Imaging and Pathology @ KULAK, KU Leuven campus Kulak, Kortrijk, Belgium
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68Ga-PSMA PET/CT in radioactive iodine-refractory differentiated thyroid cancer and first treatment results with 177Lu-PSMA-617. EJNMMI Res 2020; 10:18. [PMID: 32144510 PMCID: PMC7060303 DOI: 10.1186/s13550-020-0610-x] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 02/18/2020] [Indexed: 01/19/2023] Open
Abstract
Background Differentiated thyroid carcinoma (DTC) is the most common type of thyroid cancer. Treatment with surgery, radioactive iodine (RAI), and TSH suppression is effective in most patients. Five to 15% of patients become RAI refractory and need alternative therapy; however, treatment options are limited. 68Ga-PSMA PET/CT, originally developed for prostate cancer, is also applicable to other malignancies, including thyroid carcinoma. The uptake of PSMA in thyroid carcinoma gives opportunities for imaging and therapy of RAI-refractory DTC. The aim of this study was to analyze imaging on 68Ga-PSMA PET/CT and evaluate the response to 177Lu-PSMA-617 therapy in patients with RAI-refractory DTC. Materials and methods Five patients with RAI-refractory DTC underwent 68Ga-PSMA PET/CT to determine their eligibility for 177Lu-PSMA-617 therapy. 68Ga-PSMA PET/CTs were analyzed visually and quantitatively. Response to 177Lu-PSMA-617 therapy was evaluated using imaging and thyroglobulin (Tg) values. Results Tracer uptake suspicious for distant metastases was depicted in all 68Ga-PSMA PET/CTs. Based on tracer uptake, three patients were eligible for 177Lu-PSMA-617 therapy, of whom two were treated. One patient showed disease progression on imaging 1 month later, while her Tg values gradually increased from 18 to 63 μg/L in the months after treatment. Another patient showed partial, temporary response of lung and liver metastases. Her Tg levels initially decreased from 17 to 9 μg/L. However, 7 months after treatment, there was disease progression on imaging and Tg levels had increased to 14 μg/L. Imaging with 68Ga-PSMA PET/CT could be compared to 18FDG PET/CT in three patients. Two patients showed additional lesions on 68Ga-PSMA PET/CT, and one patient showed concordant imaging. Conclusion 68Ga-PSMA PET/CT appears to have added value in patients with RAI-refractory DTC, as it is able to detect various types of lesions, some of which were not picked up by 18FDG PET/CT. Furthermore, 68Ga-PSMA PET/CT might be used to identify patients eligible for treatment with 177Lu-PSMA-617. One of the two patients who underwent 177Lu-PSMA-617 therapy showed a modest, temporary response. To draw conclusions about the effectiveness of this therapy, more research is needed.
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Wang H, Liu P, Mi J, Chen J, Liu Y. A Preliminary Study of Adoptive T-cell Transfer Therapy for Patients With Non-Small-cell Lung Adenocarcinoma With Brain Metastasis: A Case Report of 3 Patients. Clin Lung Cancer 2020; 21:e270-e273. [PMID: 32192894 DOI: 10.1016/j.cllc.2020.02.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 02/04/2020] [Accepted: 02/13/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Hailong Wang
- Department of Oncology, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
| | - Pengfei Liu
- Department of Oncology, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
| | - Jiahui Mi
- Department of Thoracic Surgery, Peking University Peoples Hospital, Beijing, China
| | - Junhui Chen
- Intervention and Cell Therapy Center, Peking University Shenzhen Hospital, Shenzhen, China
| | - Yong Liu
- Intervention and Cell Therapy Center, Peking University Shenzhen Hospital, Shenzhen, China.
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Vornov JJ, Peters D, Nedelcovych M, Hollinger K, Rais R, Slusher BS. Looking for Drugs in All the Wrong Places: Use of GCPII Inhibitors Outside the Brain. Neurochem Res 2019; 45:1256-1267. [PMID: 31749072 DOI: 10.1007/s11064-019-02909-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 11/06/2019] [Accepted: 11/08/2019] [Indexed: 12/12/2022]
Abstract
In tribute to our friend and colleague Michael Robinson, we review his involvement in the identification, characterization and localization of the metallopeptidase glutamate carboxypeptidase II (GCPII), originally called NAALADase. While Mike was characterizing NAALADase in the brain, the protein was independently identified by other laboratories in human prostate where it was termed prostate specific membrane antigen (PSMA) and in the intestines where it was named Folate Hydrolase 1 (FOLH1). It was almost a decade to establish that NAALADase, PSMA, and FOLH1 are encoded by the same gene. The enzyme has emerged as a therapeutic target outside of the brain, with the most notable progress made in the treatment of prostate cancer and inflammatory bowel disease (IBD). PSMA-PET imaging with high affinity ligands is proving useful for the clinical diagnosis and staging of prostate cancer. A molecular radiotherapy based on similar ligands is in trials for metastatic castration-resistant prostate cancer. New PSMA inhibitor prodrugs that preferentially block kidney and salivary gland versus prostate tumor enzyme may improve the clinical safety of this radiotherapy. The wide clinical use of PSMA-PET imaging in prostate cancer has coincidentally led to clinical documentation of GCPII upregulation in a wide variety of tumors and inflammatory diseases, likely associated with angiogenesis. In IBD, expression of the FOLH1 gene that codes for GCPII is strongly upregulated, as is the enzymatic activity in diseased patient biopsies. In animal models of IBD, GCPII inhibitors show substantial efficacy, suggesting potential theranostic use of GCPII ligands for IBD.
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Affiliation(s)
- James J Vornov
- Johns Hopkins Drug Discovery, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA
- Medpace, Cincinnati, OH, USA
| | - Diane Peters
- Johns Hopkins Drug Discovery, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA
- Department of Molecular and Comparative Pathobiology, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA
| | - Mike Nedelcovych
- Johns Hopkins Drug Discovery, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA
| | - Kristen Hollinger
- Johns Hopkins Drug Discovery, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA
| | - Rana Rais
- Johns Hopkins Drug Discovery, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA
| | - Barbara S Slusher
- Johns Hopkins Drug Discovery, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA.
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA.
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA.
- Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA.
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA.
- Department of Oncology, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA.
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38
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Morgenroth A, Tinkir E, Vogg ATJ, Sankaranarayanan RA, Baazaoui F, Mottaghy FM. Targeting of prostate-specific membrane antigen for radio-ligand therapy of triple-negative breast cancer. Breast Cancer Res 2019; 21:116. [PMID: 31640747 PMCID: PMC6805467 DOI: 10.1186/s13058-019-1205-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 09/23/2019] [Indexed: 12/20/2022] Open
Abstract
Background Triple-negative breast cancer has extremely high risk of relapse due to the lack of targeted therapies, intra- and inter-tumoral heterogeneity, and the inherent and acquired resistance to therapies. In this study, we evaluate the potential of prostate-specific membrane antigen (PSMA) as target for radio-ligand therapy (RLT). Methods Tube formation was investigated after incubation of endothelial HUVEC cells in tumor-conditioned media and monitored after staining using microscopy. A binding study with 68Ga-labeled PSMA-addressing ligand was used to indicate targeting potential of PSMA on tumor-conditioned HUVEC cells. For mimicking of the therapeutic application, tube formation potential and vitality of tumor-conditioned HUVEC cells were assessed following an incubation with radiolabeled PSMA-addressing ligand [177Lu]-PSMA-617. For in vivo experiments, NUDE mice were xenografted with triple-negative breast cancer cells MDA-MB231 or estrogen receptor expressing breast cancer cells MCF-7. Biodistribution and binding behavior of [68Ga]-PSMA-11 was investigated in both tumor models at 30 min post injection using μPET. PSMA- and CD31-specific staining was conducted to visualize PSMA expression and neovascularization in tumor tissue ex vivo. Results The triple-negative breast cancer cells MDA-MB231 showed a high pro-angiogenetic potential on tube formation of endothelial HUVEC cells. The induced endothelial expression of PSMA was efficiently addressed by radiolabeled PSMA-specific ligands. 177Lu-labeled PSMA-617 strongly impaired the vitality and angiogenic potential of HUVEC cells. In vivo, as visualized by μPET, radiolabeled PSMA-ligand accumulated specifically in the triple-negative breast cancer xenograft MDA-MB231 (T/B ratio of 43.3 ± 0.9), while no [68Ga]-PSMA-11 was detected in the estrogen-sensitive MCF-7 xenograft (T/B ratio of 1.1 ± 0.1). An ex vivo immunofluorescence analysis confirmed the localization of PSMA on MDA-MB231 xenograft-associated endothelial cells and also on TNBC cells. Conclusions Here we demonstrate PSMA as promising target for two-compartment endogenous radio-ligand therapy of triple-negative breast cancer.
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Affiliation(s)
- Agnieszka Morgenroth
- Department of Nuclear Medicine, University Hospital Aachen, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany.
| | - Ebru Tinkir
- Department of Nuclear Medicine, University Hospital Aachen, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany
| | - Andreas T J Vogg
- Department of Nuclear Medicine, University Hospital Aachen, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany
| | - Ramya Ambur Sankaranarayanan
- Department of Nuclear Medicine, University Hospital Aachen, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany
| | - Fatima Baazaoui
- Department of Nuclear Medicine, University Hospital Aachen, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany
| | - Felix M Mottaghy
- Department of Nuclear Medicine, University Hospital Aachen, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany.,Department of Radiology and Nuclear Medicine, Maastricht University Medical Center X, Maastricht, The Netherlands
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Emond EC, Groves AM, Hutton BF, Thielemans K. Effect of positron range on PET quantification in diseased and normal lungs. Phys Med Biol 2019; 64:205010. [PMID: 31539891 DOI: 10.1088/1361-6560/ab469d] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The impact of positron range on PET image reconstruction has often been investigated as a blurring effect that can be partly corrected by adding an element to the PET system matrix in the reconstruction, usually based on a Gaussian kernel constructed from the attenuation values. However, the physics involved in PET is more complex. In regions where density does not vary, positron range indeed involves mainly blurring. However, in more heterogeneous media it can cause other effects. This work focuses on positron range in the lungs and its impact on quantification, especially in the case of pathologies such as cancer or pulmonary fibrosis, for which the lungs have localised varying density. Using Monte Carlo simulations, we evaluate the effects of positron range for multiple radionuclides (18F, 15O, 68Ga, 89Zr, 82Rb, 64Cu and 124I) as, for novel radiotracers, the choice of the labelling radionuclide is important. The results demonstrate quantification biases in highly heterogeneous media, where the measured uptake of high-density regions can be increased by the neighbouring radioactivity from regions of lower density, with the effect more noticeable for radionuclides with high-energy positron emission. When the low-density regions are considered to have less radioactive uptake (e.g. due to the presence of air), the effect is less severe.
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Affiliation(s)
- Elise C Emond
- Institute of Nuclear Medicine, University College London, London NW1 2BU, United Kingdom. Author to whom correspondence should be addressed
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Incidental Detection of Pleomorphic Sarcoma on 68Ga-PSMA PET/CT in a Patient With Prostate Cancer. Clin Nucl Med 2019; 45:e120-e121. [PMID: 31490315 DOI: 10.1097/rlu.0000000000002760] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Ga prostate-specific membrane antigen (PSMA) PET/CT is used in the staging, evaluation of biochemical recurrence, and response assessment of patients with prostate cancer. In addition to the PSMA-expressing prostate cancer cells, Ga-PSMA binds to the neovasculaature of various other solid tumors and benign lesions. We report a case of a 72-year-old man with recently diagnosed adenocarcinoma of prostate, incidentally found to have pleomorphic sarcoma on the staging Ga-PSMA PET/CT.
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Kawatani M, Yamamoto K, Yamada D, Kamiya M, Miyakawa J, Miyama Y, Kojima R, Morikawa T, Kume H, Urano Y. Fluorescence Detection of Prostate Cancer by an Activatable Fluorescence Probe for PSMA Carboxypeptidase Activity. J Am Chem Soc 2019; 141:10409-10416. [PMID: 31244179 DOI: 10.1021/jacs.9b04412] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Prostate cancer (PCa) is a common malignant tumor among adult males, and convenient intraoperative detection of PCa would reduce the risk of leaving positive surgical margins, especially during nerve-sparing procedures. To achieve rapid, fluorescence-based visualization of PCa, we focused on the glutamate carboxypeptidase (CP) activity of prostate-specific membrane antigen (PSMA), a type II transmembrane glycoprotein that is attracting attention as a PCa biomarker. Based on our finding that aryl glutamate conjugates with an azoformyl linker are recognized by PSMA and have a sufficiently low LUMO (lowest unoccupied molecular orbital) energy level to quench the fluorophore through photoinduced electron transfer, we designed and synthesized a first-in-class activatable fluorescence probe for CP activity of PSMA. The developed probe allowed us to visualize the CP activity of PSMA in living cells and in clinical specimens from PCa patients and is expected to be useful for rapid intraoperative detection and diagnosis of PCa.
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Affiliation(s)
| | | | - Daisuke Yamada
- Department of Urology, Faculty of Medicine , The University of Tokyo , 7-3-1 Hongo , Bunkyo-ku, Tokyo 113-8655 , Japan
| | - Mako Kamiya
- PRESTO, Japan Science and Technology Agency , 4-1-8 Honcho , Kawaguchi, Saitama 332-0012 , Japan
| | - Jimpei Miyakawa
- Department of Urology, Faculty of Medicine , The University of Tokyo , 7-3-1 Hongo , Bunkyo-ku, Tokyo 113-8655 , Japan
| | - Yu Miyama
- Department of Pathology, Graduate School of Medicine , The University of Tokyo , 7-3-1 Hongo , Bunkyo-ku, Tokyo 113-8655 , Japan
| | - Ryosuke Kojima
- PRESTO, Japan Science and Technology Agency , 4-1-8 Honcho , Kawaguchi, Saitama 332-0012 , Japan
| | - Teppei Morikawa
- Department of Pathology, Graduate School of Medicine , The University of Tokyo , 7-3-1 Hongo , Bunkyo-ku, Tokyo 113-8655 , Japan
| | - Haruki Kume
- Department of Urology, Faculty of Medicine , The University of Tokyo , 7-3-1 Hongo , Bunkyo-ku, Tokyo 113-8655 , Japan
| | - Yasuteru Urano
- AMED-CREST, Japan Agency for Medical Research and Development , 1-7-1 Otemachi , Chiyoda-ku, Tokyo , 100-0004 , Japan
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Jiao D, Li Y, Yang F, Han D, Wu J, Shi S, Tian F, Guo Z, Xi W, Li G, Zhao A, Yang AG, Qin W, Wang H, Wen W. Expression of Prostate-Specific Membrane Antigen in Tumor-Associated Vasculature Predicts Poor Prognosis in Hepatocellular Carcinoma. Clin Transl Gastroenterol 2019; 10:1-7. [PMID: 31116141 PMCID: PMC6602770 DOI: 10.14309/ctg.0000000000000041] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 03/12/2019] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Prostate-specific membrane antigen (PSMA) was originally found to be specifically expressed in normal prostate, and its expression was upregulated in almost all stages of prostate cancer. In recent years, PSMA was also found to be expressed in tumor-associated vasculature in many nonprostatic solid tumors. However, the expression pattern of PSMA in hepatocellular carcinoma (HCC) is not well studied. METHODS In this study, we examined PSMA expression in 103 HCC tissues using immunohistochemical staining and analyzed the association between PSMA expression and other clinicopathological features and prognosis. RESULTS Among the 103 cases, 27 cases (26%) showed PSMA expression in more than 50% of tumor-associated vasculature, 49 cases (48%) showed PSMA expression in less than 50% of vasculature, and 27 cases (26%) did not have detectable PSMA expression. Vascular PSMA expression was associated with several clinicopathological features, such as tumor stage, tumor differentiation, lymph node metastasis, and Ki-67 index. Furthermore, high vascular PSMA expression was also associated with poor prognosis in patients with HCC. Univariate and multivariate analyses showed that high vascular PSMA expression can be used as an independent prognostic marker for HCC. DISCUSSION Our study provides the evidence that PSMA is specifically expressed in tumor-associated vasculature of HCC, and vascular PSMA expression may be used as a novel prognostic marker and a vascular therapeutic target for HCC.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Antigens, Surface/analysis
- Antigens, Surface/metabolism
- Antineoplastic Agents/pharmacology
- Antineoplastic Agents/therapeutic use
- Biomarkers, Tumor/analysis
- Biomarkers, Tumor/antagonists & inhibitors
- Biomarkers, Tumor/metabolism
- Carcinoma, Hepatocellular/blood supply
- Carcinoma, Hepatocellular/mortality
- Carcinoma, Hepatocellular/pathology
- Carcinoma, Hepatocellular/therapy
- Female
- Follow-Up Studies
- Glutamate Carboxypeptidase II/analysis
- Glutamate Carboxypeptidase II/antagonists & inhibitors
- Glutamate Carboxypeptidase II/metabolism
- Hepatectomy
- Humans
- Immunohistochemistry
- Kaplan-Meier Estimate
- Liver/blood supply
- Liver/pathology
- Liver/surgery
- Liver Neoplasms/blood supply
- Liver Neoplasms/mortality
- Liver Neoplasms/pathology
- Liver Neoplasms/therapy
- Lymphatic Metastasis/pathology
- Male
- Middle Aged
- Neoplasm Staging
- Neovascularization, Pathologic/mortality
- Neovascularization, Pathologic/pathology
- Neovascularization, Pathologic/therapy
- Prognosis
- Time Factors
- Young Adult
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Affiliation(s)
- Dian Jiao
- Department of Urology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Yu Li
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Fa Yang
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Donghui Han
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Jieheng Wu
- State Key Laboratory of Cancer Biology, Department of Immunology, Fourth Military Medical University, Xi'an, China
| | - Shengjia Shi
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Feng Tian
- Department of Urology, the Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Zhangyan Guo
- State Key Laboratory of Cancer Biology, Department of Immunology, Fourth Military Medical University, Xi'an, China
| | - Wenjin Xi
- State Key Laboratory of Cancer Biology, Department of Immunology, Fourth Military Medical University, Xi'an, China
| | | | | | - An-Gang Yang
- State Key Laboratory of Cancer Biology, Department of Immunology, Fourth Military Medical University, Xi'an, China
| | - Weijun Qin
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - He Wang
- Department of Urology, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Weihong Wen
- State Key Laboratory of Cancer Biology, Department of Immunology, Fourth Military Medical University, Xi'an, China
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Morgantetti G, Ng KL, Samaratunga H, Rhee H, Gobe GC, Wood ST. Prostate specific membrane antigen (PSMA) expression in vena cava tumour thrombi of clear cell renal cell carcinoma suggests a role for PSMA-driven tumour neoangiogenesis. Transl Androl Urol 2019; 8:S147-S155. [PMID: 31236332 DOI: 10.21037/tau.2019.04.10] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background Clear cell renal cell carcinoma (ccRCC) is a malignant renal neoplasm with a peculiar propensity to propagate as a contiguous tumor extension via the renal vein and inferior vena cava, occasionally reaching the right atrium. This intravascular tumor extension, often referred to as a tumor thrombus, represents the active growing front of the cancer. Prostate specific membrane antigen (PSMA), a glycoprotein that is extensively used in prostate cancer diagnostics, is a useful vascular marker for a variety of solid tumors. It is expressed in renal carcinomas. The aim of the current investigation was to analyse and compare the expression of PSMA at the growing front of the vena cava tumor extension with that found in the primary renal lesion. Methods Immunohistochemical (IHC) analysis of PSMA and CD34 was performed on archived paraffin embedded vena cava tumour thrombus tissue and matching renal tumours. These specimens were collected from radical nephrectomies of 10 patients with vena cava invasive (pT3b) ccRCC in a large tertiary hospital in Australia. Quantitative and qualitative morphometric analysis of PSMA IHC expression was performed with Aperio ImageScope morphometry using intensity and positive pixel counts of CD34 and PSMA from the IVC tumour slides and the corresponding renal tumour mass. Results PSMA and CD34 immunostaining were noted in the neovasculature of IVC tumour and renal tumour tissue. There was a higher PSMA/CD34 positive pixel count ratio noted in IVC tumour tissue when compared to renal tumour tissue. PSMA showed consistently increased expression in vena cava tumour, in comparison with the renal tumour mass. Conclusions Intravascular venous tumour extension expresses PSMA more intensely compared to intrarenal tumour tissue neovasculature. Our data suggest a possible mechanism for PSMA in neoangiogenesis and local progression of ccRCC and therefore its usefulness as a biomarker of neoangiogenesis for future diagnostic and therapeutic advancements.
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Affiliation(s)
- Giuliano Morgantetti
- Departamento de Patologia, Faculdade de Medicina de Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Keng Lim Ng
- Translational Research Institute, University of Queensland Faculty of Medicine, Brisbane, Australia.,Department of Urology, Princess Alexandra Hospital, Brisbane, Australia
| | | | - Handoo Rhee
- Department of Urology, Princess Alexandra Hospital, Brisbane, Australia
| | - Glenda C Gobe
- Translational Research Institute, University of Queensland Faculty of Medicine, Brisbane, Australia
| | - Simon T Wood
- Department of Urology, Princess Alexandra Hospital, Brisbane, Australia
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Lesniak WG, Boinapally S, Banerjee SR, Behnam Azad B, Foss CA, Shen C, Lisok A, Wharram B, Nimmagadda S, Pomper MG. Evaluation of PSMA-Targeted PAMAM Dendrimer Nanoparticles in a Murine Model of Prostate Cancer. Mol Pharm 2019; 16:2590-2604. [DOI: 10.1021/acs.molpharmaceut.9b00181] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Wojciech G. Lesniak
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland 21287, United States
| | - Srikanth Boinapally
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland 21287, United States
| | - Sangeeta Ray Banerjee
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland 21287, United States
| | - Babak Behnam Azad
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland 21287, United States
| | - Catherine A. Foss
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland 21287, United States
| | - Chentian Shen
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland 21287, United States
- Department of Nuclear Medicine, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai 200233, China
| | - Ala Lisok
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland 21287, United States
| | - Bryan Wharram
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland 21287, United States
| | - Sridhar Nimmagadda
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland 21287, United States
| | - Martin G. Pomper
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Maryland 21287, United States
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45
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Prostate Cancer Pulmonary Metastasis Presenting as a Ground-Glass Pulmonary Nodule on 68Ga-PSMA-11 PET/CT. Clin Nucl Med 2019; 44:e353-e356. [PMID: 30789399 DOI: 10.1097/rlu.0000000000002499] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Ga-prostate-specific membrane antigen 11 (PSMA) PET/CT imaging accurately depicts metastatic prostate adenocarcinoma (PCa). Pulmonary metastases of PCa are often overlooked on follow-up imaging in patients after initial treatment and following androgen deprivation therapy. Here we present a rare case of biopsy-proven PCa pulmonary metastasis with a ground-glass appearance. The increased PSMA expression and the evolving CT features of the solid component of the ground-glass nodule detected by PSMA PET/CT imaging led to surgical resection and PET/CT-guided therapy.
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46
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Intertumoral Heterogeneity of 18F-FDG and 68Ga-PSMA Uptake in Prostate Cancer Pulmonary Metastases. Clin Nucl Med 2019; 44:e28-e32. [PMID: 30394930 DOI: 10.1097/rlu.0000000000002367] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We present a case of a 61-year-old man with history of prostate cancer and rising PSA levels referred for restaging. Ga-PSMA-11 PET/CT identified 2 lung nodules with low and moderate PSMA uptake. Subsequent F-FDG PET/CT showed high hypermetabolism in the nodule with low PSMA uptake, and low hypermetabolism in the nodule with moderate PSMA uptake. The isolated pulmonary findings and metabolic appearance is an atypical presentation of prostate cancer metastases and raised concern for a second primary malignancy. Fine-needle aspiration of the F-FDG active lung nodule confirmed metastatic prostatic adenocarcinoma that subsequently responded to androgen deprivation therapy and abiraterone acetate.
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47
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Mohammadzadeh M, Shirmohammadi M, Ghojazadeh M, Nikniaz L, Raeisi M, Aghdas SAM. Dendritic cells pulsed with prostate-specific membrane antigen in metastatic castration-resistant prostate cancer patients: a systematic review and meta-analysis. Prostate Int 2018; 6:119-125. [PMID: 30505813 PMCID: PMC6251944 DOI: 10.1016/j.prnil.2018.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2017] [Revised: 04/09/2018] [Accepted: 04/19/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Dendritic cells (DCs) are used in many malignancies as vaccines to induce immunity against specific cancer antigens. The role of DCs in metastatic castration-resistant prostate cancer (mCRPC) is not determined. In this study, the proportion of mCRPC patients with clinically significant response to targeted therapy by DCs pulsed with prostate-specific membrane antigen was evaluated, and the possible adverse effects of this modality were investigated. METHODS Major databases were searched up to Feb 2017, to identify studies in which the antitumor efficacy of DCs pulsed with the extracellular portion of PSMA was studied for the treatment of mCRPC. Data were collected by two reviewers and analyzed using Comprehensive Meta-Analysis software, version 2.0. FINDINGS Our study consisted of 6 nonrandomized prospective (cohort) trials, overall reporting on 153 mCRPC patients. The event rate that is the representative of fraction of patients showing antitumor response was 0.43 (95% confidence interval = 0.355-0.512; P = 0.097). No significant between-study heterogeneity or inconsistency was detected (I2 = 5.47; Q = 5; P = 0.382). Our study failed to demonstrate a significant therapeutic efficacy for DCs in mCRPC. However, no significant adverse effects were seen.
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Affiliation(s)
- Mohammad Mohammadzadeh
- Department of Radiology-Radiotherapy-Nuclear Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Masoud Shirmohammadi
- Department of Gastroenterology, Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Morteza Ghojazadeh
- Iranian Center for Evidence-Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- RDCC, Medical faculty, Tabriz university of medical sciences, Tabriz, Iran
| | - Leila Nikniaz
- Tabriz Health services management research center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mortaza Raeisi
- Hematology & Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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48
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Abstract
Prostate cancer cells have abundant expression of the cell surface protein prostate-specific membrane antigen (PSMA). In recent years, PET radioligands detecting this protein has therefore gained substantial interest in prostate cancer staging. It turned out that PSMA expression can be evident in both malignant and benign lesions, and we have previously reported that pulmonary opacities and bronchiectasis can be avid on Ga-PSMA PET/CT. Here, we present a case with Ga-PSMA accumulation in nonobstructive middle lobe syndrome, which further indicate that benign changes in the lungs may be falsely interpreted as malignant disease.
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49
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Evidence of Prostate-Specific Membrane Antigen Expression in Metastatic Differentiated Thyroid Cancer Using 68Ga-PSMA-HBED-CC PET/CT. Clin Nucl Med 2018; 43:e265-e268. [DOI: 10.1097/rlu.0000000000002161] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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50
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Körbel C, Linxweiler M, Bochen F, Wemmert S, Schick B, Meyer M, Maurer H, Menger MD, Zimmermann R, Greiner M. Treatment of SEC62 over-expressing tumors by Thapsigargin and Trifluoperazine. Biomol Concepts 2018; 9:53-63. [PMID: 29779013 DOI: 10.1515/bmc-2018-0006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 03/16/2018] [Indexed: 11/15/2022] Open
Abstract
Treatment with analogues of the SERCA-inhibitor Thapsigargin is a promising new approach for a wide variety of cancer entities. However, our previous studies on various tumor cells suggested resistance of SEC62 over-expressing tumors to this treatment. Therefore, we proposed the novel concept that e.g. lung-, prostate-, and thyroid-cancer patients should be tested for SEC62 over-expression, and developed a novel therapeutic strategy for a combinatorial treatment of SEC62 over-expressing tumors. The latter was based on the observations that treatment of SEC62 over-expressing tumor cells with SEC62-targeting siRNAs showed less resistance to Thapsigargin as well as a reduction in migratory potential and that the siRNA effects can be mimicked by the Calmodulin antagonist Trifluoperazine. Therefore, the combinatorial treatment of SEC62 over-expressing tumors was proposed to involve Thapsigargin and Trifluoperazine. Here, we addressed the impact of Thapsigargin and Trifluoperazine in separate and combined treatments of heterotopic tumors, induced by inoculation of human hypopharyngeal squamous cell carcinoma (FaDu)-cells into the mouse flank. Seeding of the tumor cells and/or their growth rate were significantly reduced by all three treatments, suggesting Trifluoperazine is a small molecule to be considered for future therapeutic strategies for patients, suffering from Sec62-overproducing tumors.
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Affiliation(s)
- Christina Körbel
- Institute for Clinical and Experimental Surgery, Saarland University, Homburg/Saar, saabrucken, Germany
| | - Maximilian Linxweiler
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Hospital, Homburg/Saar, saabrucken, Germany
| | - Florian Bochen
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Hospital, Homburg/Saar, saabrucken, Germany
| | - Silke Wemmert
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Hospital, Homburg/Saar, saabrucken, Germany
| | - Bernhard Schick
- Department of Otorhinolaryngology, Head and Neck Surgery, Saarland University Hospital, Homburg/Saar, saabrucken, Germany
| | - Markus Meyer
- Department of Experimental and Clinical Toxicology, Saarland University, Homburg/Saar, saabrucken, Germany
| | - Hans Maurer
- Department of Experimental and Clinical Toxicology, Saarland University, Homburg/Saar, saabrucken, Germany
| | - Michael D Menger
- Institute for Clinical and Experimental Surgery, Saarland University, Homburg/Saar, saabrucken, Germany
| | - Richard Zimmermann
- Department of Medical Biochemistry and Molecular Biology, Saarland University, Homburg/Saar, saabrucken, Germany
| | - Markus Greiner
- Department of Medical Biochemistry and Molecular Biology, Saarland University, Homburg/Saar, saabrucken, Germany
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