Lutetium-177 prostate-specific membrane antigen (PSMA) theranostics: practical nuances and intricacies.,Prostate Cancer and Prostatic Diseases

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Lutetium-177 prostate-specific membrane antigen (PSMA) theranostics: practical nuances and intricacies.
Prostate Cancer and Prostatic Diseases ( IF 5.1 ) Pub Date : 2019-10-08 , DOI: 10.1038/s41391-019-0174-x
Amir Iravani _{1,

2} , John Violet ₃ , Arun Azad _{2,

4} , Michael S Hofman _{1,

2}

Affiliation

Theranostic principles utilize a molecular biomarker specific for a tumor target, initially for imaging to assess target expression and, if deemed suitable, for targeted therapy. This presents an exciting opportunity for a highly personalized treatment strategy in the era of precision medicine. Prostate-specific membrane antigen (PSMA) theranostics has attracted increasing attention as a promising targeted treatment in metastatic prostate cancer (PC). 177Lu-DOTA-PSMA-617 (177Lu-PSMA-617) is a PSMA-targeted small molecule with favorable properties and is the most extensively investigated PSMA radioligand for radionuclide therapy (RNT) in PC. Since 2014 multiple retrospective studies and more recently a phase II prospective study demonstrated safety and impressive efficacy of 177Lu-PSMA RNT. The evidence generated by these trials led to two currently underway randomized trials in metastatic castrate-resistant PC: TheraP (NCT03392428) and VISION (NCT03511664). While we wait for these pivotal trials to read out, nuclear medicine physicians, medical oncologists, radiation oncologists, and urologists are facing a steep learning curve to master the intricacies and nuances of this novel therapeutic strategy. This review article aims to share and discuss the evolving experience in practical aspects of PSMA theranostics.

中文翻译：

Lutetium-177 前列腺特异性膜抗原 (PSMA) 治疗诊断学：实际的细微差别和复杂性。

治疗诊断学原理利用特定于肿瘤靶标的分子生物标志物，最初用于成像以评估靶标表达，如果认为合适，则用于靶向治疗。这为精准医学时代高度个性化的治疗策略提供了令人兴奋的机会。前列腺特异性膜抗原 (PSMA) 治疗诊断学作为转移性前列腺癌 (PC) 的一种有前途的靶向治疗方法，已引起越来越多的关注。177Lu-DOTA-PSMA-617 (177Lu-PSMA-617) 是一种具有良好特性的 PSMA 靶向小分子，是 PC 中用于放射性核素治疗 (RNT) 的最广泛研究的 PSMA 放射性配体。自 2014 年以来，多项回顾性研究和最近的一项 II 期前瞻性研究证明了 177Lu-PSMA RNT 的安全性和令人印象深刻的疗效。这些试验产生的证据促成了目前正在进行的两项针对转移性去势抵抗性 PC 的随机试验：TheraP (NCT03392428) 和 VISION (NCT03511664)。在我们等待这些关键试验宣读出来的同时，核医学医师、肿瘤内科医生、放射肿瘤学家和泌尿科医生正面临着陡峭的学习曲线，以掌握这种新型治疗策略的复杂性和细微差别。这篇评论文章旨在分享和讨论 PSMA 治疗诊断学实践方面不断发展的经验。泌尿科医生正面临着陡峭的学习曲线，以掌握这种新颖治疗策略的复杂性和细微差别。这篇评论文章旨在分享和讨论 PSMA 治疗诊断学实践方面不断发展的经验。泌尿科医生正面临着陡峭的学习曲线，以掌握这种新颖治疗策略的复杂性和细微差别。这篇评论文章旨在分享和讨论 PSMA 治疗诊断学实践方面不断发展的经验。

更新日期：2019-10-08

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