Oncology: GU Articles

PSMA-targeted radiotherapy of prostate cancer (PCa) has emerged recently as a promising approach to the treatment of disseminated disease. A small number of ligands have been evaluated in patients, and while early tumor response is encouraging, relapse rate is high, and these compounds localize to the parotid, salivary and lacrimal glands as well as the kidney, leading to dose-limiting toxicities and adverse events affecting quality of life.

Purpose: The potential role of prostatic-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) in non-prostate cancer tumors has shown promising results. We examined the performance of dynamic 68Ga-PSMA-11 PET/CT (DPSMA) for the evaluation of localized renal mass.

Lutetium-177-prostate-specific membrane-617 (177Lu-PSMA-617) is an effective therapy for metastatic castration resistant prostate cancer (mCRPC) with evidence of improved survival over standard care.

Radium 223 (223Ra) is an α-emitter approved for the treatment of bone metastatic prostate cancer (PCa), which exerts direct cytotoxicity towards PCa cells near the bone interface, whereas cells positioned in the core respond poorly, due to short α-particle penetrance.

Bone is the most common site of distant metastatic spread in prostate adenocarcinoma. Prostate-specific membrane antigen uptake has been described in both benign and malignant bone lesions, which can lead to false-positive findings on 68Ga-prostate-specific membrane antigen-11 positron emission tomography (68Ga-PSMA-11 PET).

Background: Treatment of advanced metastatic castration resistant prostate cancer (mCRPC) after failure of approved therapy options remains challenging. Prostate-specific membrane antigen (PSMA) targeting β- and α-emitters have been introduced with promising response rates.

Synergistic effects of immunotherapy with pembrolizumab or drugs targeting DNA damage e.g. olaparib could be used to overcome the limitations of radioligand therapy (RLT) with Lu-177 prostate specific membrane antigen (PSMA) in metastasized castrate resistant prostate cancer (mCRPC) patients.

The introduction of prostate specific membrane antigen (PSMA)-positron emission tomography (PET) using (68)Ga revolutionized prostate cancer imaging. Outperforming standard imaging, it allows complete staging of the local tumor and possible lymph nodes, visceral or bone metastases with high accuracy in only one examination (1,2).

(177)Lutetium labeled PSMA-617 is a promising new therapeutic agent for radioligand therapy (RLT) of patients with metastatic castration resistant prostate cancer (mCRPC). Initiated by the German Society of Nuclear Medicine a retrospective multicenter data analysis was started in 2015 to evaluate efficacy and safety of (177)Lu-PSMA-617 in a large cohort of patients.

Accurate assessment of lymph node (LN) metastases in prostate cancer (PCa) patients is critical for prognosis and patient management. Both prostate-specific membrane antigen- (PSMA) positron emission tomography/computed tomography (PET/CT) and ferumoxtran-10 nanoparticle-enhanced magnetic resonance imaging (nano-MRI) are imaging modalities with high potential to identify LN metastases in PCa patients.

Purpose: This is a head-to-head comparison between Gallium-68 Prostate Specific Membrane Antigen (68Ga-PSMA-11) and 18F-Fluciclovine Positron Emission Tomography/Computed Tomography (PET/CT) in a series of 10 patients with prostate cancer (PCa) recurrence.

The role of prostate-specific membrane antigen (PSMA)-targeted PET in comparison to mpMRI in the evaluation of intraprostatic cancer foci is not well defined. The aim of our study was to compare the diagnostic performances of PSMA PET/CT, mpMRI and PSMA PET/CT+mpMRI using 3 independent blinded readers for each modality and with histopathology as gold standard in the detection, intra-prostatic localization and local extension of primary prostate cancer.

Objectives:18F-rhPSMA-7 is a novel prostate specific membrane antigen (PSMA)- -ligand for positron emission tomography (PET) imaging. Here, we present data from a retrospective analysis using PET/computed tomography (CT) and PET/magnetic resonance imaging (MRI) exams to investigate the efficacy of 18F-rhPSMA-7 PET for primary N-staging of patients with prostate cancer compared with morphological imaging (CT]MRI) and validated by histopathology.

Prostate-specific membrane antigen (PSMA) is a type II transmembrane glycoprotein that is highly overexpressed on prostate cancer epithelial cells and for which there is a growing body of literature examining the role of small molecule and antibody radiotracers targeted against this protein for prostate cancer detection and therapy.

To evaluate the effect of androgen receptor (AR) inhibition on Prostate Specific Membrane Antigen (PSMA) uptake imaged using (68)Ga-PSMA-11 Positron Emission Tomography (PET) in a mouse xenograft model and in a patient with castration sensitive prostate cancer.

Targeting tumor-expressed receptors using selective molecules for diagnostic, therapeutic or both diagnostic and therapeutic (theragnostic) purposes is a promising approach in oncological applications.

Receptor tyrosine kinase (RTK) co-expression facilitates tumor resistance due to redundancies in the PI3K-AKT and KRAS-ERK signaling pathways, among others. Crosstalk between the oncogenic RTKs hepatocyte growth factor receptor (MET), epidermal growth factor receptor (EGFR), and human epidermal growth factor receptor 2 (HER2) are involved in tumor resistance to RTK-targeted therapies.

Introduction: Prostate-specific membrane antigen ligand positron emission tomography (PSMA PET) induces management changes in patients with prostate cancer. We aim to better characterize the impact of PSMA PET on management of recurrent prostate cancer in a large prospective cohort.

The impact of prostate specific membrane antigen (PSMA) PET/CT on management of prostate cancer (PCa) patients with biochemical recurrence (BCR) is well-established. However, whether and how PSMA PET/CT affects the management of patients undergoing scans for other clinical indications remains unknown.

The purpose was to evaluate the role of the synthetic amino acid positron emission tomography (PET) radiotracer fluciclovine ((18)F) in modifying the clinical and planning target volume (CTV and PTV) definition in post-prostatectomy patients undergoing salvage radiotherapy and to evaluate the resulting dosimetric consequences to surrounding organs at risk.

Purpose: The purpose of this prospective study was to estimate the effect of (68)Ga-prostate specific membrane antigen (PSMA)-11 PET on intended management of patients with biochemically recurrent prostate cancer.

A quantitative imaging biomarker is desirable to provide a comprehensive measure of whole-body tumor burden in patients with metastatic prostate cancer, and to standardize the evaluation of treatment-related changes.

We have previously reported that PET with 18F-fluoride (NaF-PET) for assessment of osseous metastatic disease led to changes in intended management in a substantial fraction of patients with prostate or other types of cancer participating in the National Oncologic PET Registry (NOPR).

Introduction: The introduction of 18F-labelled prostate-specific membrane antigen (PSMA) targeted positron emission tomography/computed-tomography (PET/CT) tracers, firstly 18F-DCFPyL and more recently 18F-PSMA-1007, have demonstrated promising results for the diagnostic workup of prostate cancer (PCa).

Introduction: 18F-2-Fluoro-2-deoxyglucose (18F-FDG) in addition to Prostate Specific Membrane Antigen (PSMA) PET has been employed to assess the eligibility for PSMA-targeted therapy by some centers.

Objectives: Lutetium-177 (177Lu)-PSMA-617 (LuPSMA) is a radioligand with high affinity for prostate specific membrane antigen (PSMA) enabling targeted beta-irradiation of prostate cancer. We have previously reported favorable activity with low toxicity in a prospective phase II trial involving 30 men with metastatic castrate-resistant prostate cancer (mCRPC).

AIM - The objective of this study was to analyze the safety and efficacy of (177)Lu-labeled DOTAGA-based prostate specific membrane antigen (PSMA) ligand (177)Lu-DOTAGA-(I-y)fk(Sub-KuE) ((177)Lu-PSMA) in patients with metastatic castration-resistant prostate cancer (mCRPC).

Introduction: The aim of this study was to analyze patterns of persistent versus recurrent or new PET lesions in a selected patient cohort with PSA persistence following salvage lymph node dissection (SLND) and pre/post procedure prostate-specific membrane antigen ligand positron emission tomography (PSMA-PET).

Introduction: Tens of different PSMA targeting radiopharmaceuticals for both imaging and therapy have been synthesized. Although variability in biodistribution and affinity for binding to the PSMA receptor between different PSMA targeting radiopharmaceuticals are known, little is known about the clinical implications of those variabilities.

Purpose: Radiohybrid prostate-specific membrane antigen (rhPSMA) ligands are a new class of prostate cancer theranostic agents. 18F-rhPSMA-7, offers the advantages of 18F-labelling and low urinary excretion compared with 68Ga-PSMA-11.

Introduction: 225Ac-PSMA-617, targeting the prostate-specific membrane antigen (PSMA) which is overexpressed on prostate cancer cells, has shown a remarkable therapeutic efficacy in heavily pre-treated metastatic castration-resistant prostate carcinoma patients.

Purpose: The main objective of this prospective study was to determine the impact of multi-phasic acquisition of 68Ga-PSMA PET/CT in the detection of recurrent prostate cancer (PCa) in the early stage of biochemical recurrence (BR) with prostate-serum-antigen (PSA) level <1ng/ml.

Introduction: 18F-PSMA-1007 PET is used in the management of patients with prostate cancer. However, recent reports indicate a high rate of non-specific bone uptake (NSBU) with 18F-PSMA-1007, which may lead to false positive diagnosis.

Prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) detects prostate cancer recurrence at low PSA levels. Radiotherapy with dose escalation to the former prostate bed has been associated with improved biochemical recurrence-free survival (BRFS).

Background: Standard-of-care imaging for initial staging of prostate cancer (PCa) underestimates disease burden. Prostate specific membrane antigen (PSMA) positron emission tomography/ computed tomography (PET/CT) detects PCa metastasis with superior accuracy with potential impact definitive radiation therapy (RT) planning for non-metastatic PCa.

Radiohybrid prostate-specific membrane antigen (rhPSMA)-ligands allow for labelling with 18F and radiometals for endoradiotherapy. rhPSMA-7.3 is designated as lead compound with promising preclinical data for 177Lu-rhPSMA-7.

In recent years several radiotracers targeting the prostate-specific membrane antigen (PSMA) have been introduced. Few of those had a high clinical impact for the treatment of patients suffering from prostate cancer.

Metabolically active tumor volume (MATV) measurements can be applied to (18)F-fluorocholine positron emission tomography/computed tomography (PET/CT) to quantify whole-body tumor burden. This study evaluates the serial application of these measurements as systemic treatment response markers and predictors of disease progression in patients with castrate-resistant prostate cancer (CRPC).

Radioligand therapy (RLT) with (177)Lu-PSMA-617 (Lu-PSMA-617) (prostate-specific membrane antigen) is a novel targeted therapy for metastatic prostate cancer. In this study, we evaluated the effect of different pre-therapeutic parameters on the therapeutic response measured by prostate-specific antigen(PSA) two months after RLT.

We prospectively evaluated the combined (18)F-NaF/(18)F-FDG PET/CT in patients with breast and prostate cancers, and compared the results to (99m)Tc MDP bone scintigraphy (BS) and whole-body MRI (WBMRI).

Objective: To determine prospectively the efficacy profile of 2 activity regimens of Lu-PSMA therapy in patients with progressive metastatic castrate resistant prostate cancer (mCRPC): 6.0 vs 7.4 GBq.

This prospective pilot study evaluated the ability of sodium fluoride (Na(18)F) positron emission tomography/computed tomography (NaF-PET/CT) to detect and monitor bone metastases over time and its correlation with clinical outcomes and survival in advanced prostate cancer.

Purpose: Positron emission tomography (PET) with small molecules targeting prostate-specific membrane antigen (PSMA) is being adopted as a clinical standard for prostate cancer (PCa) imaging. In this study, we evaluated changes in uptake on PSMA-targeted PET in men starting abiraterone or enzalutamide.

The inguinal lymph nodes are an unusual site of metastases for prostate adenocarcinoma. We present a case in which a 61-year-old man with biochemically recurrent prostate cancer underwent a (11)C-acetate Positron Emission Tomography (PET)/ Computed Tomography Attenuation Correction (CTAC) scan which demonstrated multiple foci of increased activity in the left inguinal, left iliac chain, and right inguinal regions.

To determine the diagnostic capabilities of combined prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) and sentinel node (SN) biopsy in PSMA PET/CT negative patients for the primary lymph node (LN) staging in prostate cancer (PCa) patients.

Several studies outlined the sensitivity of (68)Ga-labeled PET tracers against the prostate-specific membrane antigen (PSMA) for localization of relapsed prostate cancer in patients with renewed increase in the prostate-specific antigen (PSA), commonly referred to as biochemical recurrence.

Prostate-specific membrane antigen (PSMA)-targeted radioligand therapy can improve the outcome of patients with advanced metastatic castration-resistant prostate cancer, but patients do not respond uniformly.

Background: The European Association of Urology (EAU) Prostate Cancer Guidelines Panel recommends risk groups for biochemically recurrent prostate cancer (BCR) to identify men at high risk of progression or metastatic disease.

The purpose of this study was to investigate the feasibility and diagnostic efficacy of 68Ga-PSMA positron emission tomography/computed tomography (PET/CT) combined with PET-ultrasound image-guided biopsy in the diagnosis of prostate cancer.

Purpose: The aim of this study was to analyze the patterns of prostate bed (PB) recurrence in prostate cancer patients experiencing PSA persistence (BCP) or biochemical recurrence (BCR) after radical prostatectomy using 68Ga-PSMA-11 PET/CT (PSMA PET) and evaluate the relationship between the RTOG clinical target volumes (CTVs) and PSMA PET-defined recurrence topography.