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Current and potential future role of PSMA-PET in patients with castration-resistant prostate cancer


Fankhauser, Christian Daniel; Poyet, Cedric; Kroeze, Stephanie G C; Kranzbühler, Benedikt; Schüler, Helena I Garcia; Guckenberger, Matthias; Kaufmann, Philipp A; Hermanns, Thomas; Burger, Irene A (2018). Current and potential future role of PSMA-PET in patients with castration-resistant prostate cancer. World Journal of Urology:Epub ahead of print.

Abstract

PURPOSE: To review the current literature and discuss potential future roles of the novel positron emission tomography (PET) tracers targeting the prostate-specific membrane antigen (PSMA) in patients with castration-resistant prostate cancer (CRPC).
METHODS: A literature search on February 19th 2018 was conducted using the Medline database and www.clinicaltrials.gov . Additionally, illustrative cases of CRPC patients from our own institution who were restaged and treated based on PSMA-PET scan results are provided.
RESULTS: 11 Studies met the inclusion criteria. PSMA-PET detected more metastatic lesions compared to conventional bone scan. Several patients were up-staged from non-metastatic CRPC (nmCRPC) to metastatic CRPC (mCRPC). Currently, no clear consensus exists regarding treatment response assessment in PSMA-PET scans for mCRPC patients undergoing treatment. Also, the role of PSMA-PET as a gatekeeper for systemic therapy or radioligands is currently undefined. PSMA-guided metastasis-directed radiotherapy may not only alleviate local symptoms but has the potential to defer systemic treatment in patients with oligoprogressive CRPC.
CONCLUSION: Compared to bone scan, PSMA-PET is more sensitive and specific to detect metastases but the therapeutic consequences of PSMA-PET results in the setting of CRPC remain unclear. Until future studies define the role of PSMA-PET in patients with CRPC, the current standard for imaging remains bone scan and computerized tomography.

Abstract

PURPOSE: To review the current literature and discuss potential future roles of the novel positron emission tomography (PET) tracers targeting the prostate-specific membrane antigen (PSMA) in patients with castration-resistant prostate cancer (CRPC).
METHODS: A literature search on February 19th 2018 was conducted using the Medline database and www.clinicaltrials.gov . Additionally, illustrative cases of CRPC patients from our own institution who were restaged and treated based on PSMA-PET scan results are provided.
RESULTS: 11 Studies met the inclusion criteria. PSMA-PET detected more metastatic lesions compared to conventional bone scan. Several patients were up-staged from non-metastatic CRPC (nmCRPC) to metastatic CRPC (mCRPC). Currently, no clear consensus exists regarding treatment response assessment in PSMA-PET scans for mCRPC patients undergoing treatment. Also, the role of PSMA-PET as a gatekeeper for systemic therapy or radioligands is currently undefined. PSMA-guided metastasis-directed radiotherapy may not only alleviate local symptoms but has the potential to defer systemic treatment in patients with oligoprogressive CRPC.
CONCLUSION: Compared to bone scan, PSMA-PET is more sensitive and specific to detect metastases but the therapeutic consequences of PSMA-PET results in the setting of CRPC remain unclear. Until future studies define the role of PSMA-PET in patients with CRPC, the current standard for imaging remains bone scan and computerized tomography.

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Additional indexing

Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Urological Clinic
04 Faculty of Medicine > University Hospital Zurich > Clinic for Nuclear Medicine
Dewey Decimal Classification:610 Medicine & health
Uncontrolled Keywords:(68)Ga-PSMA, CRPC, Positron emission tomography computed tomography, Prostatic neoplasms, Review
Language:English
Date:20 July 2018
Deposited On:02 Aug 2018 15:02
Last Modified:07 Aug 2018 09:58
Publisher:Springer
ISSN:0724-4983
OA Status:Closed
Publisher DOI:https://doi.org/10.1007/s00345-018-2408-2
PubMed ID:30030659

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