Prostate-specific membrane antigen radioligand therapy with Lu-PSMA-617 is a promising treatment in metastasized castration-resistant prostate cancer with high efficacy and safety and seems to prolong progression-free survival and overall survival.
Prostate-specific membrane antigen (PSMA) ligand PET/CT is an emerging modality to detect the metastatic disease, especially in intermediate- and high-risk prostate cancer (PCa).
Prostate-specific membrane antigen (PSMA) is specific for prostate cancer cells; nevertheless when finding uptake in abnormal locations for prostate cancer metastases, it is important to consider other hypothesis, including second cancers.
Prostate specific membrane antigen (PSMA) positron-emission tomography/computed tomography (PET/CT) is a novel and promising imaging modality which aims to overcome the incapability of early identification of distant and regional metastases.
Prostate-specific membrane antigen (PSMA) expression, directly related to androgen-independence, metastasis and progression, renders this tumour associate antigen a good target for the development of new radiopharmaceuticals for PET.
PSMA PET-CT showed findings compatible with local disease in 47 patients (66.2%), lymph node metastases in 10 patients (14.1%) and distant metastases in 14 patients (19.7%).
PSM, a new prostate antigen is valuable as a marker for hematogenous micro-metastatic tumor dissemination as detected in RT-PCR assays of peripheral blood.
A significant (p ≤ 0.05) correlation between SUV<sub>max</sub> in PSMA-positive liver metastases and both size (ρ<sub>Spearman</sub> = 0.57) of metastases and PSA serum level (ρ<sub>Spearman</sub> = 0.60) was found.
All primary tumours showed PSMA expression on immunohistochemistry (5-90% expression), as well as all available specimens of local recurrence and distant metastases.
Alternatively, fluorine-18 (<sup>18</sup>F)-labelled PSMA tracers are available, such as <sup>18</sup>F-DCFPyL, which offer enhanced image quality and therefore potentially increased detection of small metastases.
At <sup>68</sup>Ga-PSMA-11 PET/CT with CTU, mean confidence of topographic attribution of focal areas of tracer accumulation was significantly higher with 2.9 ± 0.2 in total and 2.7 ± 0.9 for metastatic disease (p < 0.001).
At a median follow-up interval of 10 months (range 3-40 months), 1 patient experienced a biochemical recurrence according to the Phoenix criteria, and prostate-specific membrane antigen testing revealed that this was due to a distant nodal metastasis.
At multivariate analysis, age, sex, histotype, vascular invasion, T and N parameters, and PSMA positivity were significant predictors of distant metastases.The AUC was 0.92.
CDH6, MMP3, MTSS1 were further identified as PSMA-related genes in the prostate cancer cell lines and clinical samples, and their expression showed a negative correlation with the stage of prostate cancer (P<0.0001) and PSMA level (P<0.05) in clinical samples, indicating their possible involvement in PSMA-related PCa metastasis regulation.
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.
Currently prostate-specific membrane antigen (PSMA) is showing promise both as an imaging and therapeutic target for occult prostate cancer metastases.
Each patient then underwent both gallium-68 (Ga)-PSMA PET/computed tomography (CT) and mpMRI including diffusion-weighted whole-body imaging with background body signal suppression within an interval of 1 week and both modalities were compared for staging of primary disease, lymph node, and distant metastasis.