Expanding the role of small-molecule PSMA ligands beyond PET staging of prostate cancer.,Nature Reviews Urology

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Expanding the role of small-molecule PSMA ligands beyond PET staging of prostate cancer.
Nature Reviews Urology ( IF 12.1 ) Pub Date : 2020-01-14 , DOI: 10.1038/s41585-019-0272-5
Shankar Siva _{1,

2} , Cristian Udovicich ₁ , Ben Tran _{2,

3,

4} , Homi Zargar _{5,

6} , Declan G Murphy _{2,

7} , Michael S Hofman _{2,

8}

Affiliation

Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) is rapidly being established as arguably the leading contemporary imaging modality in the management of prostate cancer. Outside of its conventional use in the de novo staging of localized disease and detection of biochemical recurrence, additional applications for the use of PSMA PET are emerging. Uptake of PSMA tracers in other genitourinary malignancies, particularly renal cell carcinoma, has led to new fields of investigation. Therapeutic delivery of radiolabelled PSMA small molecules has shown considerable promise in advanced prostate cancer. The ability to use the same molecule for imaging and therapy - theranostics - enables a highly personalized approach. PSMA PET can also have a considerable influence in the selection and guidance of radiotherapy fields for high-risk and recurrent disease. Intriguingly, changes in intensity of PSMA uptake during systemic therapy might provide early response assessment or novel insight into the biological responses of genitourinary malignancies to treatment. An evolving range of radiolabelled PSMA radiopharmaceuticals is emerging in the multiple facets of modern clinical practice.

中文翻译：

小分子PSMA配体的作用超出了前列腺癌的PET分期。

前列腺特异性膜抗原（PSMA）正电子发射断层扫描（PET）正在迅速建立，可以说是当今前列腺癌管理中的领先成像方式。除了在局部疾病从头进行分期和生化复发检测的常规用途外，PSMA PET的其他应用正在兴起。在其他泌尿生殖系统恶性肿瘤（尤其是肾细胞癌）中摄取PSMA示踪剂已导致新的研究领域。在晚期前列腺癌中，放射标记的PSMA小分子的治疗性给药已显示出可观的前景。使用相同的分子进行成像和治疗的能力-治疗诊断学-可以实现高度个性化的方法。PSMA PET在高危和复发性疾病的放射治疗领域的选择和指导中也可能具有相当大的影响。有趣的是，全身性治疗期间PSMA摄取强度的变化可能提供早期反应评估或对泌尿生殖系统恶性肿瘤对治疗的生物学反应的新颖见解。放射性标记的PSMA放射性药物的发展范围正在现代临床实践的多个方面出现。

更新日期：2020-01-14

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