Intra-arterial administration of PSMA-targeted radiopharmaceuticals for brain tumors: is the era of interventional theranostics next?

IF 2.9 3区 医学 Q2 ONCOLOGY Expert Review of Anticancer Therapy Pub Date : 2024-10-01 Epub Date: 2024-08-29 DOI:10.1080/14737140.2024.2398492
Valerio Da Ros, Luca Filippi, Francesco Garaci
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Abstract

In recent years, prostate-specific membrane antigen (PSMA), a transmembrane glycoprotein, has emerged as a promising biomarker for theranostics, integrating diagnosis and therapy. PSMA's overexpression in various tumors, including brain metastases and high-grade gliomas, suggests its potential in neuro-oncology. Pruis et al. conducted a proof-of-concept study comparing intra-arterial (IA) and intravenous (IV) administration of 68Ga-PSMA-11 in brain tumor patients, aiming to enhance radioligand therapy (RLT) outcomes. Ten patients underwent IV and super-selective IA (ssIA) tracer administration, showing higher tumor uptake and more favorable biodistribution after ssIA administration on positron emission tomography (PET). Dosimetry modeling on the basis of PET data resulted in median absorbed radiation doses per tumor per cycle notably higher with ssIA with respect to IV administration, indicating its potential for RLT optimization. Challenges persist, notably in penetrating intact blood-brain barriers and targeting tumor cells effectively. To overcome these limitations, novel approaches like convection-enhanced delivery and focused ultrasound warrant exploration. Safety concerns, though minimal in this study, underscore the need for larger trials and AI-assisted procedures. PSMA's role in neuro-oncological theranostics is promising, but future research must address specificity and compare it with emerging targets.

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动脉内注射 PSMA 靶向放射性药物治疗脑肿瘤:下一个是介入治疗学时代吗?
近年来,前列腺特异性膜抗原(PSMA)--一种跨膜糖蛋白--已成为集诊断和治疗为一体的治疗学上一种很有前途的生物标记物。PSMA 在各种肿瘤(包括脑转移瘤和高级别胶质瘤)中的过度表达表明它在神经肿瘤学中的潜力。Pruis 等人进行了一项概念验证研究,比较了脑肿瘤患者动脉内(IA)和静脉内(IV)给药 68Ga-PSMA-11,旨在提高放射性配体疗法(RLT)的疗效。10名患者接受了静脉注射和超选择性IA(ssIA)示踪剂给药,正电子发射断层扫描(PET)显示ssIA给药后肿瘤摄取率更高,生物分布更有利。根据正电子发射计算机断层扫描数据建立的剂量测定模型显示,与静脉注射相比,ssIA每个肿瘤每个周期的中位吸收辐射剂量明显更高,这表明ssIA具有优化RLT的潜力。挑战依然存在,特别是在穿透完整的血脑屏障和有效靶向肿瘤细胞方面。为了克服这些限制,对流增强给药和聚焦超声等新方法值得探索。虽然这项研究中的安全性问题微乎其微,但它强调了进行更大规模试验和人工智能辅助手术的必要性。PSMA在神经肿瘤治疗学中的作用前景广阔,但未来的研究必须解决特异性问题,并将其与新兴靶点进行比较。
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来源期刊
CiteScore
5.10
自引率
3.00%
发文量
100
审稿时长
4-8 weeks
期刊介绍: Expert Review of Anticancer Therapy (ISSN 1473-7140) provides expert appraisal and commentary on the major trends in cancer care and highlights the performance of new therapeutic and diagnostic approaches. Coverage includes tumor management, novel medicines, anticancer agents and chemotherapy, biological therapy, cancer vaccines, therapeutic indications, biomarkers and diagnostics, and treatment guidelines. All articles are subject to rigorous peer-review, and the journal makes an essential contribution to decision-making in cancer care. Comprehensive coverage in each review is complemented by the unique Expert Review format and includes the following sections: Expert Opinion - a personal view of the data presented in the article, a discussion on the developments that are likely to be important in the future, and the avenues of research likely to become exciting as further studies yield more detailed results Article Highlights – an executive summary of the author’s most critical points.
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