采用 177Lu-PSMA 的前列腺癌血清学疗法。

IF 4.6 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Seminars in nuclear medicine Pub Date : 2024-07-01 DOI:10.1053/j.semnuclmed.2024.02.007
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引用次数: 0

摘要

这篇综述论文强调了 PSMA 靶向诊断和治疗在前列腺癌治疗中的变革性作用,尤其关注 177Lu-PSMA-617,它已获得 FDA 和 EMA 批准,用于化疗和 ARPI 治疗后的转移性阉割抗性前列腺癌 (mCRPC) 患者。本文从 VISION 试验的成功经验出发,介绍了目前的放射性配体疗法 (RLT) 适应症,强调了实用的患者选择、计划和治疗执行。它认真研究了 Lu-PSMA 与卡巴他赛和 Ra-223 的疗效比较,解决了 mCRPC 治疗的决策难题。此外,本文还讨论了 Lu-PSMA 在化疗无效患者中的应用以及在激素敏感性前列腺癌中的应用,并强调了正在进行的全球研究。一个值得关注的问题是 Lu-PSMA 的长期安全性,尤其是肾毒性风险,这需要进一步研究。研究还探讨了对Lu-PSMA有反应的患者进行再挑战的可能性,强调需要综合分析和实际数据来完善治疗方案。最后,PSMA 靶向治疗标志着前列腺癌治疗的重大进展,主张将其纳入多模式、以患者为中心的治疗方法中。该综述强调,必须开展更多的比较研究,以优化治疗顺序和结果,最终改善前列腺癌治疗的长期预后和疾病控制。
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Prostate Cancer Theranostics With 177Lu-PSMA

This review paper highlights the transformative role of PSMA-targeted diagnostics and therapy in prostate cancer management, particularly focusing on 177Lu-PSMA-617, approved by the FDA and EMA for metastatic castration-resistant prostate cancer (mCRPC) patients post-chemotherapy and ARPI treatment. Originating from the VISION trial's success, this paper navigates the current radioligand therapy (RLT) indications, emphasizing practical patient selection, planning, and treatment execution. It critically examines Lu-PSMA's comparative effectiveness against cabazitaxel and Ra-223, addressing decision-making dilemmas for mCRPC treatments. Furthermore, the paper discusses Lu-PSMA in chemotherapy-naïve patients and its application in hormone-sensitive prostate cancer, underlined by ongoing global studies. A significant concern is Lu-PSMA's long-term safety profile, particularly nephrotoxicity risks, necessitating further investigation. The possibility of Lu-PSMA rechallenge in responsive patients is explored, stressing the need for comprehensive analyses and real-world data to refine treatment protocols. Conclusively, PSMA-targeted therapy marks a significant advance in prostate cancer therapy, advocating for its integration into a multimodal, patient-centric treatment approach. The review underscores the imperative for additional comparative studies to optimize treatment sequences and outcomes, ultimately enhancing long-term prognosis and disease control in prostate cancer management.

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来源期刊
Seminars in nuclear medicine
Seminars in nuclear medicine 医学-核医学
CiteScore
9.80
自引率
6.10%
发文量
86
审稿时长
14 days
期刊介绍: Seminars in Nuclear Medicine is the leading review journal in nuclear medicine. Each issue brings you expert reviews and commentary on a single topic as selected by the Editors. The journal contains extensive coverage of the field of nuclear medicine, including PET, SPECT, and other molecular imaging studies, and related imaging studies. Full-color illustrations are used throughout to highlight important findings. Seminars is included in PubMed/Medline, Thomson/ISI, and other major scientific indexes.
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