Abstract
The rising incidence rate of the cancer in the prostate gland has increased the demand for improved diagnostic, imaging, and therapeutic approaches. Prostate-specific membrane antigen (PSMA), with folate hydrolase and carboxypeptidase and, internalization activities, is highly expressed in the epithelial cells of the prostate gland and is strongly upregulated in prostatic adenocarcinoma, with elevated expression correlating with, metastasis, progression, and androgen independence. Recently, PSMA has been an active target of investigation by several approaches, including the successful utilization of small molecule inhibitors, RNA aptamer conjugates, PSMA-based immunotherapy, and PSMA-targeted prodrug therapy. Future investigations of PSMA in prostate cancer (PCa) should focus in particular on its intracellular activities and functions. The objective of this contribution is to review the current role of PSMA as a marker for PCa diagnosis, imaging, and therapy.
Highlights
Prostate-specific membrane antigen (PSMA) is a type 2 integral membrane glycoprotein with folate hydrolase and carboxypeptidase, and internalization activities
The results showed that Ga-PSMA Positron Emission Tomography (PET)/Magnetic Resonance Imaging (MRI) was far more accurate in the detection of prostate cancer (PCa) and, at the same time, associated with lower radiation exposure [34]
Worth mentioning is the registrational phase II/III OSPREY study (NCT02981368) that evaluated the diagnostic accuracy of 18F-DCFPyL PET/CT relative to histopathology, for detecting PCa in pelvic lymph nodes in patients with high risk localized prostate cancer who are planned for radical prostatectomy (RP) with lymphadenectomy, and in patients with locally recurrent or metastatic disease willing to undergo biopsy
Summary
Prostate-specific membrane antigen (PSMA) is a type 2 integral membrane glycoprotein with folate hydrolase and carboxypeptidase, and internalization activities. This internalization capability is increased up to 3-fold when PSMA is linked to anti-PSMA antibodies. PSMA expression is highest in prostate tissue (secretory acinar epithelium), but detectable levels of PSMA protein are found in the kidney (proximal tubules), the small bowel (i.e., jejunal brush border), neuroglia (Schwann cells and astrocytes), and salivary glands [1, 2]. With the rise and evolution of several targeted approaches to examine prostate cancer using PSMA, the aim of this contribution is to review the current role of PSMA as a marker for PCa diagnosis, imaging, and therapy
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