Abstract
Background: Prostate-specific membrane antigen (PSMA) is not sufficiently overexpressed in a small proportion of prostate cancer (PCa) patients, who require other strategies for imaging and/or treatment. We reviewed potential targets other than PSMA for PCa theranostics in nuclear medicine that have already been tested in humans. Methods: We performed a systematic web search in the PubMed and Cochrane databases, with no time restrictions by pooling terms (“prostate cancer”, “prostatic neoplasms”) and (“radioligand”, “radiotracer”). Included articles were clinical studies. The results were synthetized by the target type. Results: We included 38 studies on six different targets: gastrin-releasing peptide receptors (GRPRs) (n = 23), androgen receptor (n = 11), somatostatin receptors (n = 6), urokinase plasminogen activator surface receptor (n = 4), fibroblast activation protein (n = 2 studies) and integrin receptors (n = 1). GRPRs, the most studied target, has a lower expression in high-grade PCa, CRPC and bone metastases. Its use might be of higher interest in treating earlier stages of PCa or low-grade PCa. Radiolabeled fibroblast activation protein inhibitors were the most recent and promising molecules, but specific studies reporting their interest in PCa are needed. Conclusion: Theranostics in nuclear medicine will continue to develop in the future, especially for PCa patients. Targets other than PSMA exist and deserve to be promoted.
Highlights
Prostate Cancer (PCa) is the most prevalent cancer in men worldwide, accounting for 21% of all diagnosed cancers, and being the 2nd cause of death by cancer in men [1]
Most of the developed peptides are bombesin-like gastrin-releasing peptide receptors (GRPRs) antagonists, as it was suggested that they had a better affinity to GRPRs than GRPR agonists, while they were not internalized in the cells [62]
Imaging prostate cancer (PCa) patients with radiolabeled bombesin-like peptides started in the early 2000s
Summary
Prostate Cancer (PCa) is the most prevalent cancer in men worldwide, accounting for 21% of all diagnosed cancers, and being the 2nd cause of death by cancer in men [1]. Theranostics in PCa has mainly been represented by prostate-specific membrane antigen (PSMA) ligands radiolabeled with gallium-68 or fluorine-18 for PET imaging and with lutetium-177 or actinium-225 for radioligand therapy (RLT). To date, these types of imaging and treatment are offered to metastatic castrationresistant prostate cancer (mCRPC) patients, after the failure of NAD therapy and at least 1 line of taxane chemotherapy [2,3]. Targets other than PSMA exist and deserve to be promoted
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