Radioligand therapy of metastatic castration-resistant prostate cancer: current approaches

Zool Hilmi Awang,Markus Essler,Hojjat Ahmadzadehfar

doi:10.1186/s13014-018-1037-7

Zool Hilmi Awang, Markus Essler + Show 1 more

Open Access

https://doi.org/10.1186/s13014-018-1037-7

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Journal: Radiation oncology (London, England)	Publication Date: May 23, 2018
Citations: 19	License type: open-access

Affiliation: University Hospital Bonn

Abstract

Prostate Cancer is the forth most common type of cancer. Prostate-specific membrane antigen (PSMA) is anchored in the cell membrane of prostate epithelial cells. PSMA is highly expressed on prostate epithelial cells and strongly up-regulated in prostate cancer. Therefore it is an appropriate target for diagnostic and therapy of prostate cancer and its metastases. This article discusses several articles on radionuclide treatments in prostate cancer and the results on PSMA therapy with either beta or alpha emitters as a salvage therapy.

Highlights

Prostate cancer is the fourth most common type of cancer affecting the European male population [1]
In patients who fail the initial therapy with curative intent treatment options include androgen-deprivation therapy (ADT) along with chemotherapy in the case of disease progression [4]
Up to 80% of patients with Metastatic castration-resistant prostate cancer (mCRPC) will have a treatment response to 177Lu-Prostate-specific membrane antigen (PSMA) shown by any prostate-specific antigen (PSA) decline [14, 24–30, 32–34] (Table 1)

Summary

Introduction

Prostate cancer is the fourth most common type of cancer affecting the European male population (excluding non-melanoma skin cancer) [1]. One in every six males are at risk of being affected by prostate cancer, and the risk of death because of metastatic prostate cancer is one in every 30 [2]. A combination of ADT with docetaxel in hormone-sensitive patients improves median overall survival (OS) by 13.6 months compared to ADT alone [5, 6]. In CRPC patients, a more recent approach using abiraterone and enzalutamide prolongs median survival by up to 3.9 and 4.8 months, respectively [7, 8]. Chemotherapy treatment with docetaxel and cabazitaxel is often associated with side effects but prolongs OS for a few months [4, 9, 10]. Treatment for diffused or painful bone metastases using radium-223-chloride (223Ra), which targets only the osteoblastic lesions and does not treat the nodal and visceral metastases, improves median OS by 3.6 months [11]

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