INTRODUCTION AND OBJECTIVES: Prostate cancer (CaP) overexpresses VPAC1, representing a highly suitable target for imaging and treatment. VPAC1 is over-expressed at the onset of the malignancy, which may be prior to elevation of PSA, and before cell morphology is altered. We have successfully used VPAC1 receptor-specific peptide constructs to image breast cancer in experimental animal models, and in humans. We hypothesized that VPAC1 expressed in high density on PC can be targeted for detection of intraprostatic tumor foci on whole mount radical prostatectomy specimens, using TP3805, a VPAC1 specific biomolecule labeled with Cu-64 a PET imaging radionuclide. METHODS: As part of a PET imaging protocol targeting VPAC1, men (N1⁄425) with prostate cancer undergoing radical prostatectomy were imaged preoperatively, and compared to whole mount radical prostatectomy pathologic analysis. De-paraffinized slides from whole mount pathology from two patients who participated the protocol, as well as one malignant lymph node and one benign lymph node specimens and 3 BPH negative controls underwent digital autoradiography with Cu-64, and then were H&E stained. Autoradiography images were compared with prostate H&E staining in which tumor foci were delineated. RESULTS: Prostate cancer foci (n1⁄430/31) were identified by autoradiography imaging (Figure 1). Autoradiography missed one malignant lesion due to technical artifact. Additionally, 6 small cancerous lesions were identified by autoradiography that were not previously noted by histologic examinations. A total of 7 additional lesions seen by autoradiography corresponded with HGPIN. The positive lymph node and the benign lymph node were correctly identified by auto radiography (Fig.2). For the 3 BPH patients, no cancer foci were noted by autoradiography. CONCLUSIONS: VPAC1 peptide analog constructs accurately identified foci of prostate cancer on whole mount radical prostatectomy specimens. Several additional lesions were also identified. Detection of HGPIN is consistent with the early expression of VPAC1 prior to the modulations in cell morphology. The PPV (97%) and NPV(100%) were excellent, validating VPAC1 as a potential theragnostic target for prostate cancer imaging and treatment.
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