A novel PSMA targeted dual-function near-infrared fluorescence and PET probe for the image-guided surgery and detection of prostate cancer

Fu, Haitian; Lou, Kequan; He, Huihui; Wang, Yanjuan; Mi, Yuanyuan; Li, Wenjin; Chen, Liping; Zhang, Yu; Yu, Chunjing

doi:10.1007/s00259-023-06492-x

Cited by 5 publications

(14 citation statements)

References 19 publications

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“…Since the initial clinical evaluations of PSMA-targeted radiotracers approximately a decade ago, a large amount of data has been published, mostly on 18 F-DCFPyL and 68 Ga-PSMA-11. 18 F-rhPSMA-7.3, despite being United States Food and Drug Administration (FDA)-approved, is less well studied.…”

Section: Use In Diagnostic Imaging Overviewmentioning

confidence: 99%

“…18 F-rhPSMA-7.3, despite being United States Food and Drug Administration (FDA)-approved, is less well studied. There are relatively few studies comparing PSMA radiotracers against each other, but one meta-analysis suggests overall detection rate for staging and/or recurrence is similar between 68 Ga-PSMA-11 and 18 F-DCFPyL. 6 Attempts at describing an overall sensitivity and specificity for 68 Ga-PSMA-11 give 61% and 96% for nodes, respectively, and 97% and 100% for bone lesions, 7 respectively, although those values are almost certainly context-dependent, as will be discussed below.…”

Section: Use In Diagnostic Imaging Overviewmentioning

confidence: 99%

“…There are relatively few studies comparing PSMA radiotracers against each other, but one meta-analysis suggests overall detection rate for staging and/or recurrence is similar between 68 Ga-PSMA-11 and 18 F-DCFPyL. 6 Attempts at describing an overall sensitivity and specificity for 68 Ga-PSMA-11 give 61% and 96% for nodes, respectively, and 97% and 100% for bone lesions, 7 respectively, although those values are almost certainly context-dependent, as will be discussed below. In particular, reported high specificity for bone lesions should be viewed as suspect given the low positive predictive value for solitary rib lesions 8 and the numerous pitfalls that have been reported.…”

Section: Use In Diagnostic Imaging Overviewmentioning

confidence: 99%

“…In particular, reported high specificity for bone lesions should be viewed as suspect given the low positive predictive value for solitary rib lesions 8 and the numerous pitfalls that have been reported. 9 There have been suggestions that 18 F-DCFPyL may be slightly more sensitive than 68 Ga-PSMA-11, although there are scant head-to-head data, 10 and both agents are treated as identical in the National Comprehensive Cancer Network guidelines.…”

Section: Use In Diagnostic Imaging Overviewmentioning

confidence: 99%

“…A meta-analysis covering both initial and recurrent detection rates and focusing on varieties of 68 Ga-labeled PSMA agents demonstrated the following detection rates stratified by PSA level for recurrence: 38% at <0.2 ng/mL, 67% at 0.2-1.0 ng/mL, 74% at 1.0-2.0 ng/mL, and 95% at >2.0 ng/mL. 11 Results for 18 F-DCFPyL have been similar, with reported detection rates of 88%-89% at PSA values over 0.5 ng/mL and 47%-49% below, 12,13 and overall detection of approximately 80%.…”

Section: Use In Diagnostic Imaging Overviewmentioning

confidence: 99%

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PSMA-Targeted Radiopharmaceuticals for Prostate Cancer Diagnosis and Therapy

Oldan,

Almaguel,

Voter

et al. 2024

Cancer J

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Prostate cancer (PCa) is the most common noncutaneous malignancy in men. Until recent years, accurate imaging of men with newly diagnosed PCa, or recurrent or low-volume metastatic disease, was limited. Further, therapeutic options for men with advanced, metastatic, castration-resistant disease were increasingly limited as a result of increasing numbers of systemic therapies being combined in the upfront metastatic setting. The advent of urea-based, small-molecule inhibitors of prostate-specific membrane antigen (PSMA) has partially addressed those shortcomings in diagnosis and therapy of PCa. On the diagnostic side, there are multiple pivotal phase III trials with several different agents having demonstrated utility in the initial staging setting, with generally modest sensitivity but very high specificity for determining otherwise-occult pelvic nodal involvement. That latter statistic drives the utility of the scan by allowing imaging interpreters to read with very high sensitivity while maintaining a robust specificity. Other pivotal phase III trials have demonstrated high detection efficiency in patients with biochemical failure, with high positive predictive value at the lesion level, opening up possible new avenues of therapy such as metastasis-directed therapy. Beyond the diagnostic aspects of PSMA-targeted radiotracers, the same urea-based chemical scaffolds can be altered to deliver therapeutic isotopes to PCa cells that express PSMA. To date, one such agent, when combined with best standard-of-care therapy, has demonstrated an ability to improve overall survival, progression-free survival, and freedom from skeletal events relative to best standard-of-care therapy alone in men with metastatic, castration-resistant PCa who are post chemotherapy. Within the current milieu, there are a number of important future directions including the use of artificial intelligence to better leverage diagnostic findings, further medicinal chemistry refinements to the urea-based structure that may allow improved tumor targeting and decreased toxicities, and the incorporation of new radionuclides that may better balance efficacy with toxicities than those nuclides that are available.

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Section: Use In Diagnostic Imaging Overviewmentioning

confidence: 99%