PDF(Pubmed)
Abstract：
In 1853, the perception of prostate cancer (PCa) as a rare ailment prevailed, was described by the eminent Londoner surgeon John Adams. Rapidly forward to 2018, the landscape dramatically altered. Currently, men face a one-in-nine lifetime risk of PCa, accentuated by improved diagnostic methods and an ageing population. With more than three million men in the United States alone grappling with this disease, the overall risk of succumbing to stands at one in 39. The intricate clinical and biological diversity of PCa poses serious challenges in terms of imaging, ongoing monitoring, and disease management. In the field of theranostics, diagnostic and therapeutic approaches that harmoniously merge targeted imaging with treatments are integrated. A pivotal player in this arena is radiotheranostics, employing radionuclides for both imaging and therapy, with prostate-specific membrane antigen (PSMA) at the forefront. Clinical milestones have been reached, including FDA- and/or EMA-approved PSMA-targeted radiodiagnostic agents, such as [18F]DCFPyL (PYLARIFY®, Lantheus Holdings), [18F]rhPSMA-7.3 (POSLUMA®, Blue Earth Diagnostics) and [68Ga]Ga-PSMA-11 (Locametz®, Novartis/ ILLUCCIX®, Telix Pharmaceuticals), as well as PSMA-targeted radiotherapeutic agents, such as [177Lu]Lu-PSMA-617 (Pluvicto®, Novartis). Concurrently, ligand-drug and immune therapies designed to target PSMA are being advanced through rigorous preclinical research and clinical trials. This review delves into the annals of PSMA-targeted radiotheranostics, exploring its historical evolution as a signature molecule in PCa management. We scrutinise its clinical ramifications, acknowledge its limitations, and peer into the avenues that need further exploration. In the crucible of scientific inquiry, we aim to illuminate the path toward a future where the enigma of PCa is deciphered and where its menace is met with precise and effective countermeasures. In the following sections, we discuss the intriguing terrain of PCa radiotheranostics through the lens of PSMA, with the fervent hope of advancing our understanding and enhancing clinical practice.
摘要：
1853年，人们普遍认为前列腺癌（PCa）是一种罕见的疾病，由著名的伦敦外科医生约翰·亚当斯描述。快速前进到2018年，景观发生了巨大变化。目前,男性一生中面临九分之一的PCa风险，诊断方法的改进和人口老龄化加剧了。仅在美国，就有超过300万男性与这种疾病作斗争，屈服的总体风险为39分之一。PCa复杂的临床和生物多样性在影像学方面提出了严峻的挑战，持续监测,和疾病管理。在治疗领域，整合了将靶向成像与治疗和谐结合的诊断和治疗方法。这个领域的一个关键角色是放射治疗，使用放射性核素进行成像和治疗，与前列腺特异性膜抗原（PSMA）在前列。临床里程碑已经达到,包括FDA和/或EMA批准的PSMA靶向放射诊断剂，例如[18F]DCFPyL(PYLARIFY®，兰修斯控股），[18F]rhPSMA-7.3(POSLUMA®，蓝色地球诊断)和[68Ga]Ga-PSMA-11(Locametz®,诺华/ILLUCCIX®，TelixPharmaceuticals)，以及PSMA靶向放射治疗剂，例如[177Lu]Lu-PSMA-617(Pluvicto®，诺华）。同时,旨在靶向PSMA的配体药物和免疫疗法正在通过严格的临床前研究和临床试验进行推进。这篇综述深入探讨了PSMA靶向放射治疗的历史，探索其作为PCa管理中特征分子的历史演变。我们仔细研究了它的临床后果，承认其局限性，并窥视需要进一步探索的途径。在科学探究的熔炉中，我们的目标是阐明通往未来的道路，在未来的道路上，PCa的谜团被破译，其威胁得到精确有效的对策。在以下各节中，我们通过PSMA的镜头来讨论PCa辐射的有趣地形，热切希望增进我们的理解和加强临床实践。
