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Title: | Current state of theranostics in metastatic castrate-resistant prostate cancer |
Author: | Nindra, U. Lin, P. Becker, T. Roberts, T. L. Chua, W. |
SWSLHD Author: | Nindra, Udit Lin, Peter Chua, Wei |
Issue Date: | 2024 |
Journal: | Journal of Medical Imaging and Radiation Oncology |
Abstract: | Prostate cancer remains one of the leading causes of cancer-related death in the world. There have been significant advances in chemotherapy, hormonal therapy and targeted therapy options for patients with castrate-resistant disease. However, these systemic treatments are often associated with unwanted toxicities. Targeted therapy with radiopharmaceuticals has become of key interest to limit systemic toxicity and provides a more precision oncology approach to treatment. Strontium-89, Samarium-153 EDTMP and Radium-223 have been trialled with mixed results. Strontium-89 and Samarium-153 EDTMP have shown benefits in palliating metastatic bone pain but with no impact on survival outcomes. Early therapeutic radiopharmaceuticals targeting PSMA that were developed were beta-emitting agents, but recently alpha-emitting agents are being investigated as potentially superior options. Radium-223 is the first alpha-particle emitter therapeutic agent approved by the FDA, with phase III trial evidence showing benefits in overall survival and delay in symptomatic skeletal events for patients. Recently, 177-Lutetium-PSMA-617 has demonstrated significant survival advantages in pre-treated metastatic castrate-resistant cancer patients in a number of phase II and III studies. Furthermore, 225-Actinium-PSMA-617 also showed promise even in patients pre-treated with 177-Lutetium-PSMA-617. Hence, there has been an explosion of radiopharmaceutical treatment options for patients with prostate cancer. This review explores past and current theranostic capacities in the radiopharmaceutical treatment of metastatic castrate-resistant prostate cancer. � 2024 Royal Australian and New Zealand College of Radiologists. |
ISSN: | 17549477 (ISSN) |
Digital object identifier: | 10.1111/1754-9485.13658 |
URI: | https://swslhd.intersearch.com.au/swslhdjspui/handle/1/12736 |
Department: | Liverpool Hospital, Department of Medical Oncology Liverpool Hospital, Department of Nuclear Medicine |
Appears in Collections: | Liverpool Hospital |
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