The power of PSMA PET in prostate cancer

A 360-degree deep dive of PSMA in prostate cancer – from the power of Prostate-specific membrane antigen (PSMA) PET to the rising of radioligand therapy, and the future of prostate cancer treatment.  

PSMA PET imaging has revolutionized the diagnosis and management of prostate cancer. This advanced imaging technique is invaluable across different stages of the disease, from initial staging to biochemical recurrence and treatment evaluation. Current clinical practice and guidelines underscore the importance of PSMA PET in providing precise and detailed imaging, which significantly enhances treatment planning and patient outcomes. In the realm of imaging, FDG PET plays a complementary role to PSMA PET, offering additional insights that can be critical in certain clinical scenarios. For urologists, interpreting PSMA PET imaging requires a nuanced understanding of its applications and limitations, ensuring accurate diagnosis and effective treatment strategies. 

Radioligand therapy (RLT) has emerged as a promising treatment for metastatic castration-resistant prostate cancer (mCRPC). Unblocking radioligand therapy in mCRPC involves selecting the right patients for 177Lu-PSMA-617, a targeted therapy that has shown remarkable efficacy. Treatment sequencing for mCRPC is crucial, and understanding when and how to evaluate treatment responses can optimize patient outcomes. 

Rechallenge RLT is an area of growing interest, with real-world experiences shedding light on its potential benefits and challenges. Sharing these experiences can provide valuable insights for clinicians and researchers alike. 

Achieving beyond the current standards, advancing prostate cancer treatment involves exploring next-generation radioligand therapies. New isotopes and targets are being investigated, promising even more effective and personalized treatment options for patients.