PSMA as a target for radiolabelled small molecules

Excerpt

Prostate cancer (PCa) is the most common cancer in men in Europe. When detected early, and when the disease is localized to the prostate gland, the 5-year survival rate is nearly 100 %. However, once the cancer has spread beyond the prostate, survival rates fall dramatically [1]. In recent years there has been a significant decrease in mortality mainly due to early detection. However, this early detection has led to overdiagnosis and overtreatment with resultant impact on the quality of life of men with PCa [2]. These problems are due to the variability of the clinical course of the disease and the high prevalence of microscopic disease [3, 4]. Therefore, a risk-adapted strategy is needed to choose among a wide variety of treatment options, from active surveillance to aggressive treatment. In the face of such broadly differing options that impact survival and quality of life it follows that patient-specific staging is essential for optimizing individual outcomes. Patient-specific staging drives the demand for sensitive and specific imaging of PCa including intraprostatic disease as well as local and distant metastases. Furthermore, as active surveillance becomes a more widely considered management option in low-grade disease, a sensitive method for monitoring changes in tumour volume and location would potentially eliminate the need for repetitive biopsies and enable a more advanced temporal evaluation. …