The assessment of response to therapy in prostate cancer (PCa) patients is an ongoing, open issue. Prostate-specific antigen has limitations, especially in advanced metastatic PCa, which often displays intratumor variability in terms of response to therapy. Conventional imaging (i.e. computerized tomography and bone scan) is of limited use for its low sensitivity and specificity. Positron-emission tomography (PET) with prostate-specific membrane antigen (PSMA) demonstrated higher sensitivity and specificity, and novel PSMA-based criteria have been recently proposed for treatment response, with promising results in different scenarios, from chemotherapy to radioligand therapy. PSMA-based criteria have been found to outperform the current RECIST 1.1 and Prostate Cancer Working Group 3 frameworks in describing the behavior of PCa, precisely assessing tumor phenotypes through molecular-imaging-derived parameters. This review critically explores the current evidence about the role of PSMA PET/computed tomography in the assessment of treatment response.
Therapeutic advances in medical oncology. 2024 Oct 07*** epublish ***
Martina Di Franco, Riccardo Mei, Camilo Garcia, Stefano Fanti
Nuclear Medicine, Alma Mater Studiorum University of Bologna, Via Massarenti 9, Bologna 40138, Italy., Nuclear Medicine Unit, University Hospital of Modena, Modena, Italy., Department of Nuclear Medicine, Gustave Roussy, Paris Saclay University, Villejuif, France., Nuclear Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy.