Imaging of Non-Prostate Cancers Using PSMA-Targeted Radiotracers: Rationale, Current State of the Field, and a Call to Arms

Prostate-specific membrane antigen (PSMA) is a type II transmembrane glycoprotein that is highly overexpressed on prostate cancer epithelial cells and for which there is a growing body of literature examining the role of small molecule and antibody radiotracers targeted against this protein for prostate cancer detection and therapy. Despite its name, PSMA is also expressed, to varying degrees, in the neovasculature of a wide variety of non-prostate cancers; indeed, the pathology literature is replete with promising immunohistochemistry findings. A number of groups have begun to correlate those pathology-level results with in vivo imaging and therapy in non-prostate cancers using the same PSMA-targeted agents that have been so successful in prostate cancer. The potential to leverage radiotracers targeted to PSMA beyond prostate cancer is a promising approach for many cancers, and PSMA-targeted agents may be able to supplement or fill gaps left by other agents. However, to date, the majority of the reported findings with PSMA-targeted radiotracers in non-prostate malignancies has been in case reports and small case series, and the field must adopt a more thorough approach to the design and execution of larger prospective trials in order to realize the potential of these promising agents outside of prostate cancer.

Journal of nuclear medicine : official publication, Society of Nuclear Medicine. 2018 Mar 15 [Epub ahead of print]

Roberto A Salas Fragomeni, Tali Amir, Sara Sheikhbahaei, Susan C Harvey, Mehrbod S Javadi, Lilja Solnes, Ana Kiess, Mohamad E Allaf, Martin Pomper, Michael A Gorin, Steven P Rowe

Johns Hopkins University School of Medicine, United States.