Sstr-Based Theranostics in Neuroendocrine Prostate Cancer (Nepc) Publisher



Shahrokhi P¹ ; Emamiardekani A² ; Karamzadeziarati N²
Source: Clinical and Translational Imaging Published:2023

Abstract

Purpose: Prostate cancer (PCa) is the most commonly diagnosed malignancy in men and a high-ranking cause of cancer-related death. If properly managed, these patients can have an acceptable life expectancy. Therefore, the detection of lesions associated with the recurrence of PCa in the context of castration-resistant prostate cancer (CRPC) is an important diagnostic and therapeutic challenge for clinicians. One cause of CRPC is neuroendocrine differentiation (NE) of prostate cancer (NEPC). Efforts are underway to diagnose and treat this type of PCa. The objective of this study was to review the available evidence about the patients with NEPC undergoing SSTR2 targeting for either diagnostic or therapeutic purposes. Although there is still little information in this area, this review could lighten future studies. Methods: A comprehensive literature search of published papers in the PubMed/MEDLINE database with the following search terms: (((dotatate[Title/Abstract]) OR (dotatoc[Title/Abstract])) OR (dotanoc[Title/Abstract])) AND (prostate[Title/Abstract]) was carried out. Relevant articles about NEPC, even case reports and interesting images, with a nuclear medicine approach were checked out to write this narrative review. Results: NEPC may arise in the later stages of androgen receptor pathway inhibition (ARPI) treatment in PCa patients. NE differentiation reflects higher tumor aggression, and the overexpression of somatostatin receptors in these lesions could potentially be a favorite target for diagnostic purposes. However, there is no suitable biomarker reflecting NE differentiation or SSTR expression yet. Conclusions: Since the main evidence in NEPC cells is the predominance of SSTR-1, theoretically the design of a radiopharmaceutical with greater affinity to this receptor could be useful for therapeutic and diagnostic purposes; however, the possibility of using peptide receptor radionuclide therapy (PRRNT) in patients with intense uptake of available radiotherapists (e.g., [68 Ga]Ga-DOTA-TATE) should not be ignored in following researches. © 2022, The Author(s), under exclusive licence to Italian Association of Nuclear Medicine and Molecular Imaging.