Radiology plays many roles in prostate cancer, and novel therapies are emerging

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Radiology plays many roles in prostate cancer, and novel therapies are emerging

15 September 2021

By Remy Lim

Wednesday 15 September 2021, 12:12 AM

Progressive improvement in disease burden with lutetium-177 PSMA radioligand therapy. Left to right: baseline; midtreatment after two cycles; after four treatment cycles (Image: Supplied)

To coincide with Prostate Cancer Foundation NZ’s Blue September, here is a case study that illustrates the use of radiology and radioligand therapy across a prostate cancer journey

Remy Lim

Key points, Multiparametric prostate MRI shows exquisite details of the prostate gland and is an essential first step in diagnosing prostate cancer. Prostate MR, Pract Green w Pale Yellow

1. Ahmed HU, El-Shater Bosaily A, Brown LC, et al. Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study. Lancet 2017;389(10071):815–22.

2. Kasivisvanathan V, Rannikko AS, Borghi M, et al. MRI-targeted or standard biopsy for prostate-cancer diagnosis. N Engl J Med 2018;378(19):1767–77.

3. Hofman MS, Lawrentschuk N, Francis RJ, et al. Prostate-specific membrane antigen PET-CT in patients with high-risk prostate cancer before curative-intent surgery or radiotherapy (proPSMA): a prospective, randomised, multicentre study. Lancet 2020;395(10231):1208–16.

4. Tarr GP, Kashyap P, Dixit DD, et al. Utility of Ga⁶⁸ prostate-specific membrane antigen positron-emission tomography for pre-operative staging of high-risk prostate cancer in a prospective cohort. J Med Imaging Radiat Oncol 2020;64(1):78–86.

5. Sartor O, de Bono J, Chi KN, et al. Lutetium-177-PSMA-617 for metastatic castration-resistant prostate cancer. N Engl J Med 2021;10.1056/NEJMoa2107322.

6. Hofman MS, Emmett L, Sandhu S, et al. [¹⁷⁷Lu]Lu-PSMA-617 versus cabazitaxel in patients with metastatic castration-resistant prostate cancer (TheraP): a randomised, open-label, phase 2 trial. Lancet 2021;397(10276):797–804.

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