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前列腺癌中 PSMA 导向的诊疗一体化

英文原题:PSMA-Directed Theranostics in Prostate Cancer.

PubMed 2025/07/28(内容时间) Biomedicines Q2 · IF 4.5(JCR 2025)

研究概要

前列腺癌是仅次于肺癌的男性癌症死亡主要原因。

中文摘要

在肺癌之后,前列腺癌是男性癌症死亡的第二大原因。高危局限性肿瘤负荷或转移性疾病常会进展,并对初始治疗方案产生耐药。目前正在开发新技术,以准确识别高危患者、正确分期并提供适当治疗,从而改善临床结局。前列腺特异性膜抗原(PSMA)是一种跨膜谷氨酸羧肽酶,有助于调节叶酸吸收;其过表达与前列腺癌病理特征呈正相关。PSMA表达升高是已知的独立不良生存风险因素,且去势抵抗性前列腺癌(CRPC)的大多数转移灶均为PSMA阳性。过去十年,多种基于PSMA的PET放射性药物在灵敏度和特异度上均优于传统影像方法,多项大型临床试验已证实这一结果。随着证据不断积累,这些诊断技术正被纳入标准诊疗流程,以更精细地识别恶性病灶。PSMA也是多种治疗手段的靶点,包括放射性配体及CAR-T、双特异性T细胞衔接器(BiTE)和抗体药物偶联物(ADC)等免疫疗法。本综述将讨论前列腺癌领域基于PSMA的诊疗一体化策略现状。

展开英文摘要原文

Following lung cancer, prostate cancer is the leading cause of cancer death in men. High-risk localized tumor burden or metastatic disease often progresses, refractory to initial treatment regimens. There is ongoing development of technology to appropriately identify high-risk patients, stage them correctly, and offer appropriate treatments to obtain the best clinical outcomes. Prostate cancer-specific membrane antigen (PSMA) is a transmembrane glutamate carboxypeptidase, which helps regulate folate absorption, and its overexpression is pathologically directly proportional and associated with prostate cancer. Increased PSMA expression is a known independent risk factor for poorer survival, and most metastatic lesions in CRPC are PSMA positive. Over the last decade, several PSMA-based PET radiopharmaceuticals have demonstrated superior sensitivities and specificities compared to traditional imaging methods. These outcomes have been demonstrated by several large clinical trials. As the data emerges, these diagnostics are being integrated into standard of care protocol to facilitate nuanced identification of malignant lesions. PSMA is also being targeted through several therapeutics, including radioligands and immunotherapies such as CAR-T, BiTEs, and ADCs. This review will discuss the landscape of PSMA-based theranostics in the context of prostate cancer.

论文信息

作者
Jajja SA、Sodhi N、Parent EE、Singh P
第一作者单位
NYMC-Landmark Medical Center, Woonsocket, RI 02895, USA.United States
通讯作者单位
Division of Hematology-Oncology, Department of Internal Medicine, Mayo Clinic, Phoenix, AZ 85054, USA.United States
文献类型
综述
期刊
Biomedicines2025 Jul 28
原文标识
PubMed 40868092 · DOI 10.3390/biomedicines13081837