Onkológia 1/2024

Therapy of castration-resistant prostate cancer from the point of view of nuclear medicine

The therapeutic use of the ionizing radiation of radionuclides contributes to a prolongation of survival in patients with metastatic castration-resistant prostate cancer (mCRPC). Currently, there are two radiopharmaceuticals available in Slovakia, each of them has its own benefits and weaknesses, which we discuss in the work. Radium-223 dichloride is the first approved alpha emitter for therapeutic use, indicated in patients with mCRPC in monotherapy or in combination with hormonal therapy with dominant, symptomatic bone involvement without visceral metastases, after at least two prior lines of systemic therapy or in patients unsuitable for any available systemic therapy. Radioligand therapy with lutetium-177-prostate-specific membrane antigen (Lu-177-PSMA) is currently indicated in patients with mCRPC, including visceral metastases with high expression of prostate-specific membrane antigen (PSMA) whose disease progresses after previous treatment with taxanes and second-generation hormones.

Keywords: metastatic castration-resistant prostate cancer, radium-223 dichloride, radioligand therapy, prostate-specific membrane antigen, lutetium-177-prostate-specific membrane antigen