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Molecular and Metabolic Imaging of Castration-Resistant Prostate Cancer: State of Art and Future Prospects

Author(s):

Luca Filippi*, Agostino Chiaravalloti, Pietro Basile, Orazio Schillaci and Oreste Bagni   Pages 1 - 12 ( 12 )

Abstract:


Prostate cancer (PCa) represents the most common tumor in male and one of the most relevant causes of death in Western countries. Androgen deprivation therapy (ADT) constitutes a widely used approach in advanced PCa. When PCa progresses in spite of ADT and castrate levels of testosterone, the severe clinical condition termed as metastatic castration-resistant prostate cancer (mCRPC) takes place. The only approach to mCRPC has been represented by chemotherapy with taxanes for many years. Nevertheless, recently introduced treatments such as 2nd generation antiandrogens (i.e. enzalutamide and abiraterone), cell immunotherapy with sipuleucel-T or targeted alpha therapy with 223Ra-dichloride, have dramatically changed mCRPC prognosis. These novel therapies call for an unmet need for imaging biomarkers suitable for patients’ pre-treatment stratification and response assessment. In this scenario, nuclear medicine can provide several metabolic and molecular probes for investigating pathological processes at a cellular and sub-cellular level. The aim of this paper is to review the most relevant findings of the literature published to date on this topic, giving particular emphasis to the pros and cons of each tracer and also covering future prospects for defining personalized therapeutic approaches.

Keywords:

prostate cancer, castration-resistant, antiadrogens, androgen receptor, 18F-choline, bone scan, 18F-fluciclovine, prostate specific membrane antigen, personalized medicine, theranostic nanomedicine.

Affiliation:

Nuclear Medicine Department, “Santa Maria Goretti” Hospital, via Canova, 04100, Latina, Department of Biomedicine and Prevention, University Tor Vergata, Viale Oxford 81, 00133, Rome, Nuclear Medicine Department, “Santa Maria Goretti” Hospital, via Canova, 04100, Latina, Department of Biomedicine and Prevention, University Tor Vergata, Viale Oxford 81, 00133, Rome, Nuclear Medicine Department, “Santa Maria Goretti” Hospital, via Canova, 04100, Latina



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