Novel Radiopharmaceuticals and Future of Theranostics in Genitourinary Cancers.

Carbonic anhydrase IX Gastrin-releasing peptide receptor Genitourinary cancers Positron emission tomography/computed tomography Prostate cancer Prostate-specific membrane antigen Radioligand therapy Radiopharmaceuticals Radiotracers Theranostics

Journal

European urology
ISSN: 1873-7560
Titre abrégé: Eur Urol
Pays: Switzerland
ID NLM: 7512719

Informations de publication

Date de publication:
19 Oct 2024
Historique:
received: 05 06 2024
revised: 16 09 2024
accepted: 27 09 2024
medline: 21 10 2024
pubmed: 21 10 2024
entrez: 20 10 2024
Statut: aheadofprint

Résumé

This review aims to provide an overview of novel diagnostic and therapeutic radiopharmaceuticals tested recently or used currently in genitourinary cancers within prospective phase 1-2 clinical trials, summarizing progresses and future directions. A systematic search was conducted using the PubMed/MEDLINE and ClinicalTrials.gov databases for original prospective research studies following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Forty-six papers were systematically reviewed; 74 ongoing clinical trials were identified. The results of 27 novel radiopharmaceuticals (ie, not approved by the Food and Drug Administration/European Medicines Agency and not listed in the Pharmacopeia) prospectively investigated in genitourinary cancers, mostly prostate, for diagnostic, theranostic, or therapeutic purposes (21, one, and five of the 27 radiopharmaceuticals, respectively) over the past 5 yr were presented. Most were prostate-specific membrane antigen-targeting agents (17/27); other targets included gastrin-releasing peptide receptor, carbonic anhydrase IX, Cu, six transmembrane epithelial antigen of the prostate 1, tumor-associated glycoprotein 42, and urokinase-type plasminogen activator receptor. Ongoing research confirms the same trend. Fibroblast activation protein inhibitor, PD-L1, CD8, nectin-4, and HER2 are other targets under investigation. Among the 22 ongoing therapeutic trials (out of the 74 ongoing clinical trials), targeted alpha therapy is being explored in 12, and five are evaluating combinations of radioligand therapy with other treatments. We confirmed the safety of radiopharmaceuticals (regardless of the diagnostic/therapeutic purpose) and showed promising results in terms of diagnostic accuracy and therapeutic efficacy in genitourinary cancers. There continues to be expansion in radiopharmaceutical approaches to genitourinary cancers, reflecting a strong emphasis on improving tumor detection and treatment, which will likely impact future management across the disease spectrum, with the potential for improved patient care and outcomes.

Sections du résumé

BACKGROUND AND OBJECTIVE OBJECTIVE
This review aims to provide an overview of novel diagnostic and therapeutic radiopharmaceuticals tested recently or used currently in genitourinary cancers within prospective phase 1-2 clinical trials, summarizing progresses and future directions.
METHODS METHODS
A systematic search was conducted using the PubMed/MEDLINE and ClinicalTrials.gov databases for original prospective research studies following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.
KEY FINDINGS AND LIMITATIONS UNASSIGNED
Forty-six papers were systematically reviewed; 74 ongoing clinical trials were identified. The results of 27 novel radiopharmaceuticals (ie, not approved by the Food and Drug Administration/European Medicines Agency and not listed in the Pharmacopeia) prospectively investigated in genitourinary cancers, mostly prostate, for diagnostic, theranostic, or therapeutic purposes (21, one, and five of the 27 radiopharmaceuticals, respectively) over the past 5 yr were presented. Most were prostate-specific membrane antigen-targeting agents (17/27); other targets included gastrin-releasing peptide receptor, carbonic anhydrase IX, Cu, six transmembrane epithelial antigen of the prostate 1, tumor-associated glycoprotein 42, and urokinase-type plasminogen activator receptor. Ongoing research confirms the same trend. Fibroblast activation protein inhibitor, PD-L1, CD8, nectin-4, and HER2 are other targets under investigation. Among the 22 ongoing therapeutic trials (out of the 74 ongoing clinical trials), targeted alpha therapy is being explored in 12, and five are evaluating combinations of radioligand therapy with other treatments. We confirmed the safety of radiopharmaceuticals (regardless of the diagnostic/therapeutic purpose) and showed promising results in terms of diagnostic accuracy and therapeutic efficacy in genitourinary cancers.
CONCLUSIONS AND CLINICAL IMPLICATIONS CONCLUSIONS
There continues to be expansion in radiopharmaceutical approaches to genitourinary cancers, reflecting a strong emphasis on improving tumor detection and treatment, which will likely impact future management across the disease spectrum, with the potential for improved patient care and outcomes.

Identifiants

DOI: 10.1016/j.eururo.2024.09.036 PMID: 39428326
pubmed: 39428326
pii: S0302-2838(24)02641-1
doi: 10.1016/j.eururo.2024.09.036
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Auteurs

Martina Sollini (M)

Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milano, Italy; IRCCS Nuclear Medicine Department, IRCCS San Raffaele, Milano, Italy. Electronic address: sollini.martina@hsr.it.

Jeremie Calais (J)

Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, UCLA, Los Angeles, CA, USA.

Arturo Chiti (A)

Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Milano, Italy; IRCCS Nuclear Medicine Department, IRCCS San Raffaele, Milano, Italy.

Louise Emmett (L)

Department of Theranostics and Nuclear Medicine, St Vincent's Hospital, Sydney, Australia; St Vincent's Clinical School, University of New South Wales, Sydney, Australia; Garvan Institute of Medical Research, Sydney, Australia.

Stefano Fanti (S)

Nuclear Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.

Wolfgang Fendler (W)

Department of Nuclear Medicine, West German Cancer Center, University Hospital Essen, Essen, Germany; Cancer Consortium partner site Essen/Düsseldorf, DKFZ and University Hospital Essen, Essen, Germany.

Ken Herrmann (K)

Department of Nuclear Medicine, West German Cancer Center, University Hospital Essen, Essen, Germany; Cancer Consortium partner site Essen/Düsseldorf, DKFZ and University Hospital Essen, Essen, Germany.

Thomas A Hope (TA)

Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA; Department of Radiology, San Francisco VA Medical Center, San Francisco, CA, USA; Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, CA, USA.

Oliver Sartor (O)

Department of Oncology, Mayo Clinic, Rochester, MN, USA.

Brian Shuch (B)

Department of Urology, UCLA, Los Angeles, CA, USA.

Scott Tagawa (S)

Weill Cornell Medicine, New York, NY, USA.

Michael S Hofman (MS)

Prostate Cancer Theranostics and Imaging Centre of Excellence, Molecular Imaging and Therapeutic Nuclear Medicine, Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia.

Classifications MeSH