Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=30050802
&cmd=llinks): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 215
Radium and other alpha emitters in prostate cancer
#MMPMID30050802
Sartor O
; Sharma D
Transl Androl Urol
2018[Jun]; 7
(3
): 436-444
PMID30050802
show ga
(223)Radium ((223)Ra) is the first alpha-emitting therapy proven effective in
human cancer. Prospective randomized trials indicate that (223)Ra, which
concentrates after intravenous injection in areas of osteoblastic metastatic
disease, can prolong survival in bone-dominant castrate resistant prostate cancer
patients. Though radium isotopic therapy is conceptually critical to demonstrate
that alpha emitters can be safe and effective, (223)Ra has inherent limitations
given its restriction to bone metastatic disease. To overcome this limitation,
targeted alpha therapy (TAT) is now being actively evaluated in prostate cancer,
and other neoplasms. Key to TAT in prostate tumors in current studies is the
overexpression of prostate specific membrane antigen (PSMA), a folate hydrolase
expressed on the cell surface of malignant adenocarcinomas of the prostate. Using
PSMA targeting (small molecules or antibodies), alpha emitting agents such as
(225)Actinium ((225)Ac) or (213)Bismuth ((213)Bi) can be delivered to PSMA
expressing tumors regardless of their metastatic location. Initial results from
TAT in prostate cancer are highly promising and rapid development of these agents
is anticipated in the years ahead assuming adequacy of isotope availability and
appropriate clinical trial design. TAT may be develop as an independent approach,
or synergize with a variety of other approaches including external beam
radiation, hormonal therapies, chemotherapies, various radiation sensitizers, DNA
repair inhibitors, and/or immune modulators. Clinical investigation opportunities
in this field will rapidly increase in the years ahead.