A 70-Year-Old Man Diagnosed With PSMA-Positive mCRPC

Oliver Sartor, MD, discusses how a 70-year-old man with PSMA-positive metastatic castration-resistant prostate cancer (mCRPC) represents a typical candidate for PSMA-targeted imaging and potential radioligand therapy, considering factors such as disease progression, previous treatments, and overall health status in tailoring management strategies.

The panelist discusses how 68gallium prostate-specific membrane antigen-11 (PSMA-11) gozetotide is most useful in PET-CT imaging for detecting and staging prostate cancer.

The panelist discusses how the limited availability of 68gallium PSMA-11 gozetotide in clinical practice poses challenges and suggests potential strategies to increase accessibility, such as expanding production facilities, improving distribution networks, and exploring alternative radiotracers with longer half-lives.

Oliver Sartor, MD, discusses how 68gallium PSMA-11 PET is indeed the preferred imaging modality for confirming eligibility for lutetium therapy, but when unavailable, alternative options such as F-18 PSMA PET, conventional bone scintigraphy, or CT/MRI may be considered, albeit with potential limitations in sensitivity and specificity.

Oliver Sartor, MD, discusses how unmet needs and clinical challenges for PSMA imaging in prostate cancer patients include standardizing interpretation criteria, addressing false negatives in certain tumor phenotypes, improving accessibility and cost-effectiveness, and developing strategies for patients with low PSMA expression or PSMA-negative disease.