More α Than β for Prostate Cancer?

Journal Article · Thu Sep 21 00:00:00 EDT 2017 · Journal of Nuclear Medicine

DOI:https://doi.org/10.2967/jnumed.117.198333· OSTI ID:1413909

Fendler, Wolfgang P. ^[1]; Cutler, Cathy ^[2]

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1. Univ. of California, Los Angeles, CA (United States). David Geffen School of Medicine; Ludwig
2. Brookhaven National Lab. (BNL), Upton, NY (United States)

Radionuclide therapy for prostate cancer started more than 70 y ago (1). Nuclear medicine has since evolved considerably to provide a multitude of new imaging and therapy options. The past decade witnessed an unprecedented expansion of radioligands for prostate cancer. Milestones include the first α-emitter for treatment of symptomatic bone metastases (2) and theranostic vectors directed at the prostate-specific membrane antigen (PSMA) or bombesin receptor (3–5). However, current radionuclide therapies are applied at a late stage of the disease aiming at palliation. Despite recent advances for treatment of metastatic prostate cancer, cure remains an unmet need of the 21st century. Cancer spreads early and develops slowly as submillimeter occult lesions. Lesions grow at distant sites and become detectable only when significant morphologic or metabolic alterations have formed, often years to decades after the initial spread (6). Effective ablation of small metastases is critical for cure and presents a specific challenge for β-emitting radionuclide therapy. Millimeter-range β-particles deliver insufficient amounts of radiation to millimeter-size tumor lesions, as energy deposition extends and dilutes beyond lesion boundaries (Fig. 1). α-radiation, because of its micrometer range, targets millimeter-size tumor volumes at higher relative yield (Fig. 1). Further evidence points to a superior biologic effectiveness for α-therapy based on high-linear-energy transfer resulting in frequent double-strand DNA breaks (7). However, are basic advantages of α-therapy associated with a clinical benefit?

• Research Organization: Brookhaven National Laboratory (BNL), Upton, NY (United States)
• Sponsoring Organization: USDOE Office of Science (SC), Nuclear Physics (NP)
• Grant/Contract Number: SC0012704
• OSTI ID: 1413909
• Report Number(s): BNL-114321-2017-JA; R&D Project: KBCH139; KB0202011; TRN: US1800469
• Journal Information: Journal of Nuclear Medicine, Vol. 58, Issue 11; ISSN 0161-5505
• Publisher: Society of Nuclear Medicine and Molecular Imaging
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE