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Title: More α Than β for Prostate Cancer?

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 effectivenessmore » 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?« less
Authors:
 [1] ;  [2]
  1. Univ. of California, Los Angeles, CA (United States). David Geffen School of Medicine; Ludwig
  2. Brookhaven National Lab. (BNL), Upton, NY (United States)
Publication Date:
Report Number(s):
BNL-114321-2017-JA
Journal ID: ISSN 0161-5505; R&D Project: KBCH139; KB0202011; TRN: US1800469
Grant/Contract Number:
SC0012704
Type:
Accepted Manuscript
Journal Name:
Journal of Nuclear Medicine
Additional Journal Information:
Journal Volume: 58; Journal Issue: 11; Journal ID: ISSN 0161-5505
Publisher:
Society of Nuclear Medicine and Molecular Imaging
Research Org:
Brookhaven National Laboratory (BNL), Upton, NY (United States)
Sponsoring Org:
USDOE Office of Science (SC), Nuclear Physics (NP) (SC-26)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE
OSTI Identifier:
1413909

Fendler, Wolfgang P., and Cutler, Cathy. More α Than β for Prostate Cancer?. United States: N. p., Web. doi:10.2967/jnumed.117.198333.
Fendler, Wolfgang P., & Cutler, Cathy. More α Than β for Prostate Cancer?. United States. doi:10.2967/jnumed.117.198333.
Fendler, Wolfgang P., and Cutler, Cathy. 2017. "More α Than β for Prostate Cancer?". United States. doi:10.2967/jnumed.117.198333. https://www.osti.gov/servlets/purl/1413909.
@article{osti_1413909,
title = {More α Than β for Prostate Cancer?},
author = {Fendler, Wolfgang P. and Cutler, Cathy},
abstractNote = {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?},
doi = {10.2967/jnumed.117.198333},
journal = {Journal of Nuclear Medicine},
number = 11,
volume = 58,
place = {United States},
year = {2017},
month = {9}
}