REVIEW   Free access

Minerva Urologica e Nefrologica 2018 October;70(5):450-61

DOI: 10.23736/S0393-2249.18.03152-1

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Prostate specific membrane antigen: the role in salvage lymph node dissection and radio-ligand therapy

Wei M. ONG ¹, Kamran ZARGAR-SHOSHTARI ² ✉, Shankar SIVA ^{3, 4}, Homayoun ZARGAR ^{1, 3, 5}

¹ Department of Urology, Royal Melbourne Hospital, Melbourne, Victoria, Australia; ² Department of Surgery, University of Auckland, Grafton, Auckland, New Zealand; ³ Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia; ⁴ Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, Victoria, Australia; ⁵ Australian Prostate Cancer Research Centre, Melbourne, Victoria, Australia

INTRODUCTION: Prostate-specific membrane antigen (PSMA) is a receptor highly expressed on the membranes of prostate cancer (PCa) cells and provides a new opportunity for imaging and targeted therapy in metastatic prostate cancer. The use of radio-labelled peptides with high affinity for PSMA-receptor allows for localization of oligo-metastasis to guide salvage lymph node (LN) dissection, and effective delivery of radionuclide therapy to PCa cells. This review discusses the current statistics of PSMA-guided salvage lymph-node dissection.
EVIDENCE ACQUISITION: A non-systematic literature search of the Medline, Embase, and Scopus databases was performed in December 2017 using medical subject headings and free-text protocol.
EVIDENCE SYNTHESIS: The properties of PSMA has enabled the timely detection of oligometastatic disease, potentially altering oncological outcomes of men with PCa. The utility of PSMA in directing sLND has been proven to have an impact in achieving modest biochemical response which is generally not durable.
CONCLUSIONS: Larger randomized controlled trials are needed to validate the current findings, determine treatment protocols, and weigh up its benefits and determine its standing amongst the current management strategies for PCa.

KEY WORDS: Prostatic neoplasms - Lymph node excision - Antigens