Skip to main content

Advertisement

Log in

Piflufolastat F 18: Diagnostic First Approval

  • AdisInsight Report
  • Published:
Molecular Diagnosis & Therapy Aims and scope Submit manuscript

Abstract

Piflufolastat F 18 (PYLARIFY®) is an 18F-labelled diagnostic imaging agent that has been developed by Progenics Pharmaceuticals Inc., a Lantheus company, for positron emission tomography (PET) that targets prostate-specific membrane antigen (PSMA). Piflufolastat F 18 was approved in the USA on 27 May 2021 for PET of PSMA positive lesions in men with prostate cancer with suspected metastasis who are candidates for initial definitive therapy or with suspected recurrence based on elevated serum prostate specific antigen (PSA) level. This article summarizes the milestones in the development of piflufolastat F 18 leading to this approval as a radioactive diagnostic agent in prostate cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Luining WI, Meijer D, Dahele MR, et al. Nuclear imaging for bone metastases in prostate cancer: the emergence of modern techniques using novel radiotracers. Diagnostics (Basel). 2021;11(1):117.

    Article  CAS  Google Scholar 

  2. Zimmerman ME, Meyer AR, Rowe SP, et al. Imaging of prostate cancer with positron emission tomography. Clin Adv Hematol Oncol. 2019;17(8):455–63.

    PubMed  Google Scholar 

  3. Jansen BHE, Yaqub M, Voortman J, et al. Simplified methods for quantification of (18)F-DCFPyL uptake in patients with prostate cancer. J Nucl Med. 2019;60(12):1730–5.

    Article  CAS  Google Scholar 

  4. Van de Wiele C, Sathekge M, de Spiegeleer B, et al. PSMA-targeting positron emission agents for imaging solid tumors other than non-prostate carcinoma: a systematic review. Int J Mol Sci. 2019. https://doi.org/10.3390/ijms20194886.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Keegan NM, Bodei L, Morris MJ. Seek and find: current prospective evidence for prostate-specific membrane antigen imaging to detect recurrent prostate cancer. Eur Urol Focus. 2021;7(2):267–78.

    Article  Google Scholar 

  6. Progenics Pharmaceuticals Inc. PYLARIFY® (piflufolastat F 18) injection: US prescribing information. 2021. https://www.pylarify.com/. Accessed 1 June 2021.

  7. US Food & Drug Administration. FDA approves second PSMA-targeted PET imaging drug for men with prostate cancer [media release]. https://www.fda.gov/. Accessed 27 May 2021.

  8. Lantheus Holdings. SEC Filing: Form 10-K for the fiscal year ended December 31, 2020. 25 Feb 2021. https://investor.lantheus.com/. Accessed 17 Jun 2021.

  9. SOFIE. SOFIE to commercially supply FDA-approved PYLARIFY® (piflufolastat F 18) injection [media release]. 28 May 2021. https://sofie.com/.

  10. Lantheus Holdings. PyL(Tm) (18F-DCFPyL), Lantheus PSMA-targeted prostate cancer imaging agent, to be used in POINT Biopharmas PSMA-targeted radioligand therapeutic phase 3 trial in patients with metastatic castration resistant prostate cancer [media release]. 9 Dec 2020. http://www.lantheus.com.

  11. Progenics Pharmaceuticals, Curium. Progenics and Curium announce European collaboration for prostate cancer imaging agent PyL(TM) [media release]. 3 Jan 2019. http://www.progenics.com.

  12. Progenics Pharmaceuticals. Progenics Pharmaceuticals announces exclusive worldwide licensing agreement with Johns Hopkins University for agent to image prostate cancer using PET scan [media release]. 4 Aug 2015. http://www.progenics.com.

  13. Lu M, Adler S, Lindenberg ML, et al. Dynamic 18F-DCFPyL PET/CT imaging of biopsy-proven high-risk primary prostate cancer patients [abstract no. 1254]. J Nucl Med. 2020;61(Suppl 1).

    Google Scholar 

  14. Bodar YJL, Koene BPF, Jansen BHE, et al. Standardized uptake values are adequate measures of lesional (18)F-DCFPyL uptake in patients with low prostate cancer disease burden. J Nucl Med. 2021. https://doi.org/10.2967/jnumed.120.260232.

    Article  PubMed  Google Scholar 

  15. Werner RA, Bundschuh RA, Bundschuh L, et al. Semiquantitative parameters in PSMA-targeted PET imaging with [(18)F]DCFPyL: impact of tumor burden on normal organ uptake. Mol Imaging Biol. 2020;22(1):190–7.

    Article  CAS  Google Scholar 

  16. Ferreira G, Iravani A, Hofman MS, et al. Intra-individual comparison of (68)Ga-PSMA-11 and (18)F-DCFPyL normal-organ biodistribution. Cancer Imaging. 2019;19(1):23.

    Article  Google Scholar 

  17. Van Kalmthout L, Wondergem M, Jansen B, et al. Comparison of 68Ga-PSMA-11 and 18F-DCFPyL in prostate cancer patients with biochemical recurrence after prostatectomy [abstract no. EPS-142]. Eur J Nucl Med Mol Imaging. 2019;46(Suppl 1):S369.

    Google Scholar 

  18. Perry E, Talwar A, Taubman K, et al. [(18)F]DCFPyL PET/CT in detection and localization of recurrent prostate cancer following prostatectomy including low PSA < 0.5 ng/mL. Eur J Nucl Med Mol Imaging. 2021;48(6):2038–46.

    Article  CAS  Google Scholar 

  19. Rowe SP, Campbell SP, Mana-Ay M, et al. Prospective evaluation of PSMA-targeted (18)F-DCFPyL PET/CT in men with biochemical failure after radical prostatectomy for prostate cancer. J Nucl Med. 2020;61(1):58–61.

    Article  CAS  Google Scholar 

  20. Rowe SP, Li X, Trock BJ, et al. Prospective comparison of PET imaging with PSMA-targeted 18F-DCFPyL versus Na18F for bone lesion detection in patients with metastatic prostate cancer. J Nucl Med. 2020;61(2):183–8.

    Article  CAS  Google Scholar 

  21. Chaussé G, Ben-Ezra N, Stoopler M, et al. Diagnostic performance of (18)F-DCFPyL positron emission tomography/computed tomography for biochemically recurrent prostate cancer and change-of-management analysis. Can Urol Assoc J. 2021;15(6):173–8.

  22. Koschel S, Taubman K, Sutherland T, et al. Patterns of disease detection using [(18)F]DCFPyL PET/CT imaging in patients with detectable PSA post prostatectomy being considered for salvage radiotherapy: a prospective trial. Eur J Nucl Med Mol Imaging. 2021. https://doi.org/10.1007/s00259-021-05354-8.

  23. Lindenberg L, Mena E, Turkbey B, et al. Evaluating biochemically recurrent prostate cancer: histologic validation of (18)F-DCFPyL PET/CT with comparison to multiparametric MRI. Radiology. 2020;296(3):564–72.

    Article  Google Scholar 

  24. Metser U, Ortega C, Perlis N, et al. Detection of clinically significant prostate cancer with (18)F-DCFPyL PET/multiparametric MR. Eur J Nucl Med Mol Imaging. 2021. https://doi.org/10.1007/s00259-021-05355-7.

  25. Meijer D, Jansen BHE, Wondergem M, et al. Clinical verification of 18F-DCFPyL PET-detected lesions in patients with biochemically recurrent prostate cancer. PLoS One. 2020;15(10):e0239414.

    Article  CAS  Google Scholar 

  26. Markowski MC, Sedhom R, Fu W, et al. Prostate specific antigen and prostate specific antigen doubling time predict findings on (18)F-DCFPyL positron emission tomography/computerized tomography in patients with biochemically recurrent prostate cancer. J Urol. 2020;204(3):496–502.

    Article  Google Scholar 

  27. Mena E, Lindenberg ML, Turkbey IB, et al. (18)F-DCFPyL PET/CT imaging in patients with biochemically recurrent prostate cancer after primary local therapy. J Nucl Med. 2020;61(6):881–9.

    Article  CAS  Google Scholar 

  28. Bodar YJL, Jansen BHE, van der Voorn JP, et al. Detection of prostate cancer with (18)F-DCFPyL PET/CT compared to final histopathology of radical prostatectomy specimens: is PSMA-targeted biopsy feasible? The DeTeCT trial. World J Urol. 2020. https://doi.org/10.1007/s00345-020-03490-8.

  29. Mena E, Lindenberg ML, Turkbey I, et al. The role of castrate status and androgen deprivation therapy in PSMA-based 18F-DCFPyL PET/CT imaging of metastatic prostate cancer patients [abstract no. 1357]. J Nucl Med. 2021;62(Suppl 1).

    Google Scholar 

  30. Pienta KJ, Gorin MA, Rowe SP, et al. A phase 2/3 prospective multicenter study of the diagnostic accuracy of Prostate Specific Membrane Antigen PET/CT with (18)F-DCFPyL in prostate cancer patients (OSPREY). J Urol. 2021. https://doi.org/10.1097/ju0000000000001698.

    Article  PubMed  Google Scholar 

  31. Morris MJ, Rowe SP, Gorin MA, et al. Diagnostic performance of (18)F-DCFPyL-PET/CT in men with biochemically recurrent prostate cancer: results from the CONDOR phase III, multicenter study. Clin Cancer Res. 2021. https://doi.org/10.1158/1078-0432.Ccr-20-4573.

  32. Jansen BHE, Bodar YJL, Zwezerijnen GJC, et al. Pelvic lymph-node staging with (18)F-DCFPyL PET/CT prior to extended pelvic lymph-node dissection in primary prostate cancer—the SALT trial. Eur J Nucl Med Mol Imaging. 2021;48(2):509–20.

    Article  CAS  Google Scholar 

  33. Parikh NR, Tsai S, Bennett C, et al. The impact of (18)F-DCFPyL PET-CT imaging on initial staging, radiation, and systemic therapy treatment recommendations for veterans with aggressive prostate cancer. Adv Radiat Oncol. 2020;5(6):1364–9.

    Article  Google Scholar 

  34. Gorin MA, Rowe SP, Patel HD, et al. Prostate specific membrane antigen targeted (18)F-DCFPyL positron emission tomography/computerized tomography for the preoperative staging of high risk prostate cancer: results of a prospective, phase ii, single center study. J Urol. 2018;199(1):126–32.

    Article  Google Scholar 

  35. Rousseau E, Wilson D, Lacroix-Poisson F, et al. A prospective study on (18)F-DCFPyL PSMA PET/CT imaging in biochemical recurrence of prostate cancer. J Nucl Med. 2019;60(11):1587–93.

    Article  CAS  Google Scholar 

  36. Metser U, Zukotynski K, Liu W, et al. Preliminary results of a prospective, multicenter trial assessing the impact of 18F-DCFPyL-PET/CT on the management of patients with recurrent prostate cancer [abstract no. 40]. J Nucl Med Conf. 2020;61(Suppl 1):40.

    Google Scholar 

  37. Liu W, Zukotynski K, Emmett L, et al. Utilization of salvage and systemic therapies for recurrent prostate cancer as a result of (18)F-DCFPyL PET/CT restaging. Adv Radiat Oncol. 2021;6(1):100553.

    Article  Google Scholar 

  38. Liu W, Zukotynski K, Emmett L, et al. A prospective study of 18F-DCFPyL PSMA PET/CT restaging in recurrent prostate cancer following primary external beam radiotherapy or brachytherapy. Int J Radiat Oncol Biol Phys. 2020;106(3):546–55.

    Article  Google Scholar 

  39. Meijer D, van Leeuwen PJ, Oosterholt PMJ, et al. Management impact of (18)F-DCFPyL PET/CT in hormone-sensitive prostate cancer patients with biochemical recurrence after definitive treatment: a multicenter retrospective study. Eur J Nucl Med Mol Imaging. 2021. https://doi.org/10.1007/s00259-021-05222-5.

  40. Menard C, Delouya G, Wong P, et al. Randomized controlled trial of PSMA PET/CT guided intensification of radiotherapy for prostate cancer: Detection rates and impact on radiotherapeutic management [abstract no. 34]. Int J Radiat Oncol Biol Phys. 2020;108(3 Suppl):S18.

    Article  Google Scholar 

  41. Glicksman R, Metser U, Vines D, et al. Primary analysis of a phase II study of metastasis-directed ablative therapy to PSMA (18F-DCFPyL) PET-MR/CT defined oligorecurrent prostate cancer [abstract no. 5553]. J Clin Oncol. 2020;38(15 Suppl.).

    Article  Google Scholar 

  42. Meyer AR, Carducci MA, Denmeade SR, et al. Improved identification of patients with oligometastatic clear cell renal cell carcinoma with PSMA-targeted (18)F-DCFPyL PET/CT. Ann Nucl Med. 2019;33(8):617–23.

    Article  Google Scholar 

  43. Yin Y, Campbell SP, Markowski MC, et al. Inconsistent detection of sites of metastatic non-clear cell renal cell carcinoma with PSMA-targeted [(18)F]DCFPyL PET/CT. Mol Imaging Biol. 2019;21(3):567–73.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Susan J. Keam.

Ethics declarations

Funding

The preparation of this review was not supported by any external funding.

Authorship and conflict of interest

During the peer review process the manufacturer of the agent under review was offered an opportunity to comment on the article. Changes resulting from any comments received were made by the authors on the basis of scientific completeness and accuracy. Susan Keam is a salaried employee of Adis International Ltd/Springer Nature, and declares no relevant conflicts of interest. All authors contributed to the review and are responsible for the article content.

Ethics approval, Consent to participate, Consent to publish, Availability of data and material, Code availability

Not applicable.

Additional information

This profile has been extracted and modified from the AdisInsight database. AdisInsight tracks drug development worldwide through the entire development process, from discovery, through pre-clinical and clinical studies to market launch and beyond.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (PPTX 417 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Keam, S.J. Piflufolastat F 18: Diagnostic First Approval. Mol Diagn Ther 25, 647–656 (2021). https://doi.org/10.1007/s40291-021-00548-0

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40291-021-00548-0

Navigation