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SSTR-based theranostics in neuroendocrine prostate cancer (NEPC)

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Abstract

Purpose

Prostate cancer (PCa) is the most commonly diagnosed malignancy in men and a high-ranking cause of cancer-related death. If properly managed, these patients can have an acceptable life expectancy. Therefore, the detection of lesions associated with the recurrence of PCa in the context of castration-resistant prostate cancer (CRPC) is an important diagnostic and therapeutic challenge for clinicians. One cause of CRPC is neuroendocrine differentiation (NE) of prostate cancer (NEPC). Efforts are underway to diagnose and treat this type of PCa. The objective of this study was to review the available evidence about the patients with NEPC undergoing SSTR2 targeting for either diagnostic or therapeutic purposes. Although there is still little information in this area, this review could lighten future studies.

Methods

A comprehensive literature search of published papers in the PubMed/MEDLINE database with the following search terms: (((dotatate[Title/Abstract]) OR (dotatoc[Title/Abstract])) OR (dotanoc[Title/Abstract])) AND (prostate[Title/Abstract]) was carried out. Relevant articles about NEPC, even case reports and interesting images, with a nuclear medicine approach were checked out to write this narrative review.

Results

NEPC may arise in the later stages of androgen receptor pathway inhibition (ARPI) treatment in PCa patients. NE differentiation reflects higher tumor aggression, and the overexpression of somatostatin receptors in these lesions could potentially be a favorite target for diagnostic purposes. However, there is no suitable biomarker reflecting NE differentiation or SSTR expression yet.

Conclusions

Since the main evidence in NEPC cells is the predominance of SSTR-1, theoretically the design of a radiopharmaceutical with greater affinity to this receptor could be useful for therapeutic and diagnostic purposes; however, the possibility of using peptide receptor radionuclide therapy (PRRNT) in patients with intense uptake of available radiotherapists (e.g., [68 Ga]Ga-DOTA-TATE) should not be ignored in following researches.

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Availability of data and material

Data were obtained using a literature review that can be viewed based on given references.

Code availability

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Authors and Affiliations

  1. Nuclear Medicine Center, Payambar Azam Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Hormozgan, Iran

    Pejman Shahrokhi

  2. Research Center for Nuclear Medicine, Tehran University of Medical Sciences, Tehran, Iran

    Alireza Emami-Ardekani & Najme Karamzade-Ziarati

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Contributions

Pejman Shahrokhi: reviewing and editing. Alireza Emami-Ardekani: reviewing and editing. Najme Karamzade-Ziarati: conceptualization, literature searching, drafting, image designing, reviewing and editing.

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Correspondence to Najme Karamzade-Ziarati.

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Pejman Shahrokhi declares that he has no conflict of interest. Alireza Emami-Ardekani declares that he has no conflict of interest. Najme Karamzade-Ziarati declares that she has no conflict of interest.

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Shahrokhi, P., Emami-Ardekani, A. & Karamzade-Ziarati, N. SSTR-based theranostics in neuroendocrine prostate cancer (NEPC). Clin Transl Imaging 11, 321–328 (2023). https://doi.org/10.1007/s40336-022-00535-3

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