Case Report: 18F-PSMA PET/CT Scan in Castration Resistant Prostate Cancer With Aggressive Neuroendocrine Differentiation

Overview

Journal Front Oncol

Specialty Oncology

Date 2022 Aug 8

PMID 35936689

Authors

Marco Bergamini

Alberto Dalla Volta

Irene Caramella

Luisa Bercich

Simona Fisogni

Mattia Bertoli

Francesca Valcamonico

Salvatore Grisanti

Pietro Luigi Poliani

Francesco Bertagna

Alfredo Berruti

Affiliations

Soon will be listed here.

Abstract

The development of a neuroendocrine phenotype as a mechanism of resistance to hormonal treatment is observed in up to 20% of advanced prostate cancer patients. High grade neuroendocrine prostate cancer (NEPC) is associated to poor prognosis and the therapeutic armamentarium is restricted to platinum-based chemotherapy. Prostate-specific membrane antigen (PSMA)-based positron emission tomography (PET)/computed tomography (CT) imaging has recently emerged as a potential new standard for the staging of prostate cancer and PSMA-based radioligand therapy (RLT) as a therapeutic option in advanced metastatic castration resistant prostate cancer (mCRPC). PSMA-based theranostic is not currently applied in the staging and treatment of NEPC since PSMA expression on neuroendocrine differentiated cells was shown to be lost. In this case series, we present 3 consecutive mCRPC patients with histologically proven high grade neuroendocrine differentiation who underwent PSMA-PET/CT and surprisingly showed high tracer uptake. This observation stimulates further research on the use of PSMA-based theranostic in the management of NEPC.

Citing Articles

Management Based on Pretreatment PSMA PET of Patients with Localized High-Risk Prostate Cancer Part 2: Prediction of Recurrence-A Systematic Review and Meta-Analysis.

Hoffmann M, Soydal C, Virgolini I, Tuncel M, Kairemo K, Kapp D Cancers (Basel). 2025; 17(5).

PMID: 40075689 PMC: 11899075. DOI: 10.3390/cancers17050841.

Treatment of metastatic castration-resistant prostate cancer: review of current evidence and synthesis of expert opinions on radioligand therapy.

Poon D, Cheung W, Chiu P, Chung D, Kung J, Lam D Front Oncol. 2025; 15:1530580.

PMID: 40071082 PMC: 11893367. DOI: 10.3389/fonc.2025.1530580.

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