[18F]DCFPyL PET/CT for Imaging of Prostate Cancer

Abstract

Prostate-specific membrane antigen (PSMA)-directed positron emission tomography (PET) has gained increasing interest for imaging of men affected by prostate cancer (PC). In recent years, ⁶⁸Ga-labeled PSMA compounds have been widely utilized, although there is a trend towards increased utilization of ¹⁸F-labeled agents. Among others, [¹⁸F]DCFPyL (piflufolastat F 18, PYLARIFY) has been tested in multiple major trials, such as OSPREY and CONDOR, which provided robust evidence on the clinical utility of this compound for staging, restaging, and change in management. Recent explorative prospective trials have also utilized [¹⁸F]DCFPyL PET/CT for response assessment, e.g., in patients under abiraterone or enzalutamide, rendering this ¹⁸F-labeled PSMA radiotracer as an attractive biomarker for image-guided strategies in men with PC. After recent approval by the U.S. Food and Drug Administration, one may expect more widespread use, not only in the U.S., but also in Europe in the long term. In the present review, we will provide an overview of the current clinical utility of [¹⁸F]DCFPyL in various clinical settings for men with PC.

Zusammenfassung

Die Positronen-Emissions-Tomografie (PET) mit PSMA (Prostata-spezifisches Membran-Antigen) gerichteten Liganden ist zunehmend in den Fokus der Bildgebung des Prostatakarzinoms (PC) bei Männern gerückt. In den letzten Jahren wurden in großem Umfang ⁶⁸Ga-markierte PSMA-Tracer verwendet, obwohl ein Trend zum verstärkten Einsatz von ¹⁸F-markierten Tracern zu beobachten ist. Unter anderem wurde [¹⁸F]DCFPyL (Piflufolastat F 18, PYLARIFY) in mehreren großen Studien wie OSPREY und CONDOR untersucht, die eine belastbare Evidenz für den klinischen Nutzen dieses Tracers hinsichtlich Staging, Restaging und Änderung des Managements zeigten. Neuere prospektive Untersuchungen haben [¹⁸F]DCFPyL PET/CT auch zur Beurteilung des Ansprechens eingesetzt, z. B. bei Patienten unter Abirateron oder Enzalutamid, was diesen ¹⁸F-markierten PSMA-Radiotracer zu einem attraktiven Biomarker für bildgestützte Strategien bei Männern mit PC macht. Nach der kürzlich erfolgten Zulassung durch die U.S. Food and Drug Administration (FDA) ist nicht nur in den USA, sondern langfristig auch in Europa mit einer breiteren Anwendung zu rechnen. Im vorliegenden Review geben wir einen Überblick über den aktuellen klinischen Nutzen von [¹⁸F]DCFPyL bei Männern mit PC in verschiedenen klinischen Situationen.

Schlüsselwörter

Prostatakarzinom - Theranostik - ¹⁸F-DCFPyL

Keywords

Prostate Cancer - Theranostics - ¹⁸F-DCFPyL

Publikationsverlauf

Eingereicht: 12. September 2021

Angenommen: 17. September 2021

Artikel online veröffentlicht:
14. Januar 2022

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