| Autor: |
Kleiburg F; Biomedical Photonic Imaging Group, University of Twente, Enschede, The Netherlands.; Department of Radiology, section of Nuclear Medicine, Leiden University Medical Center, Leiden, The Netherlands., Heijmen L; Department of Radiology, section of Nuclear Medicine, Leiden University Medical Center, Leiden, The Netherlands., Gelderblom H; Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands., Kielbasa SM; Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands., Bovée JV; Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands., De Geus-Oei LF; Biomedical Photonic Imaging Group, University of Twente, Enschede, The Netherlands.; Department of Radiology, section of Nuclear Medicine, Leiden University Medical Center, Leiden, The Netherlands.; Department of Radiation Science and Technology, Technical University of Delft, Delft, The Netherlands. |
| Abstrakt: |
Bone and soft tissue sarcomas are a group of rare malignant tumours with major histological and anatomical varieties. In a metastatic setting, sarcomas have a poor prognosis due to limited response rates to chemotherapy. Radioligand therapy targeting prostate-specific membrane antigen (PSMA) may offer a new perspective. PSMA is a type II transmembrane glycoprotein which is present in all prostatic tissue and overexpressed in prostate cancer. Despite the name, PSMA is not prostate-specific. PSMA expression is also found in a multitude of non-prostatic diseases including a subgroup of sarcomas, mostly in its neovascular endothelial cells. On PET/CT imaging, multiple sarcomas have also shown intense PSMA-tracer accumulation. PSMA expression and PSMA-tracer uptake seem to be highest in patients with aggressive and advanced sarcomas, who are also in highest need of new therapeutic options. Although these results provide a good rationale for the future use of PSMA-targeted radioligand therapy in a selection of sarcoma patients, more research is needed to gain insight into optimal patient selection methods, PSMA-targeting antibodies and tracers, administered doses of radioligand therapy, and their efficacy and tolerability. In this review, mRNA expression of the FOLH1 gene which encodes PSMA, PSMA immunohistochemistry, PSMA-targeted imaging and PSMA-targeted therapy in sarcomas will be discussed. |
