Research Outputs

Permanent URI for this communityhttps://hdl.handle.net/20.500.14288/2

Browse

Filters

2023 - 20243

Advanced Search

Filter by

Settings

Quartile: search.filters.quartile.N/ASubject: search.filters.subject.Prostate cancer

Search Results

Now showing 1 - 3 of 3
  • Placeholder
    PublicationMetadata only
    European association of nuclear medicine focus 5: consensus on molecular imaging and theranostics in prostate cancer
    (Elsevier B.V., 2024) Oprea-Lager, DE; MacLennan, S; Bjartell, A; Briganti, A; Burger, IA; de Jong, I; De Santis, M; Eberlein, U; Emmett, L; Fizazi, K; Gillessen, S; Herrmann, K; Heskamp, S; Iagaru, A; Jereczek-Fossa, BA; Kunikowska, J; Lam, M; Nanni, C; O'Sullivan, JM; Panebianco, V; Sala, E; Sathekge, M; Sosnowski, R; Tombal, B; Treglia, G; Tunariu, N; Walz, J; Yakar, D; Dierckx, R; Sartor, O; Fanti, S.; Tilki, Derya; School of Medicine; Koç University Hospital
    Background: In prostate cancer (PCa), questions remain on indications for prostate-specific membrane antigen (PSMA) positron emission tomography (PET) imaging and PSMA radioligand therapy, integration of advanced imaging in nomogram-based decision-making, dosimetry, and development of new theranostic applications. Objective: We aimed to critically review developments in molecular hybrid imaging and systemic radioligand therapy, to reach a multidisciplinary consensus on the current state of the art in PCa. Design, setting, and participants: The results of a systematic literature search informed a two-round Delphi process with a panel of 28 PCa experts in medical or radiation oncology, urology, radiology, medical physics, and nuclear medicine. The results were discussed and ratified in a consensus meeting. Outcome measurements and statistical analysis: Forty-eight statements were scored on a Likert agreement scale and six as ranking options. Agreement statements were analysed using the RAND appropriateness method. Ranking statements were analysed using weighted summed scores. Results and limitations: After two Delphi rounds, there was consensus on 42/48 (87.5%) of the statements. The expert panel recommends PSMA PET to be used for staging the majority of patients with unfavourable intermediate and high risk, and for restaging of suspected recurrent PCa. There was consensus that oligometastatic disease should be defined as up to five metastases, even using advanced imaging modalities. The group agreed that [177Lu]Lu-PSMA should not be administered only after progression to cabazitaxel and that [223Ra]RaCl2 remains a valid therapeutic option in bone-only metastatic castration-resistant PCa. Uncertainty remains on various topics, including the need for concordant findings on both [18F]FDG and PSMA PET prior to [177Lu]Lu-PSMA therapy. Conclusions: There was a high proportion of agreement among a panel of experts on the use of molecular imaging and theranostics in PCa. Although consensus statements cannot replace high-certainty evidence, these can aid in the interpretation and dissemination of best practice from centres of excellence to the wider clinical community. Patient summary: There are situations when dealing with prostate cancer (PCa) where both the doctors who diagnose and track the disease development and response to treatment, and those who give treatments are unsure about what the best course of action is. Examples include what methods they should use to obtain images of the cancer and what to do when the cancer has returned or spread. We reviewed published research studies and provided a summary to a panel of experts in imaging and treating PCa. We also used the research summary to develop a questionnaire whereby we asked the experts to state whether or not they agreed with a list of statements. We used these results to provide guidance to other health care professionals on how best to image men with PCa and what treatments to give, when, and in what order, based on the information the images provide.
  • Placeholder
    PublicationMetadata only
    Optimized hybrid arc for improved sparing of organs at risk: balanced combination of IMRT and VMAT in prostate cancer
    (Galenos, 2023) Ayhan Bingölbalı; Sağlam, Yücel; School of Medicine; Koç University Hospital
    Objective: In order to seek a lower toxicity risk prediction in patients with prostate cancer, we have evaluated whether prescribing a potential hybrid radiotherapy of intensity-modulated radiotherapy (IMRT) & volumetric modulated arc therapy (VMAT) optimization might increase sparing of organs at risk (OAR) and target dose conformity. Methods: The cohort for this dosimetric planning study included ten consecutive prostate cancer patients previously treated with double arc VMAT to 78 Gy. New optimized hybrid arc plans for a combination of IMRT (8 step-and-shoot fix fields: 225°, 260°, 295°, 330°, 30°, 65°, 90°, 135°) and VMAT (182°-178° clockwise) besides new IMRT (8 step-and-shoot fix fields: 225°, 260°, 295°, 330°, 30°, 65°, 90°, 135°) plans were generated per patient. Dose volume histogram parameters were compared between treated VMAT, new IMRT and new optimized hybrid arc plans for OAR doses. Results: The optimized hybrid arc technique revealed significantly lower rectum (p=0.005) and bladder (p= 0.005) doses compared to stand alone VMAT and IMRT. Conclusion: The optimized hybrid arc technique appears to combine the advantages of IMRT and VMAT to provide a more conformal and homogeneous plan with better OAR sparing in comparison to standalone VMAT or IMRT plans.
  • Placeholder
    PublicationMetadata only
    The “ins and outs” of prostate specific membrane antigen (psma) as specific target in prostate cancer therapy
    (Springer, 2023) Eltit, Felipe; Robinson, Nicole; Yu, Pak Lok Ivan; Pandey, Mitali; Lozada, Jerome; Guo, Yubin; Sharma, Manju; Ozturan, Dogancan; Ganier, Laetitia; Belanger, Eric; Perrin, David M.; Cox, Michael E.; Goldenberg, S. Larry; Lack, Nathan Alan; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); School of Medicine
    Prostate-specific membrane antigen (PSMA) is expressed in epithelial cells of the prostate gland and is strongly upregulated in prostatic adenocarcinoma, with elevated expression correlating with metastasis, progression, and androgen independence. Because of its specificity, PSMA is a major target of prostate cancer therapy;however, detectable levels of PSMA are also found in other tissues, especially in salivary glands and kidney, generating bystander damage of these tissues. Antibody target therapy has been used with relative success in reducing tumor growth and prostate specific antigen (PSA) levels. However, since antibodies are highly stable in plasma, they have prolonged time in circulation and accumulate in organs with an affinity for antibodies such as bone marrow. For that reason, a second generation of PSMA targeted therapeutic agents has been developed. Small molecules and minibodies have had promising clinical trial results, but concerns about their specificity had arisen with side effects due to accumulation in salivary glands and kidneys. Herein we study the specificity of small molecules and minibodies that are currently being clinically tested. We observed a high affinity of these molecules for PSMA in prostate, kidney and salivary gland, suggesting that their effect is not prostate specific. The search for specific prostate target agents must continue so as to optimally treat patients with prostate cancer, while minimizing deleterious effects in other PSMA expressing tissues. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.