Dr. Tagawa on Targeting PSMA in Prostate Cancer

Scott T. Tagawa, MD, MS, Richard A. Stratton Associate Professor in Hematology and Oncology, associate professor of clinical medicine and urology at Weill Cornell Medicine, and associate attending physician, Weill Cornell Medical Center/NewYork-Presbyterian Hospital, discusses the utility of beta and alpha emitters in targeting PSMA in prostate cancer.

Both patients and physicians are well aware of PSMA, says Tagawa. PSMA is found on the surface of prostate cancer cells and a couple of other areas of the body, such as the salivary glands, kidneys, and small intestines, explains Tagawa. However, PSMA is very selective and mostly found in prostate cancer; it can be targeted through imaging and treatment. Regarding treatment, 2 randomized studies have been completed but the field is awaiting those results, says Tagawa.

One of these studies utilized a small molecule with a beta emitter. Radiopharmaceuticals such as Lutetium-177-PSMA are a novel way to treat patients with advanced prostate cancer. This approach is has been shown to be effective, says Tagawa. Despite its promise, it is not able to kill all cells; it is not as powerful as an alpha emitter. An alpha emitter has higher energy and cell-killing ability, but that energy travels a much shorter distance, explains Tagawa. As such, use of these emitters requires getting next to the cell that will be killed because if it is in the wrong place, it could cause a lot more damage, concludes Tagawa.