Dr. Tagawa on Tumor Targeting With Radionuclides in Prostate Cancer

Scott T. Tagawa, MD, MS, FACP, professor of medicine and urology, Weill Cornell Medical College, attending physician, NewYork-Presbyterian Hospital, medical director, Genitourinary Oncology Research Program, Weill Cornell Medicine, discusses tumor targeting with radionuclides in prostate cancer.

Radium-223 dichloride (Xofigo) was approved by the FDA in 2013 for the treatment of men with symptomatic metastatic castration-resistant prostate cancer that has spread to the bones but not to other organs. The agent became the first alpha particle approved for any type of cancer, says Tagawa.

Bone metastasis is a frequent complication of prostate cancer, Tagawa explains. As such, radium-223, which targets the bone rather than the tumor, is a reasonable treatment option for this patient population, says Tagawa.

However, tumor targeting with radionuclides offers an alternative strategy, says Tagawa. For example, prostate-specific membrane antigen (PSMA) is expressed on the cell surface of most prostate cancer cells, as well as the luminal surfaces of other organs, such as the salivary glands, renal tubules, small intestine, and some imaging-relevant ganglia, Tagawa explains. PSMA targeting is relevant for diagnostic, as well as therapeutic purposes in prostate cancer, concludes Tagawa.