Dr. Tagawa on Remaining Questions With PSMA-Targeted Radionuclide Therapy in mCRPC

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/New York Presbyterian Hospital, discusses remaining questions regarding treatment selection and PSMA imaging in metastatic castration-resistant prostate cancer.

One of the remaining challenges in mCRPC is determining appropriate patient selection for PSMA-targeted agents, says Tagawa; this raises the question of PSMA imaging. Overall, it is known that some patients with negative PSA scans will still have a response to therapy. Available data suggest that those with brighter, positive scans tend to have higher responses to treatment compared with those who have negative scans. As such, if deciding between 2 therapies that are equal, the patient with the brighter scan may respond better to that particular type of therapy, says Tagawa.

Beyond that, there are other aspects that might emerge and affect treatment decisions. A smaller subset of data were presented at the 2019 Genitourinary Cancers Symposium that suggested some factors, such the presence of BRCA2, could indicate better responses, progression-free survival, and overall survival with a PSMA-targeted therapy in patients with mCRPC, concludes Tagawa.