Ushering in a new era of precision diagnostics and therapeutics for prostate cancer

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Ushering in a new era of precision diagnostics and therapeutics for prostate cancer

June 01, 2018
Molecular Imaging
From the June 2018 issue of HealthCare Business News magazine

Other imaging compounds are being developed for prostate cancer, such as radiotracers targeting prostate serum membrane antigen (PSMA), a molecule present in high quantities on the surface of many prostate cancer cells. Early studies suggest that PSMA-targeting compounds may also be very accurate for the detection of prostate cancer. Furthermore, investigations are underway to determine whether some of these compounds could be modified to become very effective therapies. By connecting the compound to a therapeutic radioisotope rather than a diagnostic one, the targeting of the compound to cancer cells could result in the delivery of localized radiation therapy inside the body, directed specifically at the tumor.

Many further clinical trials are needed to explore the full potential of these combined therapeutic/diagnostic (so-called “theranostic”) radioactive compounds. In the meantime, the use of approved imaging compounds such as Axumin continues to expand. One of the primary barriers to the use of these agents is reimbursement. Although the Food and Drug Administration has determined that Axumin is safe, and is an effective imaging agent for the detection of prostate carcinoma, many insurance companies and third-party payers do not cover its use, considering it and others in its class to be investigational rather than part of standard medical practice. This is not unusual for any new class of diagnostic or therapeutic compound, and it is the responsibility of the medical community to demonstrate through clinical trials and peer-reviewed publication that medical management and patient outcomes are improved with the incorporation of these new agents. In the meantime, however, patients often are given a choice of paying the cost of the procedure themselves or not having the test at all and relying on conventional diagnostic procedures.

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Locally, we have found that molecular imaging techniques have enhanced our ability to treat patients with a higher degree of confidence and precision at Baylor College of Medicine. Whereas previously the approaches to patients with suspected recurrent prostate cancer were often based on assumptions and probabilities, we are now able to treat our patients with targeted and customized therapies designed specifically to treat their cancer. Combining the imaging power of PET radiotracers such as Axumin with other advanced imaging methods, such as high-strength parametric MR and image-guided minimally-invasive biopsy techniques, the team at Baylor College of Medicine is at the forefront of the fight against prostate cancer.

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