VISION, TheraP, LuTectomy and beyond - is there a role for lutetium therapy in biochemical recurrence?

Purpose Of Review: This review synthesizes current evidence and recommendations for the use of lutetium-177 prostate-specific membrane antigen (LuPSMA) radioligand therapy across the spectrum of prostate cancer, focusing on its established use in metastatic castration-resistant prostate cancer (mCRPC), and evolving role in metastatic hormone-sensitive disease (mHSPC) and in neoadjuvant treatment of high-risk localized disease. We explore the potential for its use in biochemical recurrence (BCR) highlighting its limitations, and areas for future research.

Recent Findings: LuPSMA has demonstrated oncological efficacy and tolerability over standard of care treatments in mCRPC, supported by landmark trials such as VISION, TheraP, and PSMAfore.

Transcriptomic decoding of surface-based imaging phenotypes and its application to pharmacotranscriptomics.

Imaging transcriptomics has become a power tool for linking imaging-derived phenotypes (IDPs) to genomic mechanisms. Yet, its potential for guiding CNS drug discovery remains underexplored. Here, utilizing spatially-dense representations of the human brain transcriptome, we present an analytical framework for the transcriptomic decoding of high-resolution surface-based neuroimaging patterns, and for linking IDPs to the transcriptomic landscape of complex neurotransmission systems in vivo.

A meta-analysis of Retzius-sparing and hood-technique robot-assisted radical prostatectomy.

Objectives: To compare Retzius-sparing (RS-) robot-assisted radical prostatectomy (RARP), hood-technique RARP and standard RARP, assessing functional, oncological and peri-operative outcomes.

Methods: A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The primary outcome was postoperative perfect continence rate (0 pad/day) at different time points over 12 months.

First-in-human results of terbium-161 [Tb]Tb-PSMA-I&T dual beta-Auger radioligand therapy in patients with metastatic castration-resistant prostate cancer (VIOLET): a single-centre, single-arm, phase 1/2 study.

Background: Terbium-161 (Tb) emits beta-radiation similar to lutetium-177 (Lu), with additional radiation over ultra-short path lengths from Auger electrons. Tb has shown superior in-vitro and in-vivo efficacy compared with Lu. We aimed to evaluate the safety of [Tb]Tb-PSMA-I&T in patients with metastatic castration-resistant prostate cancer (mCRPC).

Impact of the R.E.N.A.L. complexity score on outcomes of stereotactic ablative body radiotherapy for primary renal cell carcinoma.

Objective: To evaluate the predictive value of the R.E.N.

Evaluating analytic strategies to obtain high-resolution, vertex-level measures of cortical neuroanatomy in children in low- and middle-income countries.

High-field magnetic resonance imaging to explore brain structure and function remains limited to high-resource settings. Novel, low-field (<0.1 T) imaging offers a more cost-effective/accessible alternative.

The Role of Prostate-specific Membrane Antigen Positron Emission Tomography for Assessment of Local Recurrence and Distant Metastases in Patients with Biochemical Recurrence of Prostate Cancer After Definitive Treatment: A Systematic Review and Meta-analysis.

Background And Objective: Positron emission tomography (PET) with prostate-specific membrane antigen (PSMA) radioligands has an established role in the assessment of recurrence of prostate cancer (PC) after primary treatment. However, an updated understanding of its diagnostic utility is warranted, particularly in the context of emerging targeted and systemic treatment options for recurrent PC. Our aim was to evaluate the diagnostic performance of PSMA PET for staging and detection of local or metastatic disease in patients with biochemical recurrence (BCR) following definitive treatment for PC.

Early Results from the CONFIRM Trial: Utility of Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography in Active Surveillance for Prostate Cancer.

Background And Objective: There is growing evidence on the utility of prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) for detection of clinically significant prostate cancer (csPC), but there are limited data on its use in active surveillance (AS). The CONFIRM trial aims to determine the utility of PSMA PET/CT in detecting csPC before confirmatory biopsy during AS.

Methods: This is an initial analysis of a prospective, nonrandomised, crossover clinical trial (ANZCTR ID ACTRN12621001648819) that included men on AS for newly diagnosed low-grade prostate cancer (PC) with "high-risk" features.

Pelvic Lymph Node Dissection in Prostate Cancer: Is It Really Necessary? A Multicentric Longitudinal Study Assessing Oncological Outcomes in Patients With Prostate Cancer Undergoing Pelvic Lymph Node Dissection vs Radical Prostatectomy Only.

Purpose: With the availability of prostate-specific membrane antigen positron emission tomography scans, it is controversial whether pelvic lymph node dissection (PLND) at the time of radical prostatectomy (RP) is still the most reliable and accurate staging modality for lymph node assessment. Furthermore, the oncological benefit of PLND remains unclear. The aim of this study was to assess whether omitting PLND in patients undergoing RP for prostate cancer (PCa) is associated with the risk of tumor recurrence and progression to metastasis.

An Online Treatment Decision Aid for Men with Low-risk Prostate Cancer Eligible for Active Surveillance and Their Partners Increases the Uptake of Active Surveillance: The Navigate Randomised Controlled Trial.

Background And Objective: Evidence suggests that curative treatment for low-risk prostate cancer (LRPC) has no survival benefits over active surveillance (AS); thus, treatment choice becomes a value-sensitive decision. Decision aids (DAs) have the potential to facilitate this process, yet no DA has been tailored to the Australian health care system or population. This study aims to evaluate the impact of an online DA (Navigate) on the uptake of AS, quality of life, and decision-making in Australia.

Radical cystectomy mortality in older patients: a systematic review and meta-analysis.

Objective: To perform a systematic review and meta-analysis of post-radical cystectomy (RC) mortality and complications in older people to aid decision-making pertinent to RC, as bladder cancer is typically a disease of older people, yet older people are less likely than their younger peers to undergo RC, predominantly due to concerns about morbidity and mortality of surgery.

Materials And Methods: A systematic search of MEDLINE, Scopus and Ovid Emcare was performed in May 2023 for all studies in the past 20 years that reported mortality and/or complications in the 90-days following RC. All studies reporting mortality or complication outcomes in patient groups aged >75 years were included.

A Comprehensive Systematic Review and Meta-analysis of the Role of Prostate-specific Membrane Antigen Positron Emission Tomography for Prostate Cancer Diagnosis and Primary Staging before Definitive Treatment.

Background And Objective: Positron emission tomography (PET) with prostate-specific membrane antigen (PSMA) in the diagnosis and primary staging of patients with prostate cancer (PCa) has an established role, but recent summative evidence on its actual diagnostic and staging value is still missing. We aimed to collect and analyze published studies reporting the accuracy of PSMA PET for the diagnosis of clinically significant prostate cancer (csPCa) and detection of distant metastases at primary staging before definitive treatment.

Methods: We performed a systematic review of the literature, by searching the PubMed/MEDLINE, Cochrane library's CENTRAL, EMBASE, and Scopus databases, from inception to April 2024.

Prevalence and Medium-Term Outcomes of Patients with Biopsy-Proven Intermediate- to High-Risk Prostate Adenocarcinoma with Low Intraprostatic Uptake on [Ga]Ga-PSMA-11 PET/CT in the proPSMA Study.

The current prevalence of low intraprostatic uptake for staging prostate-specific membrane antigen (PSMA) PET ranges between 4.4% and 17% in retrospective studies. We aimed to define the prevalence and describe the outcomes of patients with low intraprostatic uptake on PSMA PET/CT in the prospective proPSMA study.

PSMA-Guided Metastasis-Directed Therapy for Oligometastatic Renal Cell Carcinoma: The Proof-of-Concept PEDESTAL Study.

Metastasis-directed therapy (MDT) in oligometastatic renal cell carcinoma (RCC) is typically based on conventional imaging. Prostate-specific membrane antigen (PSMA) PET/CT has shown superiority over conventional imaging. Our objective was to perform a proof-of-concept study to evaluate the efficacy of PSMA-guided MDT in oligometastatic RCC.

Impact of intraprostatic PSMA maximum standardised uptake value following prostatectomy: a systematic review and meta-analysis.

Objective: To perform a systematic review and meta-analysis to assess the relationship between intraprostatic maximum standardised uptake value (SUV) of the dominant prostatic lesion as measured on preoperative prostate-specific membrane antigen (PSMA) positron emission tomography (PET) with radical prostatectomy International Society of Urological Pathology (ISUP) Grade Group, pathological tumour (pT) staging, and biochemical recurrence (BCR).

Methods: Prostate-specific membrane antigen PET may offer non-invasive assessment of histopathological and oncological outcomes before definitive treatment. SUV of the dominant lesion has been explored as a prognostic biomarker.

Snap Diagnosis: Developing an Artificial Intelligence Algorithm for Penile Cancer Detection from Photographs.

: Penile cancer is aggressive and rapidly progressive. Early recognition is paramount for overall survival. However, many men delay presentation due to a lack of awareness and social stigma.

Baseline Nodal Status on Ga-PSMA-11 Positron Emission Tomography/Computed Tomography in Men with Intermediate- to High-risk Prostate Cancer Is Prognostic for Treatment Failure: Follow-up of the proPSMA Trial.

Background And Objective: There is uncertainty regarding the clinical significance of Ga-PSMA-11 positron emission tomography (PET) computed tomography (CT) findings in men with prostate cancer. In this prespecified objective of the proPSMA study, we report the prognostic value of PET-defined nodal involvement.

Methods: Men with intermediate- to high-risk prostate cancer (grade group 3-5, prostate-specific antigen [PSA] ≥20 ng/ml, or clinical stage ≥T3) underwent Ga-PSMA-11 PET-CT or CT and bone scanning as first- or second-line imaging.

Investigating social orienting in children with Phelan-McDermid syndrome and 'idiopathic' autism.

Background: Phelan-McDermid syndrome (PMS) is a rare genetic syndrome characterized by developmental delay/intellectual disability, absent or delayed speech, physical dysmorphic features and high rates of autistic features. However, it is currently unknown whether people with PMS have similar neurocognitive atypicalities to those previously identified in idiopathic autism. Disruption in social orienting has previously been suggested as an early hallmark feature of idiopathic autism that impacts social learning and social interaction.

PSMA PET/CT patterns of recurrence after mono-brachytherapy in men with low and intermediate prostate cancer and subsequent management.

Purpose: Brachytherapy as monotherapy is a recommended treatment option for men with low to intermediate risk prostate cancer. Local recurrence is difficult to identify. This study investigated PSMA PET/CT for recurrence after brachytherapy, as well as their subsequent management when recurrence occurred only within the prostate.