Prostate-specific membrane antigen (PSMA) as a potential target for molecular imaging and treatment in bone and soft tissue sarcomas

Fleur Kleiburg*, Linda Heijmen, Hans Gelderblom, Szymon M. Kielbasa, Judith Vmg Bovée, Lioe Fee De Geus-Oei

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

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Abstract

Bone and soft tissue sarcomas are a group of rare malignant tumours with major histological and anatomical varie-ties. In a metastatic setting, sarcomas have a poor prognosis due to limited response rates to chemotherapy. Radioli-gand therapy targeting prostate-specific membrane antigen (PSMA) may offer a new perspective. PSMA is a type II transmembrane glycoprotein which is present in all prostatic tissue and overexpressed in prostate cancer. Despite the name, PSMA is not prostate-specific. PSMA expression is also found in a multitude of non-prostatic diseases including a subgroup of sarcomas, mostly in its neovascular endothelial cells. On PET/CT imaging, multiple sarcomas have also shown intense PSMA-tracer accumulation. PSMA expression and PSMA-tracer uptake seem to be highest in patients with aggressive and advanced sarcomas, who are also in highest need of new therapeutic options. Although these results provide a good rationale for the future use of PSMA-targeted radioligand therapy in a selection of sarcoma patients, more research is needed to gain insight into optimal patient selection methods, PSMA-targeting antibodies and tracers, administered doses of radioligand therapy, and their efficacy and tolerability. In this review, mRNA expression of the FOLH1 gene which encodes PSMA, PSMA immunohistochemistry, PSMA-targeted imaging and PSMA-targeted therapy in sarcomas will be discussed.

Original languageEnglish
Article number20220886
JournalBritish journal of radiology
Volume96
Issue number1145
DOIs
Publication statusPublished - 21 Feb 2023

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