PET/CT imaging for evaluating response to therapy in castration-resistant prostate cancer

Excerpt

Prostate cancer (PCa) represents the most common malignancy in men [1], and begins as an androgen-dependent tumour. Androgen deprivation therapy (ADT) represents the backbone of treatment for relapsed or advanced prostate cancer patients. However, after a median of 12–24 months of initial response, disease progression usually occurs, despite castrate levels of serum testosterone (≤50 ng/dL), defining a state called castration-resistant prostate cancer (CRPC) [2]. Metastatic CRPC (mCRPC) in advanced disease is associated with high mortality rates (overall survival [OS] of 2–3 years) [1]. In these patients, palliation is the treatment of choice, and many different therapies are available nowadays, including taxane-based chemotherapy and novel androgen receptor (AR)-targeted therapy [3]. However, a significant number of patients develop resistance, showing no response or showing progression during therapy. Thus, the early identification of non-responders is crucial for avoiding the administration of toxic, futile and expensive therapies. …