PSMA diagnostics and treatments of prostate cancer become mature

Prostate cancer is the second leading cause of cancer death for men in many parts of the world. Radical prostatectomy (RP) and external beam radiotherapy (EBRT) are effective treatment of localized prostate cancer but many patients recur with raising levels of prostate-specific antigen (PSA). Localized salvage therapies for suspected local failure such as salvage EBRT after RP are most effective during early PSA recurrence. In a Danish national cohort study, salvage EBRT for patients with PSA recurrence after RP undertaken without restaging imaging was effective for approximately half of the patients [ 1 ]. Improving on these results requires identification of men with truly localized or oligometastatic recurrence. However, restaging with conventional imaging such as CT and bone scans has limitations. For example, among patients with PSA recurrence after RP, those with a rising PSA < 10 µg/L rarely have positive bone scans. This is problematic because guidelines recommend that patients with PSA recurrence after RP should undergo salvage radiotherapy, while PSA is < 0.5 µg/L [ 2 ]. Thus, bone scans cannot guide salvage treatment for most patients with early-phase PSA recurrence after RP.