In salivary glands, lacrimal glands, kidneys, and gastrointestinal tract it is overexpressed physiologically. PSMA is expressed at low levels in the cytoplasm of normal prostate epithelial cells. It consists of 750 amino acids and two monomers. PSMA is a type 2 integral membrane glycoprotein with intracellular, transmembrane, and extracellular domains. Expression of prostate-specific membrane antigen (PSMA) is positively linked with PSA levels. Increased prostate-specific antigen (PSA) levels are one of the hallmarks of PCa. Peptide Receptor Radionuclide Therapy (PRRT) This paper briefly discusses the production, and clinical applications of 64Cu/ 67Cu in PCa patients. Since both belong to the same element and share similar chemistry, 67Cu can be used in lieu of 64Cu for radionuclide therapy. The coordination chemistry of copper is such that the radionuclides can be linked with several chelators, peptides, antibodies, and small molecules. Copper-67, on the other hand, decays with beta emissions of (E β − max = 0.561 MeV) with t½ of 2.57 d, long enough to cause tumor cell killing but short enough not to induce excessive radiation burden to normal tissues. Copper-64 is a positron-emitting radionuclide (E β + = 0.653 MeV) that permits positron emission tomography (PET) imaging and has beta emissions (E β − max = 0.579 MeV), which may be useful for theragnostic applications. The half-life (t½) of 64Cu is 12.7 h, long enough for uptake and biodistribution studies of a radiopharmaceutical, including antibodies that may require a longer time for localization. Their nuclear properties are highly suitable for diagnosis and therapy. Fourth, post-therapy diagnostic radiopharmaceutical help in predicting response to the treatment ( Figure 1).Īmongst the PCa theragnostics, Copper-64 and Copper-67 ( 64Cu/ 67Cu) is an emerging theragnostic radionuclide pair. Third, the location of the primary lesion and its tumor volume determined from the pre-therapy scan, the estimated highest whole-body dose, and critical tissue radiation dose help to calculate a personalized therapeutic dose. Second, the biodistribution of the diagnostic radiopharmaceutical further helps to determine the possible adverse effects of therapeutic radiopharmaceutical. The findings allow to select a patient who is most likely to benefit from the therapy. First, a diagnostic radiopharmaceutical is administered to the patient, and molecular imaging is performed. The use of theragnostic radionuclide pairs can be highly beneficial in the management of cancer as well as other life-threatening diseases. They can belong to the same or different elements and can have similar chemistry and pharmacokinetics. Theragnostic radionuclide pairs are a combination of diagnostic and therapeutic radionuclides sharing the same target inside the body. At this stage, patient survival may be improved by using theragnostic radionuclide pairs. The disease, however, advances to metastatic castration-resistant prostate cancer (mCRPC). Most patients respond to these regimens initially. A testosterone-reducing drug combined with androgen deprivation therapy is the first-line therapy for metastatic PCa.
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