This is another one in a chain of anecdotal evidence where patients with BRCA/ATM respond well to PSMA targeted therapies (no long term survival analysis done yet though). The PSMA expression of this cohort is several times those of other "unselected" CRPC or HSPC patients.
Perhaps Lu/Ac should be brought up forward for this cohort? Worth a discussion with your MOs if you fall into this category.
"TAKE-HOME MESSAGE
In this retrospective study, expression of membranous prostate-specific membrane antigen (PSMA) was scored via immunohistochemistry and was correlated with sequencing (matching same-patient biopsies) and clinical data. The expression of membranous PSMA was heterogeneous, more common in castration-resistant disease, and associated with a higher Gleason score (P=.04), and worse overall survival (P=.006). In addition, tumors with DNA damage repair had more membranous PSMA expression (P=.016), specifically aberrations in BRCA2 and ATM in the validation cohorts.
As PSMA theranostics is gaining increasing interest as a valid treatment option for metastatic prostate cancer, this very interesting and provocative study raises important questions regarding the expression of PSMA and genomic markers of response, deserving further investigation."
Stage 4 A Prostate cancer
FDA Approves another PSMA PET scan for Prostate Cancer Imaging
Some prostate cancer cells are invisible to PSMA GA-68 scan?
Lutetium 177 PSMA radionuclide therapy for men with prostate cancer
68Ga-PSMA I&T PET/CT for primary staging of prostate cancer
