TY - JOUR T1 - Molecular radiotheragnostics in prostate cancer JF - Clinical Medicine JO - Clin Med SP - 458 LP - 461 DO - 10.7861/clinmedicine.17-5-458 VL - 17 IS - 5 AU - Yong Du AU - Sabina Dizdarevic Y1 - 2017/10/01 UR - http://www.rcpjournals.org/content/17/5/458.abstract N2 - Two different molecular radio-theragnostic principles are applied in prostate cancer, providing a personalised management for those patients. Firstly, radiopharmaceuticals with the same or similar mechanism of action but different energy (gamma-γ, eg 99mTc-diphosphonates or positron-β+, eg 18F-NaF emitting isotopes) can be used to identify patients with osteoblastic metastases for a treatment with bone seeking beta (β-) or alpha (α-) emitting radionuclides to deliver targeted molecular radiotherapy. A number of such β- emitting molecules have been used for bone palliation. More recently, an alpha emitting 223Ra-dicholoride demonstrated not only symptomatic relief but also significantly improved overall survival in castration-resistant prostate cancer with predominant bone metastases. The second principle involves utilisation of the same prostatic specific membrane antigen (PSMA) or similar compound (eg PSMA-11, PSMA-617), but different label with either β+ (68Ga) or γ (99mTc) emitting radioisotope for imaging and subsequently β- (177Lu) or α (225Ac) emitting radionuclide for treatment. ER -