Molecular Imaging in Focus: PSMA PET Pioneer Martin Pomper, MD, PhD Traces PSMA’s Origins and the Path Ahead for Theranostics in Prostate Cancer
In a recent episode of our “Molecular Imaging in Focus” series, Martin Pomper, MD, PhD, discussed the origin of PSMA PET, shared his perspective on non-PSMA targets in prostate cancer and offered his thoughts on the potential promise of emerging theranostics.
Recently honored at the Society of Nuclear Medicine and Molecular Imaging (SNMMI) conference with the Benedict Cassen Prize recognizing research leading to significant advances in nuclear medicine science, Martin Pomper, MD, PhD, developed the first small molecules for imaging prostate-specific membrane antigen (PSMA) and the first commercial PSMA-targeted PET agent.
In a recent episode of our “Molecular Imaging in Focus” series, Dr. Pomper reflected on the discovery of PSMA that occurred approximately 25 years ago.
“The thing that I'm proud of is developing, or just frankly having the idea that PSMA was the same as an enzyme that was in the brain that I was trying to study. Then I pivoted from the brain to the prostate because it was hard to get these compounds across the blood-brain barrier, and the compounds light up prostate cancer very nicely,” recalled Dr. Pomper, a professor and chair of the Department of Radiology at the University of Texas (UT) Southwestern Medical Center in Dallas.
Subsequent modeling work with a radiochemist revealed a 20-angstrom long linker between the PSMA-binding molecule and the radionuclide, a scaffold that underlies theranostic agents including Pluvicto and PSMA I&T, according to Dr. Pomper. In addition to the benefits of PSMA PET imaging for urologists and oncologists treating patients with prostate cancer, Dr. Pomper said the emergence of PSMA has facilitated improved integration of nuclear medicine into patient care.
“ … PSMA brought (theranostics) into the mainstream, and I think really helped not just their analysis, but really helped nuclear medicine in general, and got people in the field to be a little bit more patient facing with all these prostate cancer patients coming through,” added Dr. Pomper, the Effie and Wofford Cain Distinguished Chair of Diagnostic Imaging at UT Southwestern.
Dr. Pomper also discussed the potential of non-PSMA targets, such as fibroblast activation protein (FAP) and prostatic acid phosphatase (ACP3), that may offer utility in the treatment of neuroendocrine prostate cancer.
With the continued rise of venture capital interest in the field and more chemists and researchers exploring the development of new agents, Dr. Pomper is bullish about the future of theranostics, increased collaboration between oncologists and nuclear medicine physicians, and the potential impact on patient outcomes.
“(Theranostics are) being accepted by oncologists. So hopefully, if we could partner with them more closely, we could do more patient facing. We can really get deeper into how to manage our patients rather than just sort of seeing their films as it were. … But the main thing is that I think it can help affect cures for diseases that currently are incurable,” emphasized Dr. Pomper.
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