The Reading Room Podcast: Current Insights and Emerging Trends in Molecular Imaging and Theranostics for Prostate Cancer

Daniel George, M.D., Brian Helfand, M.D., Ph.D., and Ashesh Jani, M.D., spoke about the potential impact of new research they presented at the American Society of Clinical Oncology Genitourinary Cancers (ASCO-GU) symposium in a new Diagnostic Imaging podcast and shared their perspectives on future directions with molecular imaging and theranostics.

Dr. Helfand was bullish about the ability of future research to not only discern key differences between PET radiotracers but to further examine their capability to facilitate earlier detection of smaller lesions.

“I would say that the current limit of (lesion) resolution of any of these agents is about four millimeters, but we may be even pushing that further, ideally getting equivalent to the microscopic level so we can really detect disease very early on, and most accurately,” added Dr. Helfand, chief of the Division of Urology and associate chief scientific officer at Endeavor Health in Evanston, Ill.

Dr. George said molecular imaging offers the potential to improve patient selection as well as individualized timing of theranostics.

“I think there are (a couple of) key trends with precision imaging, and one is what you're seeing today with PSMA PET helping us to target who should get these therapies. I think it'll also help us understand when is it a good time to stop the therapy? As those image images show the target resolving, there may be less need to give the systemic exposure, and maybe some more targeted radiation or therapeutic approaches could be used,” noted Dr. George, co-chair of the DCI Center for Prostate and Urologic Centers, and director of genitourinary oncology at the Duke Cancer Institute in Durham, N.C.

Dr. Jani said there is “renaissance” with molecular imaging, emphasizing its pervasive impact in the staging of prostate cancer and facilitating appropriate treatment.

“I think we're in the golden age of molecular imaging. I think molecular imaging is really helping us with initial staging. Then … if a patient has had an initial treatment and recurs, the PSA is going up afterwards. It really is helping us to identify where the source of the PSA is more accurately so we can decide if we need to give just local therapy; if we need to give metastasis directed therapy at these areas that are outside of the prior treatment; (or) if we need to give a systemic therapy that works all over as opposed to giving something that's more directed. So it is transformative. It really allows us to make improved decisions in the clinical setting, particularly for recurrences,” maintained Dr. Jani, a James C. Kennedy Professor in Prostate Cancer at the Winship Cancer Institute of Emory University, and a professor in the Department of Radiation Oncology at the Emory University School of Medicine.

(Editor’s note: For related content, see “What New Research Reveals About 18F-flotufolastat PET/CT for Detecting Biochemical Recurrence and Bone Metastasis in PCa,” “New Study Shows High Efficacy and Patient Tolerance with 177Lu-PSMA-617 in Older Men with mCRPC” and “Comparing the Urinary Radioactivity of PET Radiotracers: What a Multicenter Study Reveals.”)

For more insights from Dr. George, Dr. Helfand and Dr. Jani, listen below or subscribe on your favorite podcast platform.