Target Heterogeneity in Oncology: The Best Predictor for Differential Response to Radioligand Therapy in Neuroendocrine Tumors and Prostate Cancer
Tumor or target heterogeneity (TH) implies presence of variable cellular populations having different genomic characteristics within the same tumor, or in different tumor sites of the same patient. The challenge is to identify this heterogeneity, as it has emerged as the most common cause of ‘treatm...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-07-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/13/14/3607 |
| _version_ | 1797527471452585984 |
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| author | Ameya D Puranik Clarisse Dromain Neil Fleshner Mike Sathekge Marianne Pavel Nina Eberhardt Friedemann Zengerling Ralf Marienfeld Michael Grunert Vikas Prasad |
| author_facet | Ameya D Puranik Clarisse Dromain Neil Fleshner Mike Sathekge Marianne Pavel Nina Eberhardt Friedemann Zengerling Ralf Marienfeld Michael Grunert Vikas Prasad |
| author_sort | Ameya D Puranik |
| collection | DOAJ |
| description | Tumor or target heterogeneity (TH) implies presence of variable cellular populations having different genomic characteristics within the same tumor, or in different tumor sites of the same patient. The challenge is to identify this heterogeneity, as it has emerged as the most common cause of ‘treatment resistance’, to current therapeutic agents. We have focused our discussion on ‘Prostate Cancer’ and ‘Neuroendocrine Tumors’, and looked at the established methods for demonstrating heterogeneity, each with its advantages and drawbacks. Also, the available theranostic radiotracers targeting PSMA and somatostatin receptors combined with targeted systemic agents, have been described. Lu-177 labeled PSMA and DOTATATE are the ‘standard of care’ radionuclide therapeutic tracers for management of progressive treatment-resistant prostate cancer and NET. These approved therapies have shown reasonable benefit in treatment outcome, with improvement in quality of life parameters. Various biomarkers and predictors of response to radionuclide therapies targeting TH which are currently available and those which can be explored have been elaborated in details. Imaging-based features using artificial intelligence (AI) need to be developed to further predict the presence of TH. Also, novel theranostic tools binding to newer targets on surface of cancer cell should be explored to overcome the treatment resistance to current treatment regimens. |
| first_indexed | 2024-03-10T09:43:17Z |
| format | Article |
| id | doaj.art-9944427089a94679b16c3ee456e4cc55 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T09:43:17Z |
| publishDate | 2021-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-9944427089a94679b16c3ee456e4cc552023-11-22T03:26:13ZengMDPI AGCancers2072-66942021-07-011314360710.3390/cancers13143607Target Heterogeneity in Oncology: The Best Predictor for Differential Response to Radioligand Therapy in Neuroendocrine Tumors and Prostate CancerAmeya D Puranik0Clarisse Dromain1Neil Fleshner2Mike Sathekge3Marianne Pavel4Nina Eberhardt5Friedemann Zengerling6Ralf Marienfeld7Michael Grunert8Vikas Prasad9Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai 400012, IndiaDepartment of Diagnostic and Interventional Radiology, CHUV University Hospital, Rue du Bugnon 46, 1011 Lausanne, SwitzerlandDepartment of Urology, University of Toronto, 610 University Avenue Toronto, Toronto, ON M5G 2M9, CanadaDepartment of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Pretoria 0001, South AfricaDepartment of Medicine, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, GermanyDepartment of Nuclear Medicine, University Hospital Ulm, 89081 Ulm, GermanyDepartment of Urology, University Hospital Ulm, 89081 Ulm, GermanyInstitute of Pathology, University Hospital Ulm, 89081 Ulm, GermanyDepartment of Nuclear Medicine, University Hospital Ulm, 89081 Ulm, GermanyDepartment of Nuclear Medicine, University Hospital Ulm, 89081 Ulm, GermanyTumor or target heterogeneity (TH) implies presence of variable cellular populations having different genomic characteristics within the same tumor, or in different tumor sites of the same patient. The challenge is to identify this heterogeneity, as it has emerged as the most common cause of ‘treatment resistance’, to current therapeutic agents. We have focused our discussion on ‘Prostate Cancer’ and ‘Neuroendocrine Tumors’, and looked at the established methods for demonstrating heterogeneity, each with its advantages and drawbacks. Also, the available theranostic radiotracers targeting PSMA and somatostatin receptors combined with targeted systemic agents, have been described. Lu-177 labeled PSMA and DOTATATE are the ‘standard of care’ radionuclide therapeutic tracers for management of progressive treatment-resistant prostate cancer and NET. These approved therapies have shown reasonable benefit in treatment outcome, with improvement in quality of life parameters. Various biomarkers and predictors of response to radionuclide therapies targeting TH which are currently available and those which can be explored have been elaborated in details. Imaging-based features using artificial intelligence (AI) need to be developed to further predict the presence of TH. Also, novel theranostic tools binding to newer targets on surface of cancer cell should be explored to overcome the treatment resistance to current treatment regimens.https://www.mdpi.com/2072-6694/13/14/3607heterogeneityProstate Cancerneuroendocrine tumorPSMAGa-68PET/CT |
| spellingShingle | Ameya D Puranik Clarisse Dromain Neil Fleshner Mike Sathekge Marianne Pavel Nina Eberhardt Friedemann Zengerling Ralf Marienfeld Michael Grunert Vikas Prasad Target Heterogeneity in Oncology: The Best Predictor for Differential Response to Radioligand Therapy in Neuroendocrine Tumors and Prostate Cancer Cancers heterogeneity Prostate Cancer neuroendocrine tumor PSMA Ga-68 PET/CT |
| title | Target Heterogeneity in Oncology: The Best Predictor for Differential Response to Radioligand Therapy in Neuroendocrine Tumors and Prostate Cancer |
| title_full | Target Heterogeneity in Oncology: The Best Predictor for Differential Response to Radioligand Therapy in Neuroendocrine Tumors and Prostate Cancer |
| title_fullStr | Target Heterogeneity in Oncology: The Best Predictor for Differential Response to Radioligand Therapy in Neuroendocrine Tumors and Prostate Cancer |
| title_full_unstemmed | Target Heterogeneity in Oncology: The Best Predictor for Differential Response to Radioligand Therapy in Neuroendocrine Tumors and Prostate Cancer |
| title_short | Target Heterogeneity in Oncology: The Best Predictor for Differential Response to Radioligand Therapy in Neuroendocrine Tumors and Prostate Cancer |
| title_sort | target heterogeneity in oncology the best predictor for differential response to radioligand therapy in neuroendocrine tumors and prostate cancer |
| topic | heterogeneity Prostate Cancer neuroendocrine tumor PSMA Ga-68 PET/CT |
| url | https://www.mdpi.com/2072-6694/13/14/3607 |
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