Why is it that some men’s immune systems can be whipped up into a frenzy and can attack metastatic cancer, causing it to melt away?
Earlier in this issue (see stories 1 and 2), we’ve talked about Martin Pomper’s PSMA-targeting small molecule, and how well it can show otherwise hidden metastatic cancer on a PET scan. Can it be used even earlier – at the time of diagnosis – to help determine which men have clinically significant, high-grade tumors?
There is a critical need for such discernment, says urologist Michael Gorin, M.D., because PSA is often not that helpful. “A major shortcoming of the PSA test is that it is not specific for detecting clinically significant, highgrade tumors, leading to overdiagnosis of low-grade or indolent prostate cancer that probably doesn’t even need to be treated.”
It would be nice to have more insight before prostate biopsy – so men who probably have indolent cancer wouldn’t have to have needles stuck in their prostate. “PSMA is expressed by prostate cancer cells, and the degree of expression directly correlates with prostate cancer grade and stage.” To this end, Gorin is testing how well PSMA-targeted PET/CT scanning works before biopsy in men who are being screened for prostate cancer.