In-111-capromab pendetide - The evolution of prostate specific membrane antigen and the nuclear imaging of its In-111-labelled murine antibody in theevaluation of prostate cancer

Each year, approximately 210 000 American men are diagnosed with prostate c ancer and 41 800 die from the disease - numbers roughly equal to the incide nce and mortality for breast cancer in women. Prostate cancer usually shows no symptoms in early stages, when it is most treatable, To detect the dise ase early, physicians usually recommend that every man 50 years and older h ave an annual examination consisting of a digital rectal examination and a prostate specific antigen (PSA) blood test. Conventional treatments such as surgical removal of the diseased prostate, external beam radiation, radioa ctive seed therapy and hormonal and/or chemotherapy treatment regimens are most successful for early stage prostate cancer and have limited effectiven ess in advanced stages of the disease. For this reason, accurate staging of primary and recurrent prostate cancer is mandatory for proper therapeutic decisions. Nuclear medicine imaging of prostate cancer using the radiolabelled monoclo nal antibody, In-111-capromab pendetide, has proven useful in newly diagnos ed patients with biopsy-proven prostate cancer in which there is high suspi cion of distant metastatic disease and for prostatectomy patients with risi ng PSA levels and/or suspicion of recurrence or metastatic disease. Althoug h not intended as a screening tool, it is used in conjunction with standard evaluation procedures for improved staging of patients, The monoclonal ant ibody, designated 7E11-C5, binds the prostate specific membrane antigen (PS MA) expressed on the surface of prostate epithelial cells and up-regulated in tumour cells. The sensitivity and specificity for prostate cancer involved lymph node det ection has been reported as 62 to 75% and 72 to 86%, respectively, compared with sensitivities of 4% and 15% for computerised tomography and magnetic resonance imaging. In-111-capromab pendetide imaging has proven to be an ac curate, non-invasive tool for detecting and staging sites of recurrence in the postprostatectomy patient as well as metastatic sites in the patient wi th newly diagnosed prostate cancer.