PSMA-targeted PET imaging in patients with metastatic triple-negative breast cancer: results of the prospective PRISMA trial

Manley, M; Nader-Marta, G; Ozturk, AA; Kassas, M; Roth&#233;, F; Taraji, L; Sotiriou, C; Wimana, Z; Salgado, R; Flamen, P; Gebhart, G

Author(s): Manley, M; Nader-Marta, G; Ozturk, AA; Kassas, M; Rothé, F; Taraji, L; Sotiriou, C; Wimana, Z; Salgado, R; Flamen, P; Gebhart, G;
Details: Publication Year 2026-04,Volume 53,Issue #5,Page 3152-3161
Journal Title: European Journal of Nuclear Medicine and Molecular Imaging
Publication Type: Research article
Abstract: PURPOSE: Radioligand therapy (RLT) targeting prostate-specific membrane antigen (PSMA) improves survival in metastatic castration-resistant prostate cancer. PSMA is also expressed in triple-negative breast cancer (TNBC), a subtype with limited treatment options. This prospective study assessed PSMA uptake on [(68)Ga]Ga-PSMA-11 PET/CT in patients with metastatic TNBC (mTNBC) to evaluate the feasibility of PSMA-targeted RLT. METHODS: This single-center prospective study enrolled patients with progressive mTNBC. Each patient underwent [(18)F]FDG PET/CT followed by [(68)Ga]Ga-PSMA-11 PET/CT. Visual PSMA positivity was defined as uptake greater than healthy liver in most lesions. For quantitative analysis, target lesions (TLs) ≥ 1.5 cm and PERCIST-measurable on FDG PET/CT were anatomically matched to PSMA PET/CT. SUVmax was measured and compared to liver background. RESULTS: Twenty patients (median age 53.5 years; median 3 prior systemic therapies) were included. On visual assessment, 50.0% had PSMA uptake exceeding liver in most lesions. Quantitative analysis included 106 FDG-avid TLs; 67.0% showed PSMA SUVmax above liver. On a per-patient basis, 35.0% had all TLs and 30.0% had most TLs above liver SUVmean. However, 65.0% had at least one lesion below liver background, indicating heterogeneity. Higher PSMA uptake was associated with fewer prior treatments, prior immunotherapy, and low androgen receptor expression. PSMA PET/CT identified brain metastases in 10.0% of patients. CONCLUSION: [(68)Ga]Ga-PSMA-11 PET/CT revealed clinically relevant PSMA expression in a subset of mTNBC patients. These results support further investigation of PSMA-targeted RLT in this biomarker-defined population.
Publisher: Springer Nature
Keywords: Humans; Middle Aged; *Glutamate Carboxypeptidase II/metabolism; *Positron Emission Tomography Computed Tomography/methods; *Triple Negative Breast Neoplasms/diagnostic imaging/pathology/metabolism; Female; *Antigens, Surface/metabolism; Aged; Prospective Studies; Neoplasm Metastasis; Adult; Gallium Radioisotopes; Gallium Isotopes; *Edetic Acid/analogs & derivatives; Fdg pet/ct; Psma pet/ct; Triple-negative breast cancer
Department(s): Laboratory Research
Publisher's Version: https://doi.org/10.1007/s00259-025-07667-4
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2026-01-08 04:40:49

Last Modified: 2026-04-07 12:09:47