The challenge of the research activities carried on by the Radiotracers4PSMA community is to elucidate the molecular mechanism of action of theranostic probes targeting prostate-specific membrane antigen (PSMA) through computational strategies, experimental approaches, and clinical practice. That will help tackle the challenges of PSMA-radiotracer non-responders (negative PSMA PET despite the presence of cancer) and off-target still-responders (off-target positive PSMA PET).

Originally in Zlatopolskiy, B. D. et al. (2019). Discovery of 18F-JK-PSMA-7, a PET Probe for the Detection of Small PSMA-Positive Lesions. JNucl.Med.,60, 817–823. https://doi.org/10.2967/jnumed.118.218495
Prostate-specific membrane antigen (PSMA) is a zinc-metallopeptidase localised at the plasma membrane and is highly expressed in prostate cancer cells. As such, PSMA represents an attractive target for the diagnosis and therapy of prostate cancer, as well as for several other types of tumors. Significant advancements in radiochemistry have led to the development of various PSMA-targeting radiopharmaceuticals for positron emission tomography (PET), designed as small molecules that bind to the extracellular domain of PSMA. These small molecules offer several advantages over previously developed anti-PSMA monoclonal antibodies.
However, in recent years, cases of PSMA PET-negative prostate cancers and instances of off-target bindings have been reported. To address the issue of PSMA-radiotracer non-responders (patients with negative PSMA PET despite the presence of cancer) and still-responders (patients with off-target positive PSMA PET), this project investigates the biomolecular binding processes of the three fluorinated radiotracers most commonly used in clinical practice. The goal is to fully elucidate their binding mechanisms at a molecular level, providing insights to overcome this challenge.