Piflufolastat F-18 (F-18-DCFPyL) for PSMA PET imaging in prostate cancer

Introduction Accurate imaging is essential for staging prostate cancer and guiding management decisions. Conventional imaging modalities are hampered by a limited sensitivity for metastatic disease. Nearly all prostate cancers express prostate-specific membrane antigen (PSMA) and F-18-DCFPyL (piflufolastat F 18) is a new FDA-approved positron emission tomography (PET) agent that targets PSMA for improved staging of prostate cancer. Areas covered This article provides an overview of PSMA, the mechanism of action of F-18-DCFPyL, and compares the performance of F-18-DCFPyL to conventional prostate imaging modalities. Current prostate cancer imaging guidelines are reviewed, as well as what changes can be expected in the future with increased access to PSMA-PET. Expert opinion The OSPREY and CONDOR clinical trials have demonstrated the superiority of F-18-DCFPyL over conventional imaging modalities for the staging and restaging of prostate cancer. The remarkable diagnostic accuracy of PSMA-PET is reshaping prostate cancer imaging and the modularity of these agents hint at exciting new diagnostic and therapeutic opportunities that have the potential to improve the care of patients with prostate cancer as a whole.