In the Philippines, prostate cancer is the third most common malignancy among men. Over time, it tends to recur and/or progress to metastatic castration-resistant prostate cancer, wherein conventional therapies no longer work. Taking advantage of the high expression of prostate-specific membrane antigen (PSMA) on prostate cancer cells, 68GA- and 177 Lu-PSMA theranostics provides a targeted approach to imaging and therapy. With it's availabity in our country, patients now have an appealing and accessible treatment option. In this paper, we present five cases of metastatic castration-resistant prostate cancer, who have undergone 68Ga-PSMA PET/CT scans and 177Lu-PSMA radioligand therapies in the Philippines, to showcase the usefulness of theranostics in the local setting.
Positron Emission Tomography Computed Tomography ; Precision Medicine ; Prostatic Neoplasms ; Philippines

A 43-year-old female with a surgically unresectable and non-secretory mediastinal small cell neuroendocrine carcinoma waws previously given the protein kinase inhibitor Everolimus with intolerable nausea and fatigue. High somatostatin receptor expression of the known tumor was seen on 68Ga-DOTATATE PET/CT scan. She was then given 6.4 GBq of 177 Lu-DOTATATE with no adverse events. A follow-up 68Ga-DOTATATE PET/CT scan three months post-treatment showerd stable DOTATATE affinity with no evidence of metastasis. this case presents an overview of peptide receptor radionuclide therapy (PRRT), especially for multidisciplinary teams in the Philippines, as 68Ga and 177 Lu theranostics is introduced in the country.
Precision Medicine ; Philippines ; Carcinoma, Neuroendocrine

Background: Breast cancer, chemotherapy and endocrine treatment are risk factors for osteoporosis. Dual-energy x-ray absorptiometry (DXA) remains the gold standard in the diagnosis of osteoporosis. A quantitative computed tomography (QCT) with a bone mineral density analysis software on the whole abdomen CT may be used for screening osteoporosis without additional radiation exposure or cost. Objective: To determine the accuracy of QCT in detecting osteoporosis among breast cancer patients using DXA as gold standard. Methods: This is a cross-sectional analytic study of 76 Filipino women with breast cancer who underwent both DXA and whole abdomen CT scans. The DXA measurements were obtained using Lunar iDXA manufactured by GE Healthcare while the QCT measurements were made using the BMD analysis software available in the Philips Extended Brilliance Workspace post-processing system. Results: Out of the 76 Filipino women with breast cancer, 92% were menopausal women with mean age of 58.9 (SD 8.7) years, 69.7% had IDCA and 94.7% had mastectomy. Majority had normal BMD (44.7%), 34.2% had osteopenia and 21.1% had osteoporosis based on DXA. QCT has 90% (95% CI: 55.5-99.8) sensitivity, 63.6% (95% CI: 30.1- 89.1) specificity, 69.2% (95% CI: 50.1-83.5) PPV, 87.5 (95% CI:50.8-97.9) NPV, 2.5 (95% CI:1.1-5.6) LR(+) and 0.16 (95% CI:0.02-1.06) LR (-). Conclusion The prevalence of osteoporosis and osteopenia among Filipino women with breast cancer was 21.1% and 34.2%. The sensitivity and specificity of QCT in detecting osteoporosis was 90% and 63.6%.
Osteoporosis ; Bone Diseases, Metabolic ; Breast Neoplasms