23,300 Canadians are expected to be diagnosed with, and 4,200 more expected to die from, prostate cancer in 2020 alone. The mortality numbers are lower than they used to be as survival has significantly improved thanks to the development of both targeted therapies and prostate cancerspecific imaging agents. Prostate cancer generally begins as hormone-sensitive adenocarcinoma (PCa), a disease treatable with androgen deprivation therapy Persistent treatment can result in the emergence of castration-resistant prostate cancer (CRPC), requiring second-generation androgen receptor-targeting agents. While initially successful, this second line of therapy often leads to the evolution of neuroendocrine prostate cancer (NEPC), characterized by aggressive androgen receptorindependent growth. It is a priority to obtain imaging tools capable of detecting disease that has progressed to NEPC as its emergence means that treatment must be modified to improve survival; prognosis becomes very poor as the tumour mutates. Unfortunately, these imaging tools do not exist.
The project aims to provide a pair of probes to distinguish between PSMA-positive prostate cancer and NAALADaseL1 positive prostate cancer (associated with neuroendocrine and likely treatment resistant). It can also help determine if a cancer is progressing from one stage to another.