New Study Shows Promise for Two Next-Generation PSMA Imaging Agents in Prostate Cancer

A prospective clinical trial has found that two novel prostate-specific membrane antigen (PSMA) PET tracers—AZ-093 and its hypoxia-targeting derivative AZ-NI-093—offer strong potential for improving prostate cancer imaging.

Involving 60 patients, the study compared AZ-093 with standard PSMA tracers (PSMA-11 and PSMA-617) and evaluated AZ-NI-093 directly against AZ-093. Both new agents were well tolerated and demonstrated biodistribution similar to existing PSMA radiopharmaceuticals.

AZ-093 showed significantly higher tumor uptake than PSMA-11 and PSMA-617 while maintaining comparable detection rates. The hypoxia-responsive AZ-NI-093 provided an additional boost in tumor uptake at both 60 and 150 minutes post-injection, with the greatest benefits seen in large, high-grade primary tumors and metastatic lesions. Tumor hypoxia, measured by hypoxia-inducible factor 1 expression, correlated strongly with the enhanced uptake of AZ-NI-093.

Researchers conclude that both tracers are promising candidates for future clinical use, with AZ-NI-093 showing particular value for imaging hypoxic prostate cancer. Larger studies are planned to further validate these findings.