NECTIN-4 targeted theranostics for urothelial cancer: getting ready for primetime?

locally advanced and metastatic urothelial carcinoma (UC) presents a bleak prognosis, with limited treatment options. NECTIN-4, an overexpressed protein in UC, has become a target for therapy. enfortumab vedotin (EV) gained food and drug administration approval for advanced UC treatment, but patient selection based on NECTIN-4 expression remains challenging. In the study under evaluation, duan et al. introduced a novel PET/CT imaging approach using 68Ga-N188, a molecular probe, to visualize NECTIN-4 expression in UC. their study encompassed preclinical evaluations and translational assessments in both healthy individuals and UC patients. results demonstrated the potential of 68Ga-N188 in identifying NECTIN-4 expression in UC lesions. additionally, the study utilized long axial field-of-view (LAFOV) PET/CT, enhancing sensitivity and enabling dynamic studies for improved radiopharmaceutical evaluation. In summary, the study from duan and colleagues introduces a promising molecular imaging technique that could aid in patient selection for EV therapy and the development of targeted drugs for UC. It also highlights the potential of LAFOV PET/CT in enhancing imaging precision and expanding future therapeutic possibilities for UC.