{"entity":{"id":"psma-pet-expression","kind":"biomarker","name":"PSMA expression by PET (PSMA-positive)","aka":["PSMA PET positive","PSMA-positive","PSMA expression","PSMA PET","Ga-68 PSMA-11 uptake","piflufolastat PET","PSMA-avid","PSMA uptake greater than liver"],"tldr":"PSMA-positive means prostate cancer deposits light up on a PSMA PET scan more than the liver does. It is the entry ticket for lutetium-177 PSMA therapy and the basis of the imaging that now stages most advanced prostate cancer.","summary":"Gallium-68 gozetotide (Locametz, Illuccix), piflufolastat F-18 (Pylarify) and flotufolastat F-18 (Posluma) image PSMA. The Pluvicto label requires selection with Locametz or another approved PSMA PET product based on PSMA expression in tumours; the VISION and PSMAfore trials defined positivity as at least one metastatic lesion with uptake greater than liver parenchyma and no PSMA-negative lesions above size limits (short axis 1 cm in soft tissue, 2.5 cm in nodes, or any measurable bone lesion with soft tissue component), and the label's clinical studies section repeats this. Pluvicto is now labelled for both PSMA-positive metastatic castration-resistant disease after an ARPI and, since 2026, PSMA-positive metastatic androgen pathway modulation-naive or -sensitive disease with an ARPI.","asOf":"2026-09-23","links":[{"label":"PLUVICTO prescribing information (DailyMed)","url":"https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=14908037-2892-4d98-a053-253ce35afb1a"}],"tags":["biomarker","pet"],"related":["sstr-pet-expression","ar-v7-splice-variant"],"cancers":["prostate","prostate-mcrpc","prostate-mhspc","prostate-bcr"],"sections":[],"technologies":[],"targets":[],"drugs":["pluvicto","ga68-psma-11","locametz","illuccix","pylarify","flotufolastat","lu177-psma-it","ac225-psma"],"companies":[],"institutions":[],"pathways":[],"terms":["theranostics","prrt-term"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"target":"psma","measurement":"pet-tracer-expression","scoringRule":{"text":"At least one metastatic lesion with PSMA PET uptake greater than normal liver, and no PSMA-negative measurable lesions (the VISION criteria) on an approved PSMA PET tracer.","quote":"Select patients for treatment using LOCAMETZ ® or another approved PSMA positron emission tomography (PET) product based on PSMA expression in tumors.","source":"https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=14908037-2892-4d98-a053-253ce35afb1a","sourceLabel":"PLUVICTO prescribing information"},"thresholds":[{"value":"PSMA-positive by PSMA PET","drugId":"pluvicto","cancerId":"prostate-mcrpc","regulator":"FDA","source":"https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=14908037-2892-4d98-a053-253ce35afb1a","quote":"for the treatment of adult patients with PSMA-positive metastatic androgen pathway modulation-resistant (mAPMR) prostate cancer who have been treated with ARPI therapy, and are considered appropriate to delay taxane-based chemotherapy, or have received prior taxane-based chemotherapy.","status":"current"},{"value":"PSMA-positive by PSMA PET","drugId":"pluvicto","cancerId":"prostate-mhspc","regulator":"FDA","source":"https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=14908037-2892-4d98-a053-253ce35afb1a","quote":"in combination with androgen receptor pathway inhibitor (ARPI) therapy for the treatment of adult patients with prostate-specific membrane antigen (PSMA)-positive metastatic androgen pathway modulation-naïve or -sensitive (mAPMN/S) prostate cancer.","status":"current"}],"tests":[],"assays":["psma-pet-selection"],"companionDiagnostics":[],"forPatient":"A PSMA PET scan that shows your cancer taking up the tracer more strongly than your liver makes you PSMA-positive, which is required for lutetium-177 PSMA treatment. The same scan is used to find where the cancer is. If some deposits do not take up the tracer, the treatment may not reach them, which is why the scan is read lesion by lesion."},"route":"/biomarkers/psma-pet-expression/","neighbours":{"biomarker":[{"id":"ar-v7-splice-variant","kind":"biomarker","name":"AR-V7 splice variant","route":"/biomarkers/ar-v7-splice-variant/"},{"id":"sstr-pet-expression","kind":"biomarker","name":"Somatostatin receptor expression by PET (SSTR-positive)","route":"/biomarkers/sstr-pet-expression/"}],"cancer":[{"id":"prostate-bcr","kind":"cancer","name":"Biochemical recurrence of prostate cancer","route":"/cancers/prostate-bcr/"},{"id":"prostate-mcrpc","kind":"cancer","name":"Metastatic castration-resistant prostate cancer","route":"/cancers/prostate-mcrpc/"},{"id":"prostate-mhspc","kind":"cancer","name":"Metastatic hormone-sensitive prostate cancer","route":"/cancers/prostate-mhspc/"},{"id":"prostate","kind":"cancer","name":"Prostate cancer","route":"/cancers/prostate/"}],"drug":[{"id":"lu177-psma-it","kind":"drug","name":"177Lu-PSMA-I&T","route":"/drugs/lu177-psma-it/"},{"id":"ac225-psma","kind":"drug","name":"Actinium-225 PSMA agents","route":"/drugs/ac225-psma/"},{"id":"flotufolastat","kind":"drug","name":"Flotufolastat F-18","route":"/drugs/flotufolastat/"},{"id":"ga68-psma-11","kind":"drug","name":"Gallium-68 gozetotide (PSMA-11)","route":"/drugs/ga68-psma-11/"},{"id":"illuccix","kind":"drug","name":"Illuccix (kit for Ga-68 gozetotide)","route":"/drugs/illuccix/"},{"id":"locametz","kind":"drug","name":"Locametz (kit for Ga-68 gozetotide)","route":"/drugs/locametz/"},{"id":"pluvicto","kind":"drug","name":"Lutetium-177 vipivotide tetraxetan","route":"/drugs/pluvicto/"},{"id":"pylarify","kind":"drug","name":"Piflufolastat F-18 / Pylarify TruVu","route":"/drugs/pylarify/"}],"term":[{"id":"prrt-term","kind":"term","name":"PRRT (peptide receptor radionuclide therapy)","route":"/terms/prrt-term/"},{"id":"theranostics","kind":"term","name":"Theranostics","route":"/terms/theranostics/"}],"target":[{"id":"psma","kind":"target","name":"PSMA","route":"/targets/psma/"}]}}