Prostate-Specific Membrane Antigen (PSMA): A Potential Theranostic Biomarker in Breast Cancer.

Background: Subtype classification for breast cancer (BC) patients is important for risk-stratification. Unfortunately, this parameter is not always able to discriminate between high- and low-risk diseases. Glutamate Carboxypeptidase-II (GCPII), also known as prostate-specific membrane antigen (PSMA), could be an important biomarker of aggressiveness, given that it has been reported to be expressed in BC tumor cells and even more in endothelial cells of tumor vessels. Methods: We analyzed 22 Luminal A, 47 Luminal B, 9 HER2-positive (HER2+), and 23 triple-negative (TN) BC to assess whether PSMA, Ki67 expression, and tumor-infiltrating lymphocytes (TILs) were different in BC subtypes. Results: Median PSMA and Ki67 values were significantly higher in TNBC than in Luminal A and B tumors. We saw a correlation between PSMA and Ki67 expression, especially in HER2+ tumors (p = 0.035), while an inverse correlation between PSMA and TILs was observed in Luminal A (p = 0.028). Conclusions: Our results suggest that PSMA could be used as a biomarker in BC, given that it is highly expressed in more aggressive tumors. These findings open the way to a clinical investigation for the possible use of PSMA as a theranostic biomarker in BC patients with PSMA positive PET scan.