Clinical Advances and Perspectives in Targeted Radionuclide Therapy

Abstract

Targeted radionuclide therapy has become increasingly prominent as a nuclear medicine subspecialty. For many decades, treatment with radionuclides has been mainly restricted to the use of iodine-131 in thyroid disorders. Currently, radiopharmaceuticals, consisting of a radionuclide coupled to a vector that binds to a desired biological target with high specificity, are being developed. The objective is to be as selective as possible at the tumor level, while limiting the dose received at the healthy tissue level. In recent years, a better understanding of molecular mechanisms of cancer, as well as the appearance of innovative targeting agents (antibodies, peptides, and small molecules) and the availability of new radioisotopes, have enabled considerable advances in the field of vectorized internal radiotherapy with a better therapeutic efficacy, radiation safety and personalized treatments. For instance, targeting the tumor microenvironment, instead of the cancer cells, now appears particularly attractive. Several radiopharmaceuticals for therapeutic targeting have shown clinical value in several types of tumors and have been or will soon be approved and authorized for clinical use. Following their clinical and commercial success, research in that domain is particularly growing, with the clinical pipeline appearing as a promising target. This review aims to provide an overview of current research on targeting radionuclide therapy.

Immuno-PET for Glioma Imaging: An Update

“…Shaping the future of immuno-PET in gliomas will depend significantly on the synergy between technology and radiopharmaceutical research. For instance, aptamers, single-stranded oligonucleotide DNA or RNA sequences, exhibit extremely high specificity toward tumor-associated biomarkers without inducing immunogenicity [66]. However, despite their promise, radiolabeled aptamers have seen limited application in PET imaging.…”

Glioblastoma Therapy: Past, Present and Future

“…The energy, range of radiation, and type of emission are critical in targeted radionuclide therapy. Unlike molecular imaging, which involves the use of highly penetrating γand positron (β + )-emitting radionuclides, TRT employs β − , α, or auger electron emitters with lower penetration capacity but higher ionizing energy [1087]. β − particle-emitting radionuclides (e.g., 131 I, 90 Y, 186/188 Re and 177 Lu) can irradiate tissue volumes with multicellular dimensions and induce radical formation leading to DNA single-strand breaks.…”

The application of radionuclide therapy for breast cancer

“…Radionuclides are elements, for the medical field this typically means only those radionuclides from the actinide series on the table of elements, that emit energy in the form of radiation (15). The loss of this energy turns the radionuclide from one element to another (daughter isotopes) through a process called decay.…”