Radioiodine Therapy in Differentiated Thyroid Cancer: The First Targeted Therapy in Oncology

Abstract

Iodide uptake across the membranes of thyroid follicular cells and cancer cells occurs through an active transport process mediated by the sodium-iodide symporter (NIS). The rat and human NIS-coding genes were cloned and identified in 1996. Evaluation of NIS gene and protein expression is critical for the management of thyroid cancer, and several approaches to increase NIS levels have been tried. Identification of the NIS gene has provided a means of expanding its role in radionuclide therapy and molecular target-specific theragnosis (therapy and diagnosis using the same molecular target). In this article, we describe the relationship between NIS expression and the thyroid carcinoma treatment using I-131 and alternative therapeutic approaches.

Human sodium iodide transporter gene-mediated imaging and therapy of mouse glioma, comparison between 188Re and 131I

“…188 Re/ 131 I exhibit rapid uptake in U87-hNIS cells, and the dynamic uptake pattern of 188 Re/ 131 I was similar to that of previous studies (30,31). 188 Re uptake of U87-hNIS was up to 21.3-times that of the U87-0 control group, whereas 131 I uptake was up to 25.9-fold of that of the control group.…”

“…I is an isotope commonly used in NIS-associated radionuclide therapy studies (31). However, as the radiation energy is not high enough, therapeutic efficacy of 131 I is limited (3).…”

Molecular radiotheragnostics in thyroid disease

“…Local disease recurrence in the thyroid surgical bed, cervical nodes or distant metastases is reported in 5-20% of patients, depending on primary staging, histological subtype and nodal involvement at diagnosis. 16 Surgery and 131 I therapy are the cornerstones of DTC management. Following total thyroidectomy, usually with loco-regional node dissection, 131 I is recommended to ablate normal thyroid remnant tissue, improve local disease control, increase the specificity of thyroglobulin (marker of tumour recurrence) and enable whole-body scintigraphy to identify occult metastases.…”

Iodine-131 Therapy and Lacrimal Drainage System Toxicity: Nasal Localization Studies Using Whole Body Nuclear Scintigraphy and SPECT-CT

“…[1][2][3][4][5][6][7][8][9][10] The incidence of thyroid carcinomas is on the rise and DTC's are the most common of them and include papillary and follicular carcinoma. [1][2][3][4][5] The physical half life of I-131 is 8 days and emits beta (β) rays that are used for treatment and gamma (γ) rays which are used for diagnosis. The dose if I-131 for treatment of DTC and metastasis usually ranges from 75 mCi to 250 mCi.…”

“…The dose if I-131 for treatment of DTC and metastasis usually ranges from 75 mCi to 250 mCi. [1][2][3][4][5] Following oral administration of I-131, iodide uptake happens across the follicular cells of the thyroid or neoplastic cells through a sodiumiodine symporter (NIS) active transport. [6][7][8] The NIS protein has been demonstrated not only in thyroid tissues but also in gastric mucosa, salivary glands, breast, thymus, and lacrimal drainage system.…”