To go where no one has gone before: the necessity of radiobiology studies for exploration beyond the limits of the “Holy Gray” in radionuclide therapy

Verburg, Frederik A.; Nonnekens, Julie; Konijnenberg, Mark; Jong, Marion de

doi:10.1007/s00259-020-05147-5

Cited by 11 publications

(8 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…While radionuclides like 68 Ga, 18 F, or 177 Lu have become a sort of routine in the use of radiolabeled PSMA inhibitors, other radionuclides are gaining attention due to their specific properties [ 206 , 207 , 208 ]. For example, 225 Ac can play a pivotal role in targeted alpha therapy (TAT) of prostate cancer [ 48 , 51 , 78 , 209 , 210 , 211 , 212 , 213 , 214 , 215 ], but additional preclinical studies and prospective clinical trials need to be performed to secure its safety and efficacy [ 216 , 217 , 218 , 219 , 220 , 221 ]. The importance of 225 Ac-labeled radiopharmaceuticals is affirmed by efforts to establish GMP-compliant procedures for production and quality control [ 222 , 223 , 224 , 225 , 226 ].…”

Section: Potential Radionuclides For the Future Use Of Psma Inhibitorsmentioning

confidence: 99%

Radiolabeled PSMA Inhibitors

Neels

Kopka

Liolios

et al. 2021

Cancers

View full text Add to dashboard Cite

PSMA has shown to be a promising target for diagnosis and therapy (theranostics) of prostate cancer. We have reviewed developments in the field of radio- and fluorescence-guided surgery and targeted photodynamic therapy as well as multitargeting PSMA inhibitors also addressing albumin, GRPr and integrin αvβ3. An overview of the regulatory status of PSMA-targeting radiopharmaceuticals in the USA and Europe is also provided. Technical and quality aspects of PSMA-targeting radiopharmaceuticals are described and new emerging radiolabeling strategies are discussed. Furthermore, insights are given into the production, application and potential of alternatives beyond the commonly used radionuclides for radiolabeling PSMA inhibitors. An additional refinement of radiopharmaceuticals is required in order to further improve dose-limiting factors, such as nephrotoxicity and salivary gland uptake during endoradiotherapy. The improvement of patient treatment achieved by the advantageous combination of radionuclide therapy with alternative therapies is also a special focus of this review.

show abstract

Section: Potential Radionuclides For the Future Use Of Psma Inhibitorsmentioning

confidence: 99%

Radiolabeled PSMA Inhibitors

Neels

Kopka

Liolios

et al. 2021

Cancers

View full text Add to dashboard Cite

show abstract

“…With the ambition to maximize the benefits of radiopharmaceutical products that are effective and safe for each individual patient, preclinical and translational science undertakes dedicated research to understand the biological characteristics of tumor and normal tissue intrinsic radiosensitivities and the fundamental biological mechanisms underlying the therapeutic and short-and long-term cytotoxic effects of radiopharmaceutical products, as well as determining the dose-effect relationship herein (Fig. 2) [9][10][11]. Essential aspects to investigate related to patient-and tumor-specific radiosensitivities include genetic background and underlying anomalies that impact radiosensitivity, target distribution, tumor heterogeneity, tumor micro-environment, and tumor growth and metastatic spread.…”

Section: Essential Radiobiological Studiesmentioning

confidence: 99%

“…As a consequence, distinct radiation-induced biological responses are expected for radiopharmaceuticals posing considerable challenges for in vitro, preclinical and clinical studies investigating radionuclide applications. Several research topics are suggested that should be addressed with regard to radiobiology in relation to the systemic use of radiopharmaceuticals and which have not yet been rigorously investigated [9][10][11]. Presently, there are limited studies related to the use of radiobiology in nuclear medicine.…”

Section: Introductionmentioning

confidence: 99%

EANM position paper on the role of radiobiology in nuclear medicine

Aerts

Eberlein

Holm

et al. 2021

Eur J Nucl Med Mol Imaging

View full text Add to dashboard Cite

Executive SummaryWith an increasing variety of radiopharmaceuticals for diagnostic or therapeutic nuclear medicine as valuable diagnostic or treatment option, radiobiology plays an important role in supporting optimizations. This comprises particularly safety and efficacy of radionuclide therapies, specifically tailored to each patient. As absorbed dose rates and absorbed dose distributions in space and time are very different between external irradiation and systemic radionuclide exposure, distinct radiation-induced biological responses are expected in nuclear medicine, which need to be explored. This calls for a dedicated nuclear medicine radiobiology. Radiobiology findings and absorbed dose measurements will enable an improved estimation and prediction of efficacy and adverse effects. Moreover, a better understanding on the fundamental biological mechanisms underlying tumor and normal tissue responses will help to identify predictive and prognostic biomarkers as well as biomarkers for treatment follow-up. In addition, radiobiology can form the basis for the development of radiosensitizing strategies and radioprotectant agents. Thus, EANM believes that, beyond in vitro and preclinical evaluations, radiobiology will bring important added value to clinical studies and to clinical teams. Therefore, EANM strongly supports active collaboration between radiochemists, radiopharmacists, radiobiologists, medical physicists, and physicians to foster research toward precision nuclear medicine.

show abstract

“…With interest, we have read the letter by Kao [1] which was written in response to our previous editorial [2]. Certainly, the author presents an interesting summary of recent advances and insights in the benefit of dosimetry-guided therapy in radioembolization.…”

Section: Dear Sirmentioning

confidence: 99%

“…Radioembolization in effect functions in analogy to brachytherapy, where spheres containing radiation are targeted directly toward the target tissue through local application and will stay there for the duration of physical radiation decay. This removes a number of the previously [2] discussed variables that play an important role in cell specific entity targeted therapy, such as via receptors, where the distribution volume of the patient and renal and biliary excretion as well as tumor-related factors such as expression level of the receptor and locus of expression play a role in determining both the total uptake and effective half-life. Furthermore, non-target exposure in such therapies plays a far stronger limiting role in activity prescription than in selectively infused radioembolization.…”

Section: Dear Sirmentioning

confidence: 99%