Clinical Advances and Perspectives in Targeted Radionuclide Therapy

Pharmaceutics · 4 authors, 5 centres

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TL;DR

This narrative review summarizes the evolution of targeted radionuclide therapy from thyroid treatment to precision oncology, highlighting key clinical trials and future directions.

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The paper is a narrative review that outlines the historical development and current advances in targeted radionuclide therapy. It describes the shift from using iodine-131 for thyroid disorders to modern radiopharmaceuticals that combine radionuclides with vectors (antibodies, peptides, small molecules) for selective tumor targeting. The review notes that a better understanding of cancer molecular biology and the availability of new radioisotopes have improved therapeutic efficacy and enabled personalized treatments. It references the clinical and commercial success of agents demonstrated in phase III trials like ALSYMPCA, NETTER-1, and VISION for specific cancers. The authors discuss emerging trends, such as targeting the tumor microenvironment, using α-emitters, and developing pan-cancer approaches. Limitations are not explicitly detailed, but the review implies that careful patient selection, dosimetry, and combination therapies are future challenges. The implications are that targeted radionuclide therapy is becoming an essential component of nuclear medicine and oncology.

STUDY TYPE

narrative_review

SPECIALTY

oncology

SUMMARISED BY

AI pipeline

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100% · A

ORIGINAL PAPER

PMC10303056

Clinical Advances and Perspectives in Targeted Radionuclide Therapy

Pharmaceutics

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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.

CITATION EXPORT

Nicolas Lepareur, Barthélémy Ramée, Marie Mougin-Degraef et al.. Clinical Advances and Perspectives in Targeted Radionuclide Therapy. Pharmaceutics. (2023). https://doi.org/10.3390/pharmaceutics15061733

AUTHORS

4 · 5 CENTRES

Nicolas Lepareur, Barthélémy Ramée, Marie Mougin-Degraef, Mickaël Bourgeois

1Comprehensive Cancer Center Eugène Marquis, 35000 Rennes, France
2Inserm, INRAE, Institut NUMECAN (Nutrition, Métabolismes et Cancer)—UMR 1317, Univ Rennes, 35000 Rennes, France
3Nuclear Medicine Department, Nantes University Hospital, 44000 Nantes, France; [email protected] (B.R.); [email protected] (M.M.-D.);
4Inserm, CNRS, CRCI2NA (Centre de Recherche en Cancérologie et Immunologie Intégrée Nantes—Angers)—UMR 1307, Université de Nantes, ERL 6001, 44000 Nantes, France
5Groupement d’Intérêt Public ARRONAX, 1 Rue Aronnax, 44817 Saint Herblain, France

EDITOR / REVIEWER

Frank Wuest