Recent Advances and Impending Challenges for the Radiopharmaceutical Sciences in Oncology

Overview

Journal Lancet Oncol

Specialty Oncology

Date 2024 May 31

PMID 38821098

Authors

Suzanne E Lapi

Peter J H Scott

Andrew M Scott

Albert D Windhorst

Brian M Zeglis

May Abdel-Wahab

Richard P Baum

John M Buatti

Francesco Giammarile

Ana P Kiess

Amirreza Jalilian

Peter Knoll

Aruna Korde

Jolanta Kunikowska

Sze Ting Lee

Diana Paez

Jean-Luc Urbain

Jingjing Zhang

Jason S Lewis

Affiliations

Soon will be listed here.

Abstract

This paper is the first of a Series on theranostics that summarises the current landscape of the radiopharmaceutical sciences as they pertain to oncology. In this Series paper, we describe exciting developments in radiochemistry and the production of radionuclides, the development and translation of theranostics, and the application of artificial intelligence to our field. These developments are catalysing growth in the use of radiopharmaceuticals to the benefit of patients worldwide. We also highlight some of the key issues to be addressed in the coming years to realise the full potential of radiopharmaceuticals to treat cancer.

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Improvement of End-of-Synthesis Radiochemical Purity of Lu-DOTA-PSMA-Ligands with Alternative Synthesis Approaches: Conversion Upswing and Side-Products Minimization.

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Radioimmunotheragnosis in Cancer Research.

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References

Bradshaw T, Boellaard R, Dutta J, Jha A, Jacobs P, Li Q . Nuclear Medicine and Artificial Intelligence: Best Practices for Algorithm Development. J Nucl Med. 2021; 63(4):500-510. PMC: 10949110. DOI: 10.2967/jnumed.121.262567. View

Buck A, Serfling S, Lindner T, Hanscheid H, Schirbel A, Hahner S . CXCR4-targeted theranostics in oncology. Eur J Nucl Med Mol Imaging. 2022; 49(12):4133-4144. PMC: 9525349. DOI: 10.1007/s00259-022-05849-y. View

Sartor O, de Bono J, Chi K, Fizazi K, Herrmann K, Rahbar K . Lutetium-177-PSMA-617 for Metastatic Castration-Resistant Prostate Cancer. N Engl J Med. 2021; 385(12):1091-1103. PMC: 8446332. DOI: 10.1056/NEJMoa2107322. View

Rodriguez-Ruiz M, Rodriguez I, Leaman O, Lopez-Campos F, Montero A, Conde A . Immune mechanisms mediating abscopal effects in radioimmunotherapy. Pharmacol Ther. 2018; 196:195-203. DOI: 10.1016/j.pharmthera.2018.12.002. View

Thakral P, Sen I, Das S, Manda D, Cb V, Malik D . Dosimetric analyses of intra-arterial versus standard intravenous administration of 177Lu-DOTATATE in patients of well differentiated neuroendocrine tumor with liver-dominant metastatic disease. Br J Radiol. 2021; 94(1126):20210403. PMC: 9328058. DOI: 10.1259/bjr.20210403. View

Loktev A, Lindner T, Mier W, Debus J, Altmann A, Jager D . A Tumor-Imaging Method Targeting Cancer-Associated Fibroblasts. J Nucl Med. 2018; 59(9):1423-1429. PMC: 6126438. DOI: 10.2967/jnumed.118.210435. View

Shi M, Jakobsson V, Greifenstein L, Khong P, Chen X, Baum R . Alpha-peptide receptor radionuclide therapy using actinium-225 labeled somatostatin receptor agonists and antagonists. Front Med (Lausanne). 2022; 9:1034315. PMC: 9767967. DOI: 10.3389/fmed.2022.1034315. View

Sunderland J, Ponto L, Capala J . Radiopharmaceutical Delivery for Theranostics: Pharmacokinetics and Pharmacodynamics. Semin Radiat Oncol. 2020; 31(1):12-19. DOI: 10.1016/j.semradonc.2020.07.009. View

Giammarile F, Delgado Bolton R, El-Haj N, Freudenberg L, Herrmann K, Mikhail M . Changes in the global impact of COVID-19 on nuclear medicine departments during 2020: an international follow-up survey. Eur J Nucl Med Mol Imaging. 2021; 48(13):4318-4330. PMC: 8214460. DOI: 10.1007/s00259-021-05444-7. View

10.

Giammarile F, Delgado Bolton R, El-Haj N, Mikhail M, Morozova O, Orellana P . Impact of COVID-19 on Nuclear Medicine Departments in Africa and Latin America. Semin Nucl Med. 2021; 52(1):31-40. PMC: 8639221. DOI: 10.1053/j.semnuclmed.2021.06.018. View

11.

Bodei L, Herrmann K, Schoder H, Scott A, Lewis J . Radiotheranostics in oncology: current challenges and emerging opportunities. Nat Rev Clin Oncol. 2022; 19(8):534-550. PMC: 10585450. DOI: 10.1038/s41571-022-00652-y. View

12.

Lin M, Paolillo V, Le D, Macapinlac H, Ravizzini G . Monoclonal antibody based radiopharmaceuticals for imaging and therapy. Curr Probl Cancer. 2021; 45(5):100796. DOI: 10.1016/j.currproblcancer.2021.100796. View

13.

Chitneni S, Koumarianou E, Vaidyanathan G, Zalutsky M . Observations on the Effects of Residualization and Dehalogenation on the Utility of -Succinimidyl Ester Acylation Agents for Radioiodination of the Internalizing Antibody Trastuzumab. Molecules. 2019; 24(21). PMC: 6864793. DOI: 10.3390/molecules24213907. View

14.

Starovoitova V, Tchelidze L, Wells D . Production of medical radioisotopes with linear accelerators. Appl Radiat Isot. 2013; 85:39-44. DOI: 10.1016/j.apradiso.2013.11.122. View

15.

Zhang C, Yu X, Gao L, Zhao Y, Lai J, Lu D . Noninvasive Imaging of CD206-Positive M2 Macrophages as an Early Biomarker for Post-Chemotherapy Tumor Relapse and Lymph Node Metastasis. Theranostics. 2017; 7(17):4276-4288. PMC: 5695012. DOI: 10.7150/thno.20999. View

16.

Zboralski D, Hoehne A, Bredenbeck A, Schumann A, Nguyen M, Schneider E . Preclinical evaluation of FAP-2286 for fibroblast activation protein targeted radionuclide imaging and therapy. Eur J Nucl Med Mol Imaging. 2022; 49(11):3651-3667. PMC: 9399058. DOI: 10.1007/s00259-022-05842-5. View

17.

Greifenstein L, Kramer C, Moon E, Rosch F, Klega A, Landvogt C . From Automated Synthesis to In Vivo Application in Multiple Types of Cancer-Clinical Results with [Ga]Ga-DATA.SA.FAPi. Pharmaceuticals (Basel). 2022; 15(8). PMC: 9415298. DOI: 10.3390/ph15081000. View

18.

Krolicki L, Bruchertseifer F, Kunikowska J, Koziara H, Krolicki B, Jakucinski M . Safety and efficacy of targeted alpha therapy with Bi-DOTA-substance P in recurrent glioblastoma. Eur J Nucl Med Mol Imaging. 2018; 46(3):614-622. DOI: 10.1007/s00259-018-4225-7. View

19.

Poty S, Francesconi L, McDevitt M, Morris M, Lewis J . α-Emitters for Radiotherapy: From Basic Radiochemistry to Clinical Studies-Part 1. J Nucl Med. 2018; 59(6):878-884. PMC: 6004557. DOI: 10.2967/jnumed.116.186338. View

20.

Woo S, Ghafoor S, Becker A, Han S, Wibmer A, Hricak H . Prostate-specific membrane antigen positron emission tomography (PSMA-PET) for local staging of prostate cancer: a systematic review and meta-analysis. Eur J Hybrid Imaging. 2021; 4(1):16. PMC: 8218057. DOI: 10.1186/s41824-020-00085-9. View