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A limiting factor for the progress of radionuclide-based cancer diagnostics and therapy--availability of suitable
Vladimir Tolmachev1, Jörgen Carlsson, Hans Lundqvist
1Biomedical Radiation Sciences, Department of Oncology, Radiology and Clinical Immunology, Rudbeck Laboratory, Uppsala University, Uppsala, Sweden.
Abstract:
Advances in diagnostics and targeted radionuclide therapy of haematological and neuroendocrine tumours have raised hope for improved radionuclide therapy of other forms of disseminated tumours. New molecular target structures are characterized and this stimulates the efforts to develop new radiolabelled targeting agents. There is also improved understanding of factors of importance for choice of appropriate radionuclides. The choice is determined by physical, chemical, biological, and economic factors, such as a character of emitted radiation, physical half-life, labelling chemistry, chemical stability of the label, intracellular retention time, and fate of radiocatabolites and availability of the radionuclide. There is actually limited availability of suitable radionuclides and this is a limiting factor for further progress in the field and this is the focus in this article. The probably most promising therapeutic radionuclide, 211At, requires regional production and distribution centres with dedicated cyclotrons. Such centres are, with a few exceptions in the world, lacking today. They can be designed to also produce beta- and Augeremitters of therapeutic interest. Furthermore, emerging satellite PET scanners will in the near future demand long-lived positron emitters for diagnostics with macromolecular radiopharmaceuticals, and these can also be produced at such centres. To secure continued development and to meet the foreseen requirements for radionuclide availability from the medical community it is necessary to establish specialized cyclotron centres for radionuclide production.
Insights
Limited availability of therapeutic radionuclides hinders progress in targeted cancer therapy. Establishing specialized cyclotron centers is crucial for producing essential radionuclides like 211At and positron emitters for advanced diagnostics.
Area of Science:
- Nuclear medicine
- Radiopharmaceutical chemistry
- Oncology
Background:
- Targeted radionuclide therapy shows promise for disseminated cancers, including hematological and neuroendocrine tumors.
- Advancements in molecular targets and understanding radionuclide selection factors (physical, chemical, biological, economic) are driving new radiolabeled agent development.
- Limited availability of suitable radionuclides is a significant bottleneck for progress in the field.
Purpose of the Study:
- To highlight the critical issue of radionuclide availability for targeted radionuclide therapy and diagnostics.
- To emphasize the need for specialized production and distribution centers for key therapeutic and diagnostic radionuclides.
- To discuss the potential of such centers in supporting the development of novel radiopharmaceuticals and advanced imaging techniques.
Main Methods:
- Review of current advancements in radionuclide therapy and diagnostics.
- Analysis of factors influencing radionuclide selection for therapeutic and diagnostic applications.
- Assessment of the production requirements for promising radionuclides, such as 211At and positron emitters.
Main Results:
- The therapeutic radionuclide 211At requires regional production centers with dedicated cyclotrons, which are currently scarce.
- Specialized centers can also produce therapeutic beta- and Auger-emitters and long-lived positron emitters for advanced diagnostics.
- The establishment of these centers is essential to meet future demands for radionuclides.
Conclusions:
- Limited radionuclide availability impedes the advancement of targeted radionuclide therapy and diagnostics.
- Specialized cyclotron centers are necessary for the regional production and distribution of critical radionuclides.
- These centers will facilitate the development and application of novel radiopharmaceuticals, improving cancer treatment and diagnosis.
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