^203/212Pb Theranostic Radiopharmaceuticals for Image-guided Radionuclide Therapy for Cancer

Area of Science:

• Nuclear Medicine
• Radiopharmaceutical Therapy
• Oncology

Background:

• Receptor-targeted radionuclide therapy (TRT) is a promising cancer treatment.
• Alpha-particle therapy offers more potent, localized cancer cell damage due to higher Linear Energy Transfer (LET).
• Generator-produced 212Pb is a key radionuclide for alpha-TRT.

Purpose of the Study:

• To review the history, characteristics, and production of 203Pb and 212Pb for cancer theranostics.
• To highlight the potential of 212Pb for alpha-TRT and the safety of 203Pb for surrogate imaging.
• To present preclinical and clinical findings on the 203Pb/212Pb theranostic pair.

Main Methods:

• Review of historical data and current research on 203Pb and 212Pb.
• Description of decay and chemical properties relevant to theranostics.
• Analysis of production, purification, and medical physics/dosimetry perspectives.

Main Results:

• 212Pb alpha-TRT demonstrates a more potent anti-cancer effect compared to beta-TRT.
• 203Pb serves as an effective, elementally-matched imaging surrogate for 212Pb, enabling pharmacokinetic and biodistribution studies.
• The 203Pb/212Pb pair facilitates patient selection, dosimetry, and treatment planning for alpha-TRT.

Conclusions:

• The 203Pb/212Pb theranostic pair is a highly promising approach for advanced cancer therapy.
• Alpha-TRT with 212Pb offers significant advantages over beta-TRT for localized cancer treatment.
• The use of 203Pb for pre-therapeutic imaging enhances the safety and efficacy of 212Pb-based radiopharmaceutical therapy.