Radiotheranostics in oncology: current challenges and emerging opportunities

Area of Science:

• Oncology
• Nuclear Medicine
• Radiochemistry

Background:

• Structural imaging is crucial for cancer diagnosis, staging, and response assessment.
• Theranostics, integrating diagnostics with targeted therapy, are increasingly used to investigate tumor phenotypes and treatment responses noninvasively.
• Radiotheranostics represent a key area of theranostics, merging molecular imaging with targeted radionuclide therapy.

Purpose of the Study:

• To review the clinical experience with established radiotheranostics.
• To explore novel research areas in radiotheranostics.
• To identify and discuss barriers hindering the progress and broader implementation of radiotheranostics in oncology.

Main Methods:

• Review of clinical data and research literature on radiotheranostics.
• Analysis of established radiotherapeutic agents and their applications.
• Exploration of emerging radiotracer and radionuclide delivery systems.

Main Results:

• Radiotheranostics utilize molecular imaging (PET, SPECT) coupled with targeted radionuclide therapy (using small molecules, peptides, or antibodies).
• Therapeutic radionuclides typically emit alpha (α), beta (β), or Auger radiation.
• The field is experiencing exponential global expansion due to its potential for targeted tumor cell elimination with minimal adverse effects.

Conclusions:

• Radiotheranostics offer a distinct mechanism of action compared to most systemic therapies.
• There is a significant opportunity to expand patient access to radiotheranostic technologies worldwide.
• Continued research and overcoming implementation barriers are essential for realizing the full potential of radiotheranostics in cancer care.