Clinical Translation of Targeted α-Therapy: An Evolution or a Revolution?

Area of Science:

• Oncology
• Nuclear Medicine
• Radiopharmaceutical Therapy

Background:

• Radioligand therapy has advanced, particularly with beta-emitting agents for specific tumors.
• Alpha-emitting targeted therapies are emerging as next-generation theranostics due to their potent cell-killing properties.

Approach:

• This review summarizes key studies on targeted alpha therapies.
• It covers the first FDA-approved alpha-therapy (radium-223 dichloride) for prostate cancer bone metastases.
• It also discusses clinical translation concepts like targeted alpha-peptide receptor radiotherapy and actinium-225 PSMA-617.

Key Points:

• Targeted alpha therapy utilizes alpha emitters with high linear energy transfer and short range for precise tumor cell destruction.
• Clinical trials are evaluating novel targets and combination therapies to maximize efficacy.
• Early and late-stage trials are progressing for neuroendocrine tumors and metastatic prostate cancer.

Conclusions:

• Targeted alpha therapy represents a highly promising area in novel cancer treatment.
• Further research will elucidate short- and long-term toxicity profiles.
• Identifying suitable therapeutic combination partners is a key goal for future development.