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Targeted radionuclide therapy for gliomas: Emerging clinical trial landscape
Michael Weller1, Nathalie L Albert2, Norbert Galldiks3,4,5
1Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland.
Abstract:
According to the new WHO classification of 2021, gliomas are a heterogeneous group of tumors with very different histology, molecular genetics, and prognoses. In addition to glioblastomas, the most common gliomas, there are also numerous less common gliomas, some of which have a very favorable prognosis. Targeted radionuclide therapy is a therapeutic option that can be attractive if a tumor can be targeted based on its molecular characteristics. It is particularly useful when tumors cannot be completely resected or when conventional imaging does not fully capture the extent of the tumor. Numerous approaches to radionuclide therapy for gliomas are in early development. The most advanced approaches for patients with gliomas in the clinic employ L-type amino acid transporter 1 as an uptake mechanism for radiolabeled amino acids or target somatostatin receptor 2 or gastrin-releasing peptide receptor. Here, we discuss the various target structures of radionuclide therapy in gliomas and provide an outlook for which glioma entities radionuclide therapy could most likely provide a therapeutic alternative.
Insights
Targeted radionuclide therapy shows promise for gliomas by targeting molecular characteristics. This approach is especially beneficial for gliomas that are difficult to resect or image fully, offering a potential new treatment avenue.
Area of Science:
- Neuro-oncology
- Nuclear Medicine
- Molecular Imaging
Background:
- Gliomas are a diverse group of brain tumors with varying prognoses, as per the 2021 WHO classification.
- Targeted radionuclide therapy offers a personalized treatment approach based on tumor molecular profiles.
- This therapy is valuable for unresectable gliomas or when conventional imaging is insufficient.
Purpose of the Study:
- To review current and emerging target structures for radionuclide therapy in gliomas.
- To evaluate the potential of radionuclide therapy for different glioma subtypes.
Main Methods:
- Discussion of molecular targets utilized in glioma radionuclide therapy.
- Review of advanced clinical approaches targeting L-type amino acid transporter 1, somatostatin receptor 2, and gastrin-releasing peptide receptor.
Main Results:
- Several molecular targets are being explored for glioma radionuclide therapy.
- Radiolabeled amino acids targeting L-type amino acid transporter 1 are among the most advanced clinical approaches.
Conclusions:
- Radionuclide therapy holds significant potential as an alternative treatment for specific glioma entities.
- Further research into molecular targeting can optimize radionuclide therapy efficacy for gliomas.
