Overview of Adverse Reactions of Radiopharmaceuticals

Area of Science:

• Nuclear medicine
• Radiopharmaceutical science
• Oncology

Background:

• Theranostics combines radioactive isotopes for molecular imaging and targeted therapy using radiopharmaceuticals (RPs).
• RPs, comprising a pharmaceutical ligand and a radionuclide, are vital for PET and SPECT imaging and radionuclide therapy.
• Understanding adverse reactions (ARs) is crucial for safe and effective theranostic applications.

Purpose of the Study:

• To review adverse reactions associated with diagnostic and therapeutic radiopharmaceuticals.
• To emphasize the severity and clinical management of these adverse reactions.
• To explore the mechanisms of RP toxicity and limitations in current assessment tools.

Main Methods:

• Systematic review and synthesis of published literature on radiopharmaceutical adverse effects.
• Categorization of adverse reactions by specificity and systemic effects.
• Evaluation of severity and clinical management strategies for adverse events.

Main Results:

• Diagnostic RPs exhibit rare and minimal side effects.
• Therapeutic RPs, while targeting cancer cells, have generally fewer and less severe adverse effects than conventional therapies.
• Severe toxicity from therapeutic RPs is uncommon and often preventable; however, validated assessment tools are limited.

Conclusions:

• Radionuclide therapy presents a less invasive, targeted treatment with a favorable safety profile.
• Ongoing evaluation of ARs and development of standardized assessment tools are vital for improving patient outcomes and RP safety.
• Enhanced monitoring and reporting systems are essential for advancing theranostic safety.