Challenges and Opportunities in Radioligand Therapy.

Area of Science:

• Nuclear Medicine
• Oncology
• Radiochemistry

Background:

• Radioligand therapy (RLT) represents an advancement in established nuclear medicine practices.
• Radioiodine laid the groundwork for theranostics, a key component of RLT.
• RLT is increasingly utilized in modern cancer management.

Purpose of the Study:

• To define Radioligand therapy (RLT) and its current applications.
• To highlight prototype RLT agents and their targets.
• To discuss challenges and opportunities in RLT for precision medicine.

Main Methods:

• Review of established nuclear medicine practices and theranostic principles.
• Identification of prototype radioligand therapies and their molecular targets.
• Analysis of advancements in instrumentation and radiochemistry driving RLT.

Main Results:

• RLT encompasses established nuclear medicine practices, with radioiodine as a historical foundation.
• Prototype RLTs include ⁶⁸Ga-DOTATATE and ¹⁷⁷Lu-DOTATATE for neuroendocrine tumors, and ⁶⁸Ga-PSMA-617 and ¹⁷⁷Lu-PSMA-617 for prostate cancer.
• Significant progress in instrumentation and radiochemistry is enhancing RLT's role in nuclear oncology.

Conclusions:

• RLT is a transformative approach in cancer management, particularly in nuclear oncology.
• Realizing precision medicine through RLT involves addressing challenges and leveraging opportunities.
• Ensuring global equitable access to RLT is a critical consideration for its widespread implementation.