Radiotheranostics in solid tumors: focus on radiopharmaceutical therapy and clinical challenges

Area of Science:

• Oncology
• Nuclear Medicine
• Radiopharmaceutical Therapy

Background:

• Theranostic radiopharmaceuticals combine diagnostic imaging and targeted radionuclide therapy for personalized oncology.
• This integrated approach enables precise patient selection, treatment planning, and response assessment.

Purpose of the Study:

• To review the current state and future directions of radiotheranostics in personalized medicine.
• To highlight clinical successes and persistent challenges in the field.

Main Methods:

• Comprehensive literature search of major biomedical databases (PubMed, Scopus, Web of Science).
• Analysis of clinical successes and existing barriers to radiotheranostic adoption.

Main Results:

• Successful clinical applications include peptide receptor radionuclide therapy for neuroendocrine tumors and PSMA-targeted radioligand therapy for prostate cancer.
• Personalized dosimetry and PET imaging are crucial for patient selection and optimizing treatment efficacy.
• Challenges include toxicity management, target heterogeneity, radionuclide production, logistics, and standardization.

Conclusions:

• Radiotheranostics offer significant potential for personalized cancer care, with ongoing innovation driving clinical practice.
• Addressing challenges in toxicity, logistics, and standardization is essential for broader implementation.
• Future advancements depend on robust clinical trials and combination strategies to overcome resistance and heterogeneity.