Theranostics and Molecular-targeted Endo-radiotherapy: The Current Landscape and Future Directions

Area of Science:

• Nuclear medicine
• Oncology
• Radiopharmaceutical therapy

Background:

• Molecular theranostics is transforming personalized medicine and precision oncology.
• It is crucial in managing differentiated thyroid carcinoma, neuroendocrine tumors, and metastatic prostate cancer.
• Theranostics holds significant potential for early-stage and diverse cancer applications.

Purpose of the Study:

• To review advancements in nuclear theranostics.
• To highlight expanded indications for established therapies.
• To discuss novel radiolabeled agents and their potential.

Main Methods:

• Review of established radionuclide therapies: peptide receptor radionuclide therapy (PRRT), prostate specific membrane antigen radioligand therapy (PRLT), and meta-iodobenzylguanidine therapy (MIBG therapy).
• Exploration of novel theranostic agents targeting fibroblast activated protein (FAPI), chemokine receptors (e.g., pentixfor/pentixather), integrins, and cholecystokinin receptors.

Main Results:

• Established therapies (PRRT, PRLT, MIBG) show expanded clinical utility.
• Emerging theranostic agents targeting FAPI, chemokine receptors, integrins, and cholecystokinin receptors demonstrate promising potential.
• Nuclear theranostics offers a growing armamentarium for various malignancies.

Conclusions:

• Nuclear theranostics is a rapidly evolving field with significant clinical impact.
• Expanded indications and novel agents are broadening the scope of theranostic applications in oncology.
• Continued research promises further integration of theranostics into cancer management.