Targeted radionuclide therapy in combined-modality regimens.

Abstract

Targeted radionuclide therapy (TRT) is a branch of cancer medicine concerned with the use of radioisotopes, radiolabelled molecules, nanoparticles, or microparticles that either naturally accumulate in or are designed to target tumours. TRT combines the specificity of molecular and sometimes physical targeting with the potent cytotoxicity of ionising radiation. Targeting vectors for TRT include antibodies, antibody fragments, proteins, peptides, and small molecules. The diversity of available carrier molecules, together with the large panel of suitable radioisotopes with unique physicochemical properties, allows vector-radionuclide pairings to be matched to the molecular, pathological, and physical characteristics of a tumour. Some pairings are designed for dual therapeutic and diagnostic applications. Use of TRT is increasing with the adoption into practice of radium-223 dichloride for the treatment of bone metastases and with the ongoing clinical development of, among others, 177Lu-dodecanetetraacetic acid tyrosine-3-octreotate (DOTATATE) for the treatment of neuroendocrine tumours and 90Y-microspheres for the treatment of hepatic tumours. The increasing use of TRT raises the question of how best to integrate TRT into multimodality protocols. Achievements in this area and the future prospects of TRT are evaluated in this Review.

• Authors: Martin R Gill, Nadia Falzone, Yong Du, Katherine A Vallis
• Journal: The Lancet. Oncology (Lancet Oncol) Vol. 18 Issue 7 Pg. e414-e423 (07 2017) ISSN: 1474-5488 [Electronic] England
• PMID: 28677577 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2017 Elsevier Ltd. All rights reserved.

Chemical References

• 90Y-octreotate, DOTA(0)-Tyr(3)-Thr(8)-
• Antibodies, Monoclonal
• Antineoplastic Agents
• Immunotoxins
• Organometallic Compounds
• Radioisotopes
• 3-Iodobenzylguanidine
• ibritumomab tiuxetan
• lutetium Lu 177 dotatate
• radium Ra 223 dichloride
• Octreotide
• Radium

Topics

• 3-Iodobenzylguanidine (therapeutic use)
• Antibodies, Monoclonal (therapeutic use)
• Antineoplastic Agents (therapeutic use)
• Chemoradiotherapy (methods)
• DNA Repair (drug effects)
• Humans
• Immunotoxins (therapeutic use)
• Microspheres
• Molecular Targeted Therapy
• Neoplasms (therapy)
• Octreotide (analogs & derivatives, therapeutic use)
• Organometallic Compounds (therapeutic use)
• Radioisotopes (therapeutic use)
• Radiotherapy (methods)
• Radium (therapeutic use)