Next generation radiotheranostics promoting precision medicine

K L Pomykala; B A Hadaschik; O Sartor; S Gillessen; C J Sweeney; T Maughan; M S Hofman; K Herrmann

doi:10.1016/j.annonc.2023.03.001

Next generation radiotheranostics promoting precision medicine

Ann Oncol. 2023 Jun;34(6):507-519. doi: 10.1016/j.annonc.2023.03.001. Epub 2023 Mar 15.

Authors

K L Pomykala¹, B A Hadaschik², O Sartor³, S Gillessen⁴, C J Sweeney⁵, T Maughan⁶, M S Hofman⁷, K Herrmann⁸

Affiliations

¹ Institute for Artificial Intelligence in Medicine, University Hospital Essen, Essen, Germany.
² Department of Urology, University Hospital Essen, Essen, Germany.
³ School of Medicine, Tulane University, New Orleans, USA.
⁴ Oncology Institute of Southern Switzerland, Bellinzona, Switzerland; Università della Svizzera Italiana, Lugano, Switzerland; Division of Cancer Sciences, University of Manchester, Manchester, UK.
⁵ Dana-Farber Cancer Institute, Boston, USA; Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
⁶ Oxford Institute for Radiation Oncology, University of Oxford, Oxford, UK.
⁷ Prostate Cancer Theranostics and Imaging Centre of Excellence (ProsTIC), Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia.
⁸ Department of Nuclear Medicine, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany. Electronic address: ken.herrmann@uk-essen.de.

PMID: 36924989
DOI: 10.1016/j.annonc.2023.03.001

Abstract

Radiotheranostics is a field of rapid growth with some approved treatments including ¹³¹I for thyroid cancer, ²²³Ra for osseous metastases, ¹⁷⁷Lu-DOTATATE for neuroendocrine tumors, and ¹⁷⁷Lu-PSMA (prostate-specific membrane antigen) for prostate cancer, and several more under investigation. In this review, we will cover the fundamentals of radiotheranostics, the key clinical studies that have led to current success, future developments with new targets, radionuclides and platforms, challenges with logistics and reimbursement and, lastly, forthcoming considerations regarding dosimetry, identifying the right line of therapy, artificial intelligence and more.

Keywords: (177)Lu-DOTATATE; (177)Lu-PSMA; endoradiotherapy; positron emission tomography; radiotheranostics; targeted radioligand therapy.

Publication types

Review

MeSH terms

Artificial Intelligence
Humans
Male
Precision Medicine
Prostate-Specific Antigen
Prostatic Neoplasms* / pathology
Prostatic Neoplasms, Castration-Resistant* / drug therapy
Radioisotopes / therapeutic use
Radiometry
Radiopharmaceuticals / therapeutic use

Substances

Radioisotopes
Prostate-Specific Antigen
Radiopharmaceuticals