Radiotheranostics in oncology: current challenges and emerging opportunities.
Radiotheranostics in oncology: current challenges and emerging opportunities.
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DOI：
10.1038/s41571-022-00652-y
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发表时间：
2022-08
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结构成像仍然是癌症患者诊断、分期和反应评估的重要组成部分；然而，随着临床医生越来越多地寻求无创性地研究肿瘤表型并评估治疗的功能和分子反应，放射治疗--诊断成像与靶向治疗的结合--正变得越来越广泛。放射其他学领域是本综述的重点，它将分子成像(主要是正电子发射计算机断层扫描和单光子发射计算机断层扫描)与靶向放射性核素治疗相结合，后者涉及使用小分子、多肽和/或抗体作为治疗性放射性核素的载体，通常是那些发射α-，β或俄歇辐射的放射性核素。放射治疗在肿瘤学中的指数式全球扩张源于它以最小的不良反应靶向和消除肿瘤细胞的潜力，这是由于其作用机制与大多数其他系统疗法截然不同。目前，存在着一个巨大的机会，可以扩大可以从这项技术中受益的患者数量，以满足世界各地成千上万患者的迫切需求。在这篇综述中，我们描述了已建立的放射治疗的临床经验，以及新的研究领域和进步的各种障碍。
Structural imaging remains an essential component of diagnosis, staging and response assessment in patients with cancer; however, as clinicians increasingly seek to noninvasively investigate tumour phenotypes and evaluate functional and molecular responses to therapy, theranostics — the combination of diagnostic imaging with targeted therapy — is becoming more widely implemented. The field of radiotheranostics, which is the focus of this Review, combines molecular imaging (primarily PET and SPECT) with targeted radionuclide therapy, which involves the use of small molecules, peptides and/or antibodies as carriers for therapeutic radionuclides, typically those emitting α-, β- or auger-radiation. The exponential, global expansion of radiotheranostics in oncology stems from its potential to target and eliminate tumour cells with minimal adverse effects, owing to a mechanism of action that differs distinctly from that of most other systemic therapies. Currently, an enormous opportunity exists to expand the number of patients who can benefit from this technology, to address the urgent needs of many thousands of patients across the world. In this Review, we describe the clinical experience with established radiotheranostics as well as novel areas of research and various barriers to progress.
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