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

Next generation radiotheranostics promoting precision medicine

K L Pomykala  1 , B A Hadaschik  2 , O Sartor  3 , S Gillessen  4 , C J Sweeney  5 , T Maughan  6 , M S Hofman  7 , K Herrmann  8
Affiliations
Free article
Review

Next generation radiotheranostics promoting precision medicine

K L Pomykala et al. Ann Oncol. 2023 Jun.
Free article

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.

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Conflict of interest statement

Disclosure KP reports consultation fees from ABX, outside the submitted work. BH has had advisory roles for ABX, Advanced Accelerator Applications (AAA)/Novartis, Astellas, AstraZeneca, Bayer, Bristol Myers Squibb, Janssen R&D, Lightpoint Medical, Inc., and Pfizer; has received research funding from Astellas, Bristol Myers Squibb, AAA/Novartis, German Research Foundation, Janssen R&D, and Pfizer; and has received compensation for travel from Astellas, AstraZeneca, Bayer and Janssen R&D, all outside the submitted work. OA is a consultant for AAA, Astellas, AstraZeneca, Bayer, Blue Earth Diagnostics, Inc., Bavarian Nordic, Bristol Myers Squibb, Clarity Pharmaceuticals, Clovis, Constellation, Dendreon, EMD Serono, Fusion, Isotopen Technologien Meunchen, Janssen, Myovant, Myriad, Noria Therapeutics, Inc., Novartis, Noxopharm, Progenics, POINT Biopharma, Pfizer, Sanofi, Tenebio, Telix, Theragnostics. He reports grant/research support from AAA, Amgen, AstraZeneca, Bayer, Constellation, Endocyte, Invitae, Janssen, Lantheus, Merck, Progenics, Tenebio, outside the submitted work. SG received (last 3 years) personal honoraria for participation in advisory boards from Amgen, Merck Sharp & Dohme (MSD), Orion; other honoraria from Radio-televisione Svizzera Italiana (RSI), German-speaking European School of Oncology (DESO); invited speaker for ESMO, Swiss group for Clinical Cancer Research (SAKK), Swiss Academy of Multidisciplinary Oncology (SAMO), Orikata academy research group, China Anti-Cancer Association Genitourinary Oncology Committee (CACA-GU); speaker’s bureau for Janssen Cilag; travel grant from Proteomedix and AstraZeneca. Institutional honoraria for participation in advisory boards or in independent data monitoring committees and steering committees from AAA International, Amgen, AstraZeneca, Bayer, Bristol Myers Squibb, Modra Pharmaceuticals, MSD, Myriad Genetic, Novartis, Orion, Pfizer, Roche, Telixpharma Tolero Pharmaceuticals; other honoraria from Silvio Grasso Consulting, WebMD-Medscape. Patent royalties and other intellectual property for a research method for biomarker WO2009138392. CS is a consultant for Astellas, Bayer, Genentech/Roche, Janssen, Pfizer, AstraZeneca, Lilly, and Point BioPharma and reports research funding from Astellas, Bayer, Janssen, and AstraZeneca, outside the submitted work. TM reports consultancy fees from AstraZeneca, Perspectum, Pierre Fabre and research support from AstraZeneca, Merck KgAa, Bayer, PsiOxus, Almac Diagnostics, outside the submitted work. MSH acknowledged philanthropic/government grant support from the Prostate Cancer Foundation (PCF) funded by CANICA Oslo Norway, Peter MacCallum Foundation, Medical Research Future Fund, NHMRC investigator grant, Movember, U.S. Department of Defense and the Prostate Cancer Foundation of Australia (PCFA). MSH acknowledges grant support from AAA/Novartis, Australian Nuclear Science and Technology Organisation (ANSTO), Bayer, Isotopia. Consulting fees for lectures or advisory boards from Astellas, AstraZeneca, Janssen, Merck/MSD, Mundipharma and Point Biopharma, outside the submitted work. KH reports personal fees from Bayer, personal fees and other from Sofie Biosciences, personal fees from Sirtex, non-financial support from ABX, personal fees from Adacap, personal fees from Curium, personal fees from Endocyte, grants and personal fees from BTG, personal fees from Ipsen, personal fees from Siemens Healthineers, personal fees from GE Healthcare, personal fees from Amgen, personal fees from Novartis, personal fees from Y-mAbs, personal fees from Aktis Oncology, personal fees from Theragnostics, personal fees from Pharma15, personal fees from Debiopharm, personal fees from AstraZeneca, personal fees from Janssen, outside the submitted work.

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