Translating the theranostic concept to neuro-oncology: disrupting barriers

Affiliations

¹ Department of Nuclear Medicine, Ludwig Maximilians University Hospital, Ludwig Maximilians University Munich, Munich, Germany.
² Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland; Department of Neurosurgery, University Hospital and University of Zurich, Zurich, Switzerland.
³ Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University, Rome, Italy.
⁴ Department of Nuclear Medicine, Ludwig Maximilians University Hospital, Ludwig Maximilians University Munich, Munich, Germany; Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria.
⁵ Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; Institute of Neuroscience and Medicine (INM-3), Research Center Juelich, Juelich, Germany; Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Germany.
⁶ Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
⁷ Institute of Neuroscience and Physiology, Department of Clinical Neuroscience, Sahlgrenska Academy, Gothenburg, Sweden; Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
⁸ Department of Radiation Oncology, University Hospital Tübingen, Tübingen, Germany.
⁹ Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands; Medical Delta, Delft, The Netherlands.
¹⁰ Department of Nuclear Medicine and Nancyclotep Imaging Platform, CHRU-Nancy, IADI, INSERM, UMR 1254, Université de Lorraine, Nancy, France.
¹¹ Nuclear Medicine Unit, Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy.
¹² Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland.
¹³ Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria. Electronic address: matthias.preusser@meduniwien.ac.at.

PMID: 39214115
DOI: 10.1016/S1470-2045(24)00145-1

Review

Translating the theranostic concept to neuro-oncology: disrupting barriers

Nathalie L Albert et al. Lancet Oncol. 2024 Sep.

. 2024 Sep;25(9):e441-e451.

doi: 10.1016/S1470-2045(24)00145-1.

Authors

Affiliations

¹ Department of Nuclear Medicine, Ludwig Maximilians University Hospital, Ludwig Maximilians University Munich, Munich, Germany.
² Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland; Department of Neurosurgery, University Hospital and University of Zurich, Zurich, Switzerland.
³ Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University, Rome, Italy.
⁴ Department of Nuclear Medicine, Ludwig Maximilians University Hospital, Ludwig Maximilians University Munich, Munich, Germany; Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria.
⁵ Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; Institute of Neuroscience and Medicine (INM-3), Research Center Juelich, Juelich, Germany; Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Germany.
⁶ Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands.
⁷ Institute of Neuroscience and Physiology, Department of Clinical Neuroscience, Sahlgrenska Academy, Gothenburg, Sweden; Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
⁸ Department of Radiation Oncology, University Hospital Tübingen, Tübingen, Germany.
⁹ Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands; Medical Delta, Delft, The Netherlands.
¹⁰ Department of Nuclear Medicine and Nancyclotep Imaging Platform, CHRU-Nancy, IADI, INSERM, UMR 1254, Université de Lorraine, Nancy, France.
¹¹ Nuclear Medicine Unit, Department of Experimental and Clinical Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy.
¹² Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland.
¹³ Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria. Electronic address: matthias.preusser@meduniwien.ac.at.

PMID: 39214115
DOI: 10.1016/S1470-2045(24)00145-1

Abstract

Theranostics integrate molecular imaging and targeted radionuclide therapy for personalised cancer therapy. Theranostic treatments have shown meaningful efficacy in randomised clinical trials and are approved for clinical use in prostate cancer and neuroendocrine tumours. Brain tumours represent an unmet clinical need and theranostics might offer effective treatment options, although specific issues need to be considered for clinical development. In this Policy Review, we discuss opportunities and challenges of developing targeted radionuclide therapies for the treatment of brain tumours including glioma, meningioma, and brain metastasis. The rational choice of molecular treatment targets is highlighted, including the potential relevance of different types of targeted radionuclide therapeutics, and the role of the blood-brain barrier and blood-tumour barrier. Furthermore, we discuss considerations for effective clinical trial design and conduct, as well as logistical and regulatory challenges for implementation of radionuclide therapies into neuro-oncological practice. Rational development will foster successful translation of the theranostic concept to brain tumours.

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Conflict of interest statement

Declaration of interests NLA has received honoraria for consultation or advisory board participation from Novartis, Advanced Accelerator Applications, Servier, and Telix Pharmaceuticals; and has received research funding from Novocure. ELR has received a research grant from Bristol Myers Squibb; and received honoraria for advisory board participation from AstraZeneca, Bayer, Janssen, Leo Pharma, Pfizer, Pierre Fabre, Roche, Seagen, and Servier. GM has received honoraria for speaker activity and travel support from Brainlab and Accuray. MJM has received research funding from Bristol Myers Squibb and travel support from Pierre Fabre. NG received honoraria for lectures from Blue Earth Diagnostics and for advisory board participation from Telix Pharmaceuticals. MN has received speaker fees for educational lectures from AstraZeneca and Brainlab. MS has received consultancy fees from Bracco and speaker fees from AuntMinnie and Fondazione Internazionale Menarini (all paid to institution). AV has received honoraria for consultation or advisory board participation from Curium, Eisai, General Electrics, and Novartis. MW has received research grants from Quercis and Versameb; and honoraria for lectures or advisory board participation or consulting from Bayer, Curevac, Medac, Neurosense, Novartis, Novocure, Orbus, Philogen, Roche, and Servier. MP has received honoraria for lectures, consultation, or advisory board participation from Bayer, Bristol Myers Squibb, Novartis, Gerson Lehrman Group, CMC Contrast, GlaxoSmithKline, Mundipharma, Roche, BMJ Journals, MedMedia, AstraZeneca, AbbVie, Eli Lilly, Medahead, Daiichi Sankyo, Sanofi, Merck Sharp & Dome, Tocagen, Adastra, Gan & Lee Pharmaceuticals, Janssen, Servier, Miltenyi, Böhringer-Ingelheim, Telix, and Medscape. All other authors declare no competing interests.

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Translating the theranostic concept to neuro-oncology: disrupting barriers

Affiliations

Translating the theranostic concept to neuro-oncology: disrupting barriers

Authors

Affiliations

Abstract

Conflict of interest statement

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Medical