Combination strategies to improve targeted radionuclide therapy

In recent years, targeted radionuclide therapy (TRT) has emerged as a promising strategy for cancer treatment. In contrast to conventional radiotherapy, TRT delivers ionising radiation to tumours in a targeted manner, reducing the dose that healthy tissues are exposed to. Existing TRT strategies inc...

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Main Authors: Chan, T, O'Neill, E, Habjan, C, Cornelissen, B
Format: Journal article
Language:English
Published: Society of Nuclear Medicine 2020
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author Chan, T
O'Neill, E
Habjan, C
Cornelissen, B
author_facet Chan, T
O'Neill, E
Habjan, C
Cornelissen, B
author_sort Chan, T
collection OXFORD
description In recent years, targeted radionuclide therapy (TRT) has emerged as a promising strategy for cancer treatment. In contrast to conventional radiotherapy, TRT delivers ionising radiation to tumours in a targeted manner, reducing the dose that healthy tissues are exposed to. Existing TRT strategies include the use of 177Lu-DOTATATE and 131I-MIBG, FDA-approved agents for the treatment of neuroendocrine tumours, and 177Lu-PSMA, which is being investigated for the treatment of prostate cancer. Although promising results have been obtained with these agents, clinical evidence acquired to date suggests that only a small percentage of patients achieve complete response. Consequently, there have been attempts to improve the efficacy of TRT through combinations with other therapeutic agents; such strategies include administering concurrent TRT and chemotherapy, and the use of TRT with known or putative radiosensitisers such as PARP and mTOR inhibitors. In addition to potentially achieving greater therapeutic effects than the respective monotherapies, these strategies may lead to lower dosages or number of cycles required and, in turn, reduce unwanted toxicities and reduce costs for healthcare providers. As of now, several clinical trials have been conducted to assess the benefits of TRT-based combination therapies, sometimes despite limited preclinical evidence being available in the public domain to support their use. Whilst some clinical trials have yielded promising results, others have shown no clear survival benefit of particular combination treatments. Here, we present a comprehensive review of combination strategies with TRT reported in the literature to date and evaluate their therapeutic potential.
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spelling oxford-uuid:1476bc02-ebc0-4a6c-a253-caa7e9ecb5012022-03-26T10:19:58ZCombination strategies to improve targeted radionuclide therapyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:1476bc02-ebc0-4a6c-a253-caa7e9ecb501EnglishSymplectic ElementsSociety of Nuclear Medicine2020Chan, TO'Neill, EHabjan, CCornelissen, BIn recent years, targeted radionuclide therapy (TRT) has emerged as a promising strategy for cancer treatment. In contrast to conventional radiotherapy, TRT delivers ionising radiation to tumours in a targeted manner, reducing the dose that healthy tissues are exposed to. Existing TRT strategies include the use of 177Lu-DOTATATE and 131I-MIBG, FDA-approved agents for the treatment of neuroendocrine tumours, and 177Lu-PSMA, which is being investigated for the treatment of prostate cancer. Although promising results have been obtained with these agents, clinical evidence acquired to date suggests that only a small percentage of patients achieve complete response. Consequently, there have been attempts to improve the efficacy of TRT through combinations with other therapeutic agents; such strategies include administering concurrent TRT and chemotherapy, and the use of TRT with known or putative radiosensitisers such as PARP and mTOR inhibitors. In addition to potentially achieving greater therapeutic effects than the respective monotherapies, these strategies may lead to lower dosages or number of cycles required and, in turn, reduce unwanted toxicities and reduce costs for healthcare providers. As of now, several clinical trials have been conducted to assess the benefits of TRT-based combination therapies, sometimes despite limited preclinical evidence being available in the public domain to support their use. Whilst some clinical trials have yielded promising results, others have shown no clear survival benefit of particular combination treatments. Here, we present a comprehensive review of combination strategies with TRT reported in the literature to date and evaluate their therapeutic potential.
spellingShingle Chan, T
O'Neill, E
Habjan, C
Cornelissen, B
Combination strategies to improve targeted radionuclide therapy
title Combination strategies to improve targeted radionuclide therapy
title_full Combination strategies to improve targeted radionuclide therapy
title_fullStr Combination strategies to improve targeted radionuclide therapy
title_full_unstemmed Combination strategies to improve targeted radionuclide therapy
title_short Combination strategies to improve targeted radionuclide therapy
title_sort combination strategies to improve targeted radionuclide therapy
work_keys_str_mv AT chant combinationstrategiestoimprovetargetedradionuclidetherapy
AT oneille combinationstrategiestoimprovetargetedradionuclidetherapy
AT habjanc combinationstrategiestoimprovetargetedradionuclidetherapy
AT cornelissenb combinationstrategiestoimprovetargetedradionuclidetherapy