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Personalisation of Molecular Radiotherapy through Optimisation of Theragnostics

Davis, LauraMay; Smith, April-Louise; Aldridge, Matthew D; Foulkes, Jack; Peet, Connie; Wan, Simon; Gains, Jennifer E; ... Gaze, Mark N; + view all (2020) Personalisation of Molecular Radiotherapy through Optimisation of Theragnostics. Journal of Personalized Medicine , 10 (4) , Article 174. 10.3390/jpm10040174. Green open access

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Abstract

Molecular radiotherapy, or targeted radionuclide therapy, uses systemically administered drugs bearing a suitable radioactive isotope, typically a beta emitter. These are delivered via metabolic or other physiological pathways to cancer cells in greater concentrations than to normal tissues. The absorbed radiation dose in tumour deposits causes chromosomal damage and cell death. A partner radiopharmaceutical, most commonly the same vector labelled with a different radioactive atom, with emissions suitable for gamma camera or positron emission tomography imaging, is used to select patients for treatment and to assess response. The use of these pairs of radio-labelled drugs, one optimised for therapy, the other for diagnostic purposes, is referred to as theragnostics. Theragnostics is increasingly moving away from a fixed number of defined activity administrations, to a much more individualised or personalised approach, with the aim of improving treatment outcomes, and minimising toxicity. There is, however, still significant scope for further progress in that direction. The main tools for personalisation are the following: imaging biomarkers for better patient selection; predictive and post-therapy dosimetry to maximise the radiation dose to the tumour while keeping organs at risk within tolerance limits; imaging for assessment of treatment response; individualised decision making and communication about radiation protection, adjustments for toxicity, inpatient and outpatient care.

Type: Article
Title: Personalisation of Molecular Radiotherapy through Optimisation of Theragnostics
Location: Switzerland
Open access status: An open access version is available from UCL Discovery
DOI: 10.3390/jpm10040174
Publisher version: https://doi.org/10.3390/jpm10040174
Language: English
Additional information: © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Keywords: Dosimetry; imaging biomarkers; molecular radiotherapy; organs at risk; personalised dose administration; radionuclide therapy; response assessment; theragnostics
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > Research Department of Oncology
URI: https://discovery.ucl.ac.uk/id/eprint/10182896
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