Alpha and Beta Radiation for Theragnostics

PET Clin. 2024 Jul;19(3):307-323. doi: 10.1016/j.cpet.2024.03.006. Epub 2024 Apr 29.

Abstract

Targeted radionuclide therapy (TRT) has significantly evolved from its beginnings with iodine-131 to employing carrier molecules with beta emitting isotopes like lutetium-177. With the success of Lu-177-DOTATATE for neuroendocrine tumors and Lu-177-PSMA-617 for prostate cancer, several other beta emitting radioisotopes, such as Cu-67 and Tb-161, are being explored for TRT. The field has also expanded into targeted alpha therapy (TAT) with agents like radium-223 for bone metastases in prostate cancer, and several other alpha emitter radioisotopes with carrier molecules, such as Ac-225, and Pb-212 under clinical trials. Despite these advancements, the scope of TRT in treating diverse solid tumors and integration with other therapies like immunotherapy remains under investigation. The success of antibody-drug conjugates further complements treatments with TRT, though challenges in treatment optimization continue.

Keywords: Actinium-225; Alpha particle; Beta particle; Lead-212; Lutetium-177; Targeted alpha therapy; Targeted radionuclide therapy; Terbium-161.

Publication types

  • Review

MeSH terms

  • Alpha Particles* / therapeutic use
  • Beta Particles* / therapeutic use
  • Bone Neoplasms / radiotherapy
  • Bone Neoplasms / secondary
  • Humans
  • Lutetium / therapeutic use
  • Male
  • Neoplasms / radiotherapy
  • Prostatic Neoplasms / diagnostic imaging
  • Prostatic Neoplasms / radiotherapy
  • Radioisotopes* / therapeutic use
  • Radiopharmaceuticals* / therapeutic use
  • Radium / therapeutic use

Substances

  • Radioisotopes
  • Radiopharmaceuticals
  • Lutetium
  • Radium
  • Radium-223
  • Lutetium-177