Targeted Radionuclide Therapy in Oncology
Targeted radionuclide therapy (TRT) is an attractive tool for specifically deliver radiation to diffuse, primary or metastatic cancer cells in close vicinity to risk organs. It is a multidisciplinary approach that requires the collaboration of biologists, physicists, chemists, radiation oncologists and nuclear medicine physicians. During the last 50 years, advances in molecular biology have provided a wide panel of vectors against tumor cells, while improvement in radiation chemistry together with a wide isotope supply have considerably increased the number of radiolabeled molecules that are now available for preclinical and clinical studies. These progresses have led to the approval of two specialties for the treatment of the radiation-sensitive non-Hodgkin B lymphoma. However, the treatment of the radio-resistant solid tumors requires more complex and tailored approaches. Besides the choice of the most relevant clinical target and of the most appropriate vector and isotopes, TRT cannot be any longer based solely on a pharmacological approach, but requires tailored treatments founded on dose regimens and dose-effect relationship. Molecular imaging will play a central role in predicting the expression of targets, the behavior of the injected molecules and the assessment of the absorbed dose for a personalized dosimetry. A better understanding of the radiation-induced biological effects (radiobiology) of low dose-rate targeted radionuclide therapy needs to be investigated to provide TRT with the necessary knowledge for the successful use of radiation and the optimization of therapeutic combinations. In this Frontiers Research Topic, we encourage submission of original papers and reviews dealing with basic, translational and clinical research in targeted radionuclide therapy.