Evolving Targeted Radiotherapies to Treat Cancer

Targeted radionuclide therapy (TRT) is a precision cancer therapy that involves transporting a radionuclide to cancer cells using a targeting vector that recognizes molecules that are overexpressed on or unique to cancer cells. TRT takes advantage of specific properties of radionuclides such as their high energy and short path length for energy deposition within the tissue. The type of radionuclide (alpha, beta, Auger electron), dictates its depth of tissue penetration and therefore its range of effect. Auger electrons act on the nm scale and are best suited to intracellular targets, beta emitters have a range on the mm scale and alpha emitters exert their effect at less than 100 µm. TRT and particularly targeted alpha therapy have proved especially effective at treating metastatic disease. An advantage of TRT is the ability to substitute the therapeutic for an imaging radionuclide to track tumor localization and follow treatment progression.

The 2022 Accelerating Radiotherapeutic Innovations and Applications (ARIA) Workshop will discuss the emerging use of targeted mono and combination therapies to treat cancer, in particular the use of targeted radiotherapies, novel chelators, and nanotechnology. As the third workshop in the (ARIA) series, it will be a continuation of the workshop held in 2019. This Research Topic serves as a repository of the discoveries and advances featured at the workshop.

We welcome the submission of articles that focus on the development of new chelators and novel nanotechnology for radionuclide caging and attachment to targeting vectors (e.g., monoclonal antibodies, peptides, small molecules, oligonucleotides etc.) for transport to cancer cells. Topics for consideration include, but are not limited to, the following:

1. How the development of new chelators and nanotechnology can improve and expand the use of targeted radiotherapies

2. How evaluating the radiobiology and dosimetry of targeted radiotherapies alone and in combination will improve our understanding of these therapies and expand their use

3. What is the potential for combination chemotherapy, radiotherapy, and immunotherapy to deliver on the promise of precision medicine to enhance tumor cell killing while minimizing side effects to healthy tissue

4. How we can expand the production of valuable radionuclides to meet the growing need for Targeted Radionuclide Therapy.

Understanding the cellular localization and penetration of different delivery vectors, as well as the radiobiology and dosimetry of these targeted radiotherapies is essential to evaluating their effectiveness. Translation into effective patient treatments depends on the best use of appropriate in vitro and in vivo models and so alternative biological assessment models is also of interest.

Assessing the impact of these therapies at the molecular and cellular level is crucial to the development of effective treatments that maximize tumor cell killing while minimizing impact to normal cells, tissue, and organs.

We would like to acknowledge Dr. Miguel Toro Gonzalez as the Topic Coordinator as well as Dr. Sandra Davern who has contributed to the preparation of the proposal for this Research Topic.

Keywords: Targeted radionuclide therapy (TRT), Targeted alpha therapy (TAT), Cancer, Theranostics, Radioimaging, PET/SPECT/CT, Linear energy transfer (LET), Metastasis, targeting vectors, chelators, nanoparticles, nanocarriers, Beta emitters, Auger electron emitter

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.