RT Journal Article
SR Electronic
T1 Combination Strategies to Improve Targeted Radionuclide Therapy
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP jnumed.120.248062
DO 10.2967/jnumed.120.248062
A1 Tiffany Chan
A1 Edward O'Neill
A1 Christine Habjan
A1 Bart Cornelissen
YR 2020
UL http://jnm.snmjournals.org/content/early/2020/10/09/jnumed.120.248062.abstract
AB 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.