Targeted Radiopharmaceutical Therapy for Bone Metastases.

Radiopharmaceutical approaches for targeting bone metastasis have traditionally focused on palliation of pain. Several agents have been clinically used over the last several decades and have proven value in pain palliation providing pain relief and improving quality of life. The role is well established across several malignancies, most commonly used in osteoblastic prostate cancer patients. These agents have primarily based on targeting and uptake in bone matrix and have mostly included beta emitting isotopes. The advent alpha emitter and FDA approval of 223Ra-dichloride has created a paradigm shift in clinical approach from application for pain palliation to treatment of bone metastasis. The approval of 223Ra-dichloride given the survival benefit in metastatic prostate cancer patients, led to predominant use of this alpha emitter in prostate cancer patients. With rapid development of radiopharmaceutical therapies and approval of other targeted agents such as 177Lu-PSMA the approach to treatment of bone metastasis has further evolved and combination treatments have increasingly been applied. Novel approaches are needed to improve and expand the use of such therapies for treatment of bone metastasis. Combination therapies with different targeting mechanisms, combining chemotherapies and cocktail of alpha and beta emitters need further exploration.

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Copyright © 2024. Published by Elsevier Inc.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare the following financial interests/personal relationships that could be considered as potential competing interests: Neeta Pandit-Taskar reports honoraria from Actinium Pharmaceuticals; consulting or advisory role for innervate, Telix, and Lantheus; Speakers' Bureau association for Actinium Pharmaceuticals and Telix; research funding (institutional) from Bayer Health, Bristol Myers Squibb, Clarity Pharmaceuticals, Cellectar Biosciences, Imaginab, Janssen, Regeneron, Ymabs, and Innervate; and travel support from AstraZeneca. Other authors report no competing interest- financial interests or personal relationship.