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Targeted Radioligand Therapy: Physics and Biology, Internal Dosimetry and Other Practical Aspects During 177Lu/225Ac Treatment in Neuroendocrine Tumors and Metastatic Prostate Cancer Publisher Pubmed



Dadgar H1 ; Pashazadeh A2 ; Norouzbeigi N1 ; Assadi M3 ; Albalooshi B4 ; Baum RP5 ; Alibraheem A6 ; Haidar M7 ; Beheshti M8 ; Geramifar P9 ; Vali R10 ; Mohammadi S11 ; Dash S12 ; Malasani V12 Show All Authors
Authors
  1. Dadgar H1
  2. Pashazadeh A2
  3. Norouzbeigi N1
  4. Assadi M3
  5. Albalooshi B4
  6. Baum RP5
  7. Alibraheem A6
  8. Haidar M7
  9. Beheshti M8
  10. Geramifar P9
  11. Vali R10
  12. Mohammadi S11
  13. Dash S12
  14. Malasani V12
  15. Cimini A13
  16. Ricci M14
  17. Esmail AA15
  18. Murad S15
  19. Marafi F16
  20. Treglia G17, 18
  21. Khalaf AN19
  22. Anwar FM19
  23. Usmani S20
  24. Omar Y21
  25. Muhsin H22
  26. Tyurin IE23
  27. Zakhary A23
  28. Alsebaie S24
  29. Cortes DM25
  30. Alhashim M26, 27
  31. Arabi H28
  32. Zaidi H28, 29, 30, 31
Show Affiliations
Authors Affiliations
  1. 1. Cancer Research Center, RAZAVI Hospital, Imam Reza International University, Mashhad, Iran
  2. 2. Department of Nuclear Medicine, Mainz University Hospital, Mainz, Germany
  3. 3. Persian Gulf Nuclear Medicine Research Center, Department of Molecular Imaging and Radionuclide Therapy (MIRT), Bushehr Medical University Hospital, Bushehr University of Medical Sciences, Bushehr, Iran
  4. 4. Dubai Nuclear medicine and Molecular imaging Center- Dubai Academic Health corporation- DAHC, United Arab Emirates
  5. 5. CURANOSTICUM Wiesbaden-Frankfurt, Center for Advanced Radiomolecular Precision Oncology, Wiesbaden, Germany
  6. 6. Department of Nuclear Medicine, King Hussein Cancer Center, Amman, Jordan
  7. 7. Department of Clinical Radiology, American University of Beirut, Beirut, Lebanon
  8. 8. Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine and Endocrinology, University Hospital, Paracelsus Medical University Salzburg, Salzburg, A-5020, Austria
  9. 9. Research Center for Nuclear Medicine, Tehran University of Medical Sciences, Tehran, Iran
  10. 10. Nuclear Medicine department, University of Toronto, Hospital for Sick Children, Toronto, ON, Canada
  11. 11. Hospital and Health Care Professional, Pittsburgh Medical Center, Nuclear Medicine department, Pittsburg, United States
  12. 12. Department of Nuclear Medicine and Molecular Theranostics, Sarvodaya Hospital, Sector 8, Haryana, Faridabad, India
  13. 13. Nuclear Medicine Unit, St. Salvatore Hospital, L'Aquila, 67100, Italy
  14. 14. Nuclear Medicine Unit, Cardarelli Hospital, Campobasso, 86100, Italy
  15. 15. Nuclear Medicine Department, Kuwait Cancer Control Center, Kuwait City, Kuwait
  16. 16. Jaber Alahmad Center of Nuclear Medicine and Molecular Imaging, Kuwait City, Kuwait
  17. 17. Division of Nuclear Medicine, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
  18. 18. Biomedical Sciences, Universita della Svizzera italiana, Lugano, Switzerland
  19. 19. Nuclear Medicine Department, Warith International Cancer Institute, Karbala, Iraq
  20. 20. Department of Nuclear Medicine Sultan Qaboos Comprehensive Cancer Care and Research Center (SQCCCRC), Seeb, Oman
  21. 21. PET-CT department, Misr Radiology Center, Heliopolis, Egypt
  22. 22. Nuclear Medicine department, Amir Al-Momineen Specialty Hospital, Al-Najaf Governorate, Iraq
  23. 23. MOH Russia, Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation, Russian Federation
  24. 24. Ministry of National Gaurds Health Services, Jeddah, Saudi Arabia
  25. 25. Oncologia San Jose, UroTeragLATAM, Mexico
  26. 26. Radiology Department, College of Medicine, Imam Abdulrahman Bin Faisal University, King Faisal Ibn Abd Aziz Rd, Dammam, 34212, Saudi Arabia
  27. 27. Medical Imaging Services Center, King Fahad Specialist Hospital Dammam, Dammam, 32253, Saudi Arabia
  28. 28. Division of Nuclear Medicine and Molecular Imaging, Diagnostic Department, Geneva University Hospital, Geneva, Switzerland
  29. 29. Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
  30. 30. Department of Nuclear Medicine, University of Southern Denmark, Odense, Denmark
  31. 31. University Research and Innovation Center, Obuda University, Budapest, Hungary

Source: Theranostics Published:2025


Abstract

Radioligand therapy (RLT) has garnered significant attention due to the recent emergence of innovative and effective theranostic agents, which showed promising therapeutic and prognostic results in various cancers. Moreover, understanding the interaction between different types of radiation and biological tissues is essential for optimizing therapeutic interventions These concepts directly apply to clinical RLTs and play a crucial role in determining the efficacy and toxicity profile of different radiopharmaceutical agents. Personalized dosimetry is a powerful tool that aids in estimating patient-specific absorbed doses in both tumors and normal organs. Dosimetry in RLT is an area of active investigation, as our current understanding of the relationship between absorbed dose and tissue damage is primarily derived from external-beam radiation therapy. Further research is necessary to comprehensively comprehend this relationship in the context of RLTs. In the present review, we present a thorough examination of the involvement of 177Lu/225Ac radioisotopes in the induction of direct and indirect DNA damage, as well as their influence on the initiation of DNA repair mechanisms in cancer cells of neuroendocrine tumors and metastatic prostate cancer. Current data indicate that high-energy α-emitter radioisotopes can directly impact DNA structure by causing ionization, leading to the formation of ionized atoms or molecules. This ionization process predominantly leads to the formation of irreparable and intricate double-strand breaks (DSBs). On the other hand, the majority of DNA damage caused by β-emitter radioisotopes is indirect, as it involves the production of free radicals and subsequent chemical reactions. Beta particles themselves can also physically interact with the DNA molecule, resulting in single-strand breaks (SSBs) and potentially reversible DSBs. © The author(s).
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