Abstract:
Despite the development of various novel therapies, glioblastoma (GBM) remains a devastating disease, with a median survival of less than 15 months. Recently, targeted radionuclide therapy has shown significant progress in treating solid tumors, with the approval of Lutathera for neuroendocrine tumors and Pluvicto for prostate cancer by the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA). This achievement has shed light on the potential of targeted radionuclide therapy for other solid tumors, including GBM. This review presents the current status of targeted radionuclide therapy in GBM, highlighting the commonly used therapeutic radionuclides emitting alpha, beta particles, and Auger electrons that could induce potent molecular and cellular damage to treat GBM. We then explore a range of targeting vectors, including small molecules, peptides, and antibodies, which selectively target antigen-expressing tumor cells with minimal or no binding to healthy tissues. Considering that radiopharmaceuticals for GBM are often administered locoregionally to bypass the blood-brain barrier (BBB), we review prominent delivery methods such as convection-enhanced delivery, local implantation, and stereotactic injections. Finally, we address the challenges of this therapeutic approach for GBM and propose potential solutions.
摘要:
尽管开发了各种新疗法,胶质母细胞瘤(GBM)仍然是一种毁灭性的疾病,中位生存期少于15个月。最近,靶向放射性核素治疗在治疗实体肿瘤方面取得了重大进展,经美国食品和药物管理局(FDA)和欧洲药品管理局(EMA)批准,Lutathera用于神经内分泌肿瘤,Pluvicto用于前列腺癌。这一成就揭示了靶向放射性核素治疗其他实体瘤的潜力,包括GBM。本文综述了GBM中放射性核素靶向治疗的现状。突出常用的治疗放射性核素发射α,β粒子,和俄歇电子可以诱导有效的分子和细胞损伤来治疗GBM。然后我们探索一系列靶向载体,包括小分子,肽,和抗体,选择性靶向表达抗原的肿瘤细胞,与健康组织的结合最小或不结合。考虑到GBM的放射性药物通常是局部给药以绕过血脑屏障(BBB),我们回顾了突出的交付方法,如对流增强交付,局部植入,和立体定向注射。最后,我们解决了GBM这种治疗方法的挑战,并提出了潜在的解决方案.