Marshalling the potential of Auger electron radiopharmaceutical therapy

Julie Bolcaen, Mohammed Gizawy, Samantha Terry, Antonio Paulo, Bart Cornelissen, Aruna Korde, Jonathan Engle, Valery Radchenko*, Roger Howell

*Corresponding author for this work

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Auger electron radiopharmaceutical therapy (AE-RPT) may have the same therapeutic efficacy as alpha particles for oncological small disease, with lower risks of normal tissue toxicity. The seeds of using AE-emitters for RPT were planted several decades ago. Much knowledge has been gathered about the potency of the biological effects caused by the intense shower of these low-energy AEs. Given their low range, AEs deposit much of their energy in the immediate vicinity of their site of decay. However, the promise of AE-RPT has not yet been realized, with few agents evaluated in clinical trials and none becoming part of routine treatment so far. Instigated by the 2022 Technical Meeting on “Auger Electron-Emitters for Radiopharmaceutical Developments” at the International Atomic Energy Agency (IAEA), this review presents the current status of AE-RPT based on the discussions by experts in the field. A scoring system was applied to illustrate hurdles in the development of AE-RPT, and we present a selected list of well-studied and emerging AE-emitting radionuclides. Based on the number of AEs and other emissions, physical half-life, radionuclide production, radiochemical approaches, dosimetry and vector availability, recommendations are put forward to enhance and impact future efforts in AE-RPT research.
Original languageEnglish
JournalJournal of Nuclear Medicine
Publication statusAccepted/In press - 5 Jul 2023


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