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Status of radiobiology in molecular radionuclide therapy – hope for the future

Research output: Contribution to journalEditorial

Julie Nonnekens, Jean-Pierre Pouget, Bart Cornelissen, Samantha Terry

Original languageEnglish
JournalNuclear Medicine and Biology
Accepted/In press14 Apr 2022


  • 220412 Editorial

    220412_Editorial.docx, 45.8 KB, application/vnd.openxmlformats-officedocument.wordprocessingml.document

    Uploaded date:14 Apr 2022

    Version:Accepted author manuscript

    Licence:CC BY

King's Authors


Radiobiological understanding has been crucial to the success of external beam radiation (EBRT) in the clinic, with EBRT being used as part of the treatment regime for almost 50% of all cancer patients [1]. Unlike EBRT, molecular radionuclide therapy (MRT) has the ability and promise to treat disseminated cancer, with excellent examples in the clinic such as [223Ra]RaCl2 [2], [177Lu]Lu-DOTATATE [3], [177Lu]Lu-PSMA [4] and [225Ac]Ac-PSMA for treatment of different metastasised cancer types [5]. Equally, the flexibility of targeting pharmaceuticals being radiolabelled with different radionuclides emitting alpha, beta or Auger electron-emitters enables the treatment of tumours ranging from single circulating tumour cells or micrometastases to larger tumours [6, 7]. With more and more MRT modalities being developed and increasing efforts in radiobiological research in this field, now is an increasingly important time in MRT research.
In this special issue, we are excited to showcase the diversity of radiobiological studies being carried out in molecular radionuclide therapies. Topics in radiobiology are covered as either a research paper, commentary, or review. They are mostly biological in nature to highlight the variety of studies that can be carried out to link with dosimetry measurements [8].
The research papers cover studies in cytogenetics after radium-223 treatment [9], the role of antioxidants in the radiosensitivity to [177Lu]Lu-DOTATATE [10], relating the biological effects of radionuclides such as Auger electron-emitters gallium-67 and indium-111 to that of EBRT [11] and determining the DNA damaging capacity of Auger electron-emitter thallium-201 [12]. The future of Auger electron-emitting radiopharmaceuticals was also discussed in a commentaries [13]. Finally, reviews covered studies using gold nanoparticles [14], drug and MRT combination therapies [15, 16], subcellular localisation methodologies for radionuclides [17], biomarkers of therapy response[18], healthy tissue toxicity [19, 20], and extranuclear targets, bystander and systemic responses [21].
This issue has been an excellent follow-up to our calls to arm highlighting the urgency for radiobiological research in MRT [22] and to our symposium that will be held every two years (notes of first symposium were published [23]). We have great hope that this will further stimulate the creation of new discussions, research, networks, and collaborations.

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