Nuclear medicine is expected to make
major advances in cancer diagnosis
and therapy; tumor-targeted radiopharmaceuticals preferentially eradicate
tumors while causing minimal damage to healthy tissues. The current
scope of nuclear medicine can be significantly expanded by integration
with nanomedicine, which utilizes nanoparticles for cancer diagnosis
and therapy by capitalizing on the increased surface area-to-volume
ratio, the passive/active targeting ability and high loading capacity,
the greater interaction cross section with biological tissues, the
rich surface properties of nanomaterials, the facile decoration of
nanomaterials with a plethora of functionalities, and the potential
for multiplexing several functionalities within one construct. This
review provides a comprehensive discussion of nuclear nanomedicine
using tumor-targeted nanoparticles for cancer radiation therapy with
either pre-embedded radionuclides or nonradioactive materials which
can be extrinsically triggered using various external nuclear particle
sources to produce in situ radioactivity. In addition,
it describes the prospect of combining nuclear nanomedicine with other
modalities to enable synergistically enhanced combination therapies.
The review also discusses advances in the fabrication of radionuclides
as well as describes laser ablation technologies for producing nanoradiopharmaceuticals,
which combine the ease of production with exceptional purity and rapid
biodegradability, along with additional imaging or therapeutic functionalities.
From a practical standpoint, these attributes of nanoradiopharmaceuticals
may provide distinct advantages in diagnostic/therapeutic sensitivity
and specificity, imaging resolution, and scalability of turnkey platforms.
Coupling image-guided targeted radiation therapy with the possibility
of in situ activation of nanomaterials as well as
combining with other therapeutic modalities using a multifunctional
nanoplatform could herald an era of exciting technological and therapeutic
advances to radically transform the landscape of nuclear medicine.
The review concludes with a discussion of current challenges and presents
the authors’ views on future opportunities to stimulate further
research in this rewarding field of high societal impact.