Integrating Theranostics Into Patient Care Pathways: <i>AJR</i> Expert Panel Narrative Review

O’Shea, Aileen; Iravani, Amir; Saboury, Babak; Jadvar, Hossein; Catalano, Onofrio A.; Mahmood, Umar; Heidari, Pedram

doi:10.2214/ajr.22.28237

Cited by 4 publications

(4 citation statements)

References 70 publications

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“…It can be anticipated that thyroid irradiation may also occur during targeted treatments (eg, for cancer) that employ radiopharmaceuticals. In case an agent is RAI based, such as 131 I-MIBG for neuroendocrine tumors ( 49 ), thyroid blocking is recommended. In a prospective study of 33 pediatric patients with neuroblastoma who received the first dose of 666 MBq/kg 131 I-MIBG therapy after potassium iodide and levothyroxine pretreatment, mean absorbed dose to the thyroid was 0.16 mGy/MBq of administered activity ( 50 ) as calculated using the OLINDA (Organ Level Internal Dose Assessment) dosimetry software ( 51 ).…”

Section: Radiation Exposure and Risk For Thyroid Cancermentioning

confidence: 99%

Radiation-Related Thyroid Cancer

Saenko

Mitsutake

2023

Endocrine Reviews

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Radiation is an environmental factor that elevates the risk of developing thyroid cancer. Actual and possible scenarios of exposures to external and internal radiation are multiple and diverse. This article reviews radiation doses to the thyroid and corresponding cancer risks due to planned, existing, and emergency exposure situations, and medical, public, and occupational categories of exposures. Any exposure scenario may deliver a range of doses to the thyroid, and the risk for cancer is addressed along with modifying factors. The consequences of the Chornobyl and Fukushima nuclear power plants accidents are described, summarizing the information on thyroid cancer epidemiology, treatment and prognosis, clinicopathological characteristics, and genetic alterations. The Chornobyl thyroid cancers evolve in time: becoming less aggressive and driver shifting from fusions to point mutations. A comparison of thyroid cancers from the two areas reveals numerous differences that cumulatively suggest the low probability of radiogenic nature of thyroid cancers in Fukushima. In view of continuing usage of different sources of radiation in various settings, the possible ways of reducing thyroid cancer risk from exposures are considered. For the external exposures, reasonable measures are generally in line with the “As Low As Reasonably Achievable” (ALARA) principle, while for the internal irradiation from radioiodine, thyroid blocking with stable iodine may be recommended in addition to other measures in case of anticipated exposures from a nuclear reactor accident. Finally, the perspectives of studies of radiation effects on the thyroid are discussed from the epidemiological, basic science, and clinical points of view.

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Section: Radiation Exposure and Risk For Thyroid Cancermentioning

confidence: 99%

Radiation-Related Thyroid Cancer

Saenko

Mitsutake

2023

Endocrine Reviews

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“…Octavia et al showed the presence of nuclear foci in the peripheral blood lymphocytes of patients with thyroid cancer as long as 24 months after treatment with 131 I [128]. The effect of 177 Lu, the most commonly used β-emitter, on inducing cell death mechanisms has been extensively investigated [129][130][131][132][133]. 177 Lu-octreotate increases the activation of poly(ADP-ribose) polymerase-1 (PARP1), a DNA repair enzyme, after internalization in SSTR2-expressing and SSTR5 neuroendocrine tumor cells [131].…”

Section: Radioisotopes Emitting Low-let Particles Beta Particle Emittersmentioning

confidence: 99%

DNA Damage by Radiopharmaceuticals and Mechanisms of Cellular Repair

Khazaei Monfared,

Heidari,

Klempner

et al. 2023

Pharmaceutics

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DNA is an organic molecule that is highly vulnerable to chemical alterations and breaks caused by both internal and external factors. Cells possess complex and advanced mechanisms, including DNA repair, damage tolerance, cell cycle checkpoints, and cell death pathways, which together minimize the potentially harmful effects of DNA damage. However, in cancer cells, the normal DNA damage tolerance and response processes are disrupted or deregulated. This results in increased mutagenesis and genomic instability within the cancer cells, a known driver of cancer progression and therapeutic resistance. On the other hand, the inherent instability of the genome in rapidly dividing cancer cells can be exploited as a tool to kill by imposing DNA damage with radiopharmaceuticals. As the field of targeted radiopharmaceutical therapy (RPT) is rapidly growing in oncology, it is crucial to have a deep understanding of the impact of systemic radiation delivery by radiopharmaceuticals on the DNA of tumors and healthy tissues. The distribution and activation of DNA damage and repair pathways caused by RPT can be different based on the characteristics of the radioisotope and molecular target. Here we provide a comprehensive discussion of the biological effects of RPTs, with the main focus on the role of varying radioisotopes in inducing direct and indirect DNA damage and activating DNA repair pathways.

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“…The combination of therapeutic and diagnostic functionalities into a single agent allows for monitoring and evaluation of drug delivery and effectiveness, can offer insight into the mechanisms of drug treatments, and has applications in management of patient care. [1][2][3] This "theranostic" approach is a field of great interest in recent years due to these advantages and applications. [1,2,4] One approach to developing theranostics is the formation of "d-f hybrids".…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3] This "theranostic" approach is a field of great interest in recent years due to these advantages and applications. [1,2,4] One approach to developing theranostics is the formation of "d-f hybrids". These systems combine metals from the dblock and f-block to exploit their unique properties.…”

Section: Introductionmentioning

confidence: 99%

Pt(II)‐Phenanthroline‐Ln(III)‐DOTA d–f Hybrids as Small‐Molecule Theranostics

Brito,

Price,

Bañobre‐López

et al. 2024

Eur J Inorg Chem

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1,10‐Phenanthroline d‐ or f‐metal complexes can be utilised in biomedical applications such as imaging or therapeutics. Herein, we designed bimetallic d‐block metal‐phenanthroline f‐block metal‐1,4,7,10‐tetraazacyclododecane‐1,4,7,1,0‐tetraacetic acid (DOTA) conjugates as theranostic agents to simultaneously achieve both of these applications. Luminescence studies show the 1,10‐phenanthroline‐Eu(III)‐DOTA complexes displayed an off/on/off pH‐dependent switch, demonstrating their potential as pH‐responsive lanthanide luminescence probes. Relaxometry studies showed that the 1,10‐phenanthroline‐Gd(III)‐DOTA complexes present a r1 of 5.15 ± 0.05 mM‐1 s‐1 and could thus be used as magnetic resonance (MR) contrast agents. Complexation of Pt(II) by the 1,10‐phenanthroline moiety resulted in quenching of the Eu(III) luminescence, but an enhancement of the Gd(III) relaxivity (r1 = 7.53 ± 0.69 mM‐1 s‐1). Cell viability studies of the d‐f hybrids in a cancer cell line showed the potential of these complexes as anticancer agents, as the IC50 for the Pt(II)/Gd(III) complex (IC50 = 24.9 μM) was lower than that of cisplatin (IC50 = 31.6 μM). As such, Pt(II)‐1,10‐phenanthroline‐Gd(III)‐DOTA complexes are promising theranostic agents for cancer therapy.

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Integrating Theranostics Into Patient Care Pathways: AJR Expert Panel Narrative Review

Cited by 4 publications

References 70 publications

Radiation-Related Thyroid Cancer

Radiation-Related Thyroid Cancer

DNA Damage by Radiopharmaceuticals and Mechanisms of Cellular Repair

Pt(II)‐Phenanthroline‐Ln(III)‐DOTA d–f Hybrids as Small‐Molecule Theranostics

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