State Key Laboratory of Analytical Chemistry for Life Science, School of Chemistry and Chemical Engineering, Chemistry and Biomedicine Innovation Center (ChemBIC), Nanjing University, Nanjing, 210023, China.
Department of Traditional Chinese Medicine, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, China.
ChemMedChem. 2024 Nov 18;19(22):e202400462. doi: 10.1002/cmdc.202400462. Epub 2024 Sep 12.
In nuclear medicine, theranostic probes that combine nuclear imaging capabilities with therapeutic functions have shown promise for the diagnosis and treatment of cancers. Nevertheless, the development of theranostic probes may be constrained by two principal factors: (1) the discrepancy between the slow accumulation time of the probes in the tumours and the short-lived radionuclides, and (2) the suboptimal imaging/treatment effect and high radioactive toxicity caused by long-lived radionuclides. In recent years, pretargeted strategy has been proposed as a potential solution to solve these problems. In the pretargeted strategy, two components consisting of a tumour-targeting vector (e. g., antibody) and a radionuclide are injected separately, which can then couple in the tumour tissues to trap radionuclides for nuclear imaging and/or therapy. This two-step process allows for the independent optimization of the pharmacokinetics of them in vivo, benefiting to improve nuclear imaging and/or therapy of tumours in vivo. In this concept, we will discuss the principle of the pretargeted strategy, with a focus on the discussion of different tumour-targeting vectors, including antibody-mediated delivery, nanoparticle-mediated delivery, metabolic glycan labeling-mediated accumulation, and enzyme-triggered in situ self-assembly-mediated retention. Finally, we will discuss the current challenges and perspectives on their applications for cancer theranostics in clinics.
在核医学中,将核成像功能与治疗功能相结合的治疗诊断探针在癌症的诊断和治疗方面显示出了前景。然而,治疗诊断探针的发展可能受到两个主要因素的限制:(1)探针在肿瘤中的积累时间缓慢与短寿命放射性核素之间的差异;(2)长寿命放射性核素导致的成像/治疗效果不佳和放射性毒性较高。近年来,提出了靶向前策略作为解决这些问题的一种潜在解决方案。在靶向前策略中,将由肿瘤靶向载体(例如抗体)和放射性核素组成的两种成分分开注射,然后在肿瘤组织中结合以捕获放射性核素来进行核成像和/或治疗。这个两步过程允许对它们在体内的药代动力学进行独立优化,有利于改善体内肿瘤的核成像和/或治疗。在这个概念中,我们将讨论靶向前策略的原理,重点讨论不同的肿瘤靶向载体,包括抗体介导的递药、纳米颗粒介导的递药、代谢糖基化标记介导的积累和酶触发的原位自组装介导的保留。最后,我们将讨论它们在癌症治疗诊断中的临床应用的当前挑战和前景。