Bogdanovic Bojana, Hugonnet Florent, Montemagno Christopher
Laboratory of Bioclinical Radiopharmaceutics, University Grenoble Alpes, INSERM, CHU Grenoble Alpes, 38000 Grenoble, France.
Nuclear Medicine Department, Centre Hospitalier Princesse Grace, 98000 Monaco, Monaco.
Cancers (Basel). 2025 Apr 7;17(7):1247. doi: 10.3390/cancers17071247.
Hematologic malignancies, including leukemia, lymphoma, and multiple myeloma, continue to challenge clinicians with complex treatment regimens that often involve significant side effects and limited success, especially in advanced stages. Recent advancements in nuclear medicine have introduced theranostic strategies that merge diagnostic imaging with targeted therapeutic approaches, offering the potential for more precise and personalized treatment. A key area of progress lies in the development of alpha-emitting radiopharmaceuticals, such as Ac, At, or Pb, which can deliver potent radiation directly to tumor cells, sparing healthy tissue and minimizing collateral damage. In parallel with these therapeutic advancements, molecular imaging using radiolabeled agents enables better disease monitoring, assessment of treatment efficacy, and personalized management of patients with hematologic malignancies. The integration of diagnostic imaging with radiotherapy allows for a more tailored approach, where treatment can be adjusted based on real-time information about tumor progression and response. This review examines the recent strides made in both the development of radiopharmaceuticals and their applications in molecular imaging, with a focus on the potential to improve precision, reduce toxicity, and optimize patient outcomes. The synergy between targeted therapy and molecular imaging represents a transformative shift in the management of hematologic malignancies. As these technologies evolve, they are poised to redefine treatment paradigms, offering new hope for patients and potentially improving survival rates with more effective and less toxic treatment options.
血液系统恶性肿瘤，包括白血病、淋巴瘤和多发性骨髓瘤，仍然以复杂的治疗方案挑战着临床医生，这些方案往往伴随着显著的副作用且成功率有限，尤其是在晚期阶段。核医学的最新进展引入了治疗诊断策略，将诊断成像与靶向治疗方法相结合，为更精确和个性化的治疗提供了潜力。进展的一个关键领域在于发射α粒子的放射性药物的开发，如锕、砹或铅，它们可以将强效辐射直接传递到肿瘤细胞，使健康组织免受影响并将附带损害降至最低。与这些治疗进展并行的是，使用放射性标记剂的分子成像能够更好地监测疾病、评估治疗效果以及对血液系统恶性肿瘤患者进行个性化管理。诊断成像与放射治疗的整合允许采用更具针对性的方法，即可以根据有关肿瘤进展和反应的实时信息调整治疗方案。本文综述了放射性药物开发及其在分子成像中的应用方面的最新进展，重点关注提高精度、降低毒性和优化患者预后的潜力。靶向治疗与分子成像之间的协同作用代表了血液系统恶性肿瘤管理方面的变革性转变。随着这些技术的发展，它们有望重新定义治疗模式，为患者带来新的希望，并有可能通过更有效且毒性更小的治疗方案提高生存率。
