Bogdanović Bojana, Montemagno Christopher
Grenoble Alpes University, INSERM, LRB, 38000 Grenoble, France.
Département de Biologie Médicale, Centre Scientifique de Monaco, 98000 Monaco City, Monaco.
Cancers (Basel). 2025 Jun 7;17(12):1905. doi: 10.3390/cancers17121905.
Pediatric central nervous system (CNS) tumors, including gliomas, medulloblastomas, and diffuse midline gliomas (previously diffuse intrinsic pontine gliomas), remain a major clinical challenge due to their complex biology, limited treatment effectiveness, and generally poor prognosis. Standard treatments are often aggressive and associated with substantial toxicity, particularly in advanced stages. This review highlights recent developments in radiopharmaceuticals for molecular imaging and targeted radiotherapy. A comprehensive literature analysis was conducted, focusing on radiotracers with clinical relevance in pediatric neuro-oncology, including metabolic, peptide receptor-based, and antibody-based agents. Radiopharmaceuticals such as F-FLT, CuCl, and 1-L-18F-FETrp have improved the ability to monitor tumor biology, proliferation, and treatment response, aiding in diagnosis at an early stage, assessment of tumor behavior, and detection of recurrence or progression. Additionally, peptide receptor-based radiotracers, such as Ga-DOTATATE and Lu-DOTATATE, are already used for both diagnostic purposes and targeted radiotherapy, particularly in neuroblastomas and gliomas. Antibody-based radiotracers like I-omburtamab, targeting B7-H3, are emerging as promising tools for addressing difficult-to-treat tumors such as diffuse midline glioma. Collectively, these advances provide new hope for children afflicted by these devastating malignancies, offering promising solutions for more specific and precise diagnosis and, additionally, for more effective, personalized, and less toxic tumor therapies.
小儿中枢神经系统（CNS）肿瘤，包括神经胶质瘤、髓母细胞瘤和弥漫性中线胶质瘤（以前称为弥漫性脑桥内胶质瘤），由于其生物学特性复杂、治疗效果有限且总体预后较差，仍然是一项重大的临床挑战。标准治疗通常具有侵袭性，且伴有严重毒性，尤其是在晚期。本综述重点介绍了用于分子成像和靶向放疗的放射性药物的最新进展。进行了全面的文献分析，重点关注在小儿神经肿瘤学中具有临床相关性的放射性示踪剂，包括代谢类、基于肽受体的和基于抗体的药物。诸如F-FLT、CuCl和1-L-18F-FETrp等放射性药物提高了监测肿瘤生物学、增殖和治疗反应的能力，有助于早期诊断、评估肿瘤行为以及检测复发或进展。此外，基于肽受体的放射性示踪剂，如Ga-DOTATATE和Lu-DOTATATE，已用于诊断目的和靶向放疗，特别是在神经母细胞瘤和神经胶质瘤中。基于抗体的放射性示踪剂，如靶向B7-H3的I-omburtamab，正成为治疗诸如弥漫性中线胶质瘤等难治性肿瘤的有前景的工具。总体而言，这些进展为受这些毁灭性恶性肿瘤折磨的儿童带来了新希望，为更特异、精确的诊断以及更有效、个性化且毒性更小的肿瘤治疗提供了有前景的解决方案。
