Sharma Dheeraj, Srivastava Shriyansh, Kagithala Naga Rani, Rahate Kalpana Pravin, Sridhar Sathvik Belagodu
Department of Pharmacy, School of Medical and Allied Sciences, Galgotias University, Greater Noida, 203201, India.
RAK College of Pharmacy, RAK Medical & Health Sciences University, Ras Al Khaimah, UAE.
Med Oncol. 2025 Jul 11;42(8):322. doi: 10.1007/s12032-025-02825-y.
Radiotheranostics merges diagnostic imaging and targeted radionuclide therapy to allow treatment of breast cancer to be tailored individually. It employs radiopharmaceuticals and molecular imaging modalities such as PET and SPECT for accurate characterization and treatment of the tumor. The review presents the mechanisms, clinical uses, and future potential of radiotheranostics in breast cancer. The review focuses on the potential of nuclear medicine in driving personalized treatment through biomarker-guided strategies. We discussed recent literature on well-established biomarkers like HER2, ER, and PR as well as novel targets like TROP-2. Theranostic agents like ^177Lu-DOTA-trastuzumab and novel innovations with alpha-emitters as well as dual-targeting nanoparticles are noted. Radiotheranostic agents have enhanced results, most importantly, in HER2-positive patients with metastatic or advanced breast cancer. Therapeutic promise also is brought by recent advances to hard-to-treat subtypes, such as triple-negative breast cancer. While radiotheranostics holds great promise, its wider use in the clinic is hampered by factors like heterogeneity of biomarkers, dosimetry accuracy, and regulatory limitations. Research continues to affirm its revolutionary role in the administration of tailor-made treatment regimens to breast cancer.
放射治疗诊断学将诊断成像与靶向放射性核素治疗相结合，使乳腺癌治疗能够实现个体化定制。它采用放射性药物以及正电子发射断层显像（PET）和单光子发射计算机断层显像（SPECT）等分子成像方式，对肿瘤进行精确表征和治疗。这篇综述介绍了放射治疗诊断学在乳腺癌中的作用机制、临床应用及未来潜力。该综述重点关注核医学通过生物标志物引导策略推动个性化治疗的潜力。我们讨论了有关已确立的生物标志物如人表皮生长因子受体2（HER2）、雌激素受体（ER）和孕激素受体（PR）以及新型靶点如滋养层细胞表面抗原2（TROP - 2）的近期文献。还提到了诸如177镥 - 多胺多羧基大环配体 - 曲妥珠单抗等治疗诊断剂以及α发射体和双靶向纳米颗粒的新进展。放射治疗诊断剂在HER2阳性的转移性或晚期乳腺癌患者中取得了更好的效果。近期针对三阴性乳腺癌等难以治疗的亚型所取得的进展也带来了治疗希望。尽管放射治疗诊断学前景广阔，但生物标志物的异质性、剂量测定准确性和监管限制等因素阻碍了其在临床中的更广泛应用。研究仍在不断证实其在为乳腺癌患者制定量身定制治疗方案方面的革命性作用。
