CURRENT APPROACHES TO TARGETED THERAPY: LUTETIUM-177 LABELED RADIOPHARMACEUTICALS

Abstract

Objective: In recent years, thanks to advances in targeted radionuclide therapy, significant advances have been made in the early diagnosis and treatment of diseases. With the emergence of the concept of "theranostic", which combines diagnosis and treatment methods, Lutetium-177 (Lu-177) has gained an important place in targeted therapy and has become a leading compound in this field. In this review, it is aimed to explain the basic information about radiopharmaceuticals, targeted therapy, theranostics and Lu-177, to present 177Lu-labeled molecular carriers and 177Lu-labeled radiopharmaceuticals and to review the studies on these subjects.

Result and Discussion: 177Lu is a theranostic agent with a half-life of 6.7 days, which can be used in diagnosis and treatment in nuclear medicine thanks to its γ and β rays. Its high specific activity and easy access to these activity levels as well as its relatively long half-life can be considered as the main factors of interest in the clinical use of this radionuclide. The clinical utility of 177Lu, a preferred radioisotope for targeted radionuclide therapy, in the treatment of neuroendocrine tumors, prostate cancer, non-Hodgkin lymphoma, adenocarcinoma, and liver cancer, and in alleviating bone pain, was investigated, and as a result, 177Lu was found to show great potential in cancer and pain therapy. With these areas of use, we believe that Lu-177 will have an important place in the field of nuclear medicine in the future.

Keywords

• Lutetium-177
• radionuclide
• radiopharmaceutical
• theranostic

HEDEFE YÖNELİK TEDAVİDE GÜNCEL YAKLAŞIMLAR: LUTESYUM-177 İLE İŞARETLİ RADYOFARMASÖTİKLER

Abstract

Amaç: Son yıllarda, hedefe yönelik radyonüklid tedavisindeki ilerlemeler sayesinde hastalıkların erken teşhis ve tedavisinde önemli gelişmeler kaydedilmiştir. Tanı ve tedavi yöntemlerini birleştiren “teranostik” kavramının doğmasıyla Lutesyum-177 (Lu-177), hedefe yönelik tedavide önemli bir yer edinmiş ve bu alanda öncü bir bileşik haline gelmiştir. Bu derlemede, radyofarmasötikler, hedefe yönelik tedavi, teranostikler ve Lu-177 ile ilgili temel bilgilerin anlatılması, 177Lu ile işaretli moleküler taşıyıcılar ile 177Lu’dan hareketle hazırlanan radyofarmasötiklerin sunulması ve bu konularda yapılmış olan çalışmaların gözden geçirilmesi amaçlanmıştır.

Sonuç ve Tartışma: 177Lu, yaydığı γ ve β ışınları sayesinde nükleer tıpta tanı ve tedavide kullanılabilen, 6,7 günlük yarı ömre sahip teranostik bir ajandır. Yüksek spesifik aktivitesi ve bu aktivite seviyelerine kolay erişimi ile nispeten uzun yarı ömrü, bu radyonüklidin klinik kullanımına olan ilginin ana faktörleri olarak değerlendirilebilir. Hedeflendirilmiş radyonüklid tedavisi için tercih edilen bir radyoizotop olan 177Lu’nun klinikte nöroendokrin tümörlerin, prostat kanserinin, non-Hodgkin lenfomanın, adenokarsinomun ve karaciğer kanserinin tedavisinde ve kemik ağrısını hafifletmede kullanılabilirliği araştırılmış ve sonuç olarak 177Lu’nun kanser ve ağrı tedavisinde çok büyük bir potansiyel gösterdiği bulunmuştur. Bu kullanım alanları ile Lu-177’nin, gelecekte nükleer tıp alanında önemli bir yer edineceği kanaatindeyiz.

Keywords

• Lutesyum-177
• radyonüklid
• radyofarmasötik
• teranostik

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