Radiobiology of targeted radionuclide therapy

With several specialities approved by EMA in the last years, targeted radionuclide therapy (TRT) is undergoing a strong development and treat more and more patients. Compared to previously approved radiopharmaceuticals (e.g. Zevalin (TM)), treatments are now fractionated (several injections) and spread over several months. The absorbed dose and absorbed dose rate, the genetic and/or epigenetic characteristics of the tumours, but also the intercellular communications such as those involving the immune system, are becoming the key parameters to be considered in order to improve the effectiveness of the treatment while protecting healthy tissue. Radiobiology, using both preclinical models and a growing number of available clinical data, should provide rational insight into both the efficacy and toxicity of this continuous low dose rate radiotherapy form for better patient management. (C) 2023 Elsevier Masson SAS. All rights reserved.