Targeted Radionuclide Therapy: A Precision Tool for Cancer Therapy Home A-Z Health Information Health Library A-Z Targeted Radionuclide Therapy: A Precision Tool For Cance... Overview Radiation has been a powerful tool for treating cancer for many decades. There have been challenges in delivering radiation specifically to tumour cells while not damaging surrounding normal tissues. Targeted Radionuclide Therapy (TRT) circumvents this problem. How Targeted Radionuclide Therapy works? TRT leverages the unique overexpression of specific receptors or biomolecules on cancer cells. First, imaging techniques like PET-CT identify these target molecules. Then, radioactive particles (Beta or Alpha particles) are tagged to specific conjugates that bind directly to the cancer cell targets.Once injected, these radionuclides are homed rapidly onto the target cancer cells, remaining for the next few days to deliver targeted radiation to the tumour, over micro-metre to millimetre range. This focused radiation impacts cancer cells precisely, sparing nearby healthy tissues. Targeted Radionuclide Therapy vs. Conventional Radiotherapy Conventional Radiotherapy (RT): Delivered via specialised machines, conventional RT provides high radiation doses over multiple sessions and is a standard of care for initial treatment of a variety of tumour masses, including Head and Neck cancers, Breast, Lung, and Genitourinary malignancies. These deliver high radiation over days for quick and effective cure of cancers.Targeted Radiation Therapy (TRT): Beneficial for tumours that have metastasised to multiple places in the body or those not responsive to chemotherapy or standard systemic therapies.This method offers molecular-level precision targeting, reducing radiation exposure to surrounding healthy tissue. Unlike conventional RT, which treats specific areas, TRT allows for the treatment of cancer cells throughout the body with a single dose, offering a superior safety profile. Which tumours can be treated with TRT? TRT has long been used for treating thyroid cancer (I-131 Therapy) and is an established standard of care after surgery and in metastatic situations. It was also used for neuroblastomas, phaeochromocytomas, and other cancers with I-131mIBG therapy. Recent developments in molecular targeting and radioconjugates have expanded TRT’s reach, notably inMetastatic prostate cancer: treated with Lu177 PSMA or Actinium 225 PSMA. Neuroendocrine tumours: addressed with PRRT (Peptide Receptor Radionuclide Therapy) using Lu177 or Ac225 DOTATATE.Emerging therapies: Newer ligands like FAPI are paving the way for TRT applications across an even wider range of cancers.