{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T12:12:50Z","timestamp":1788783170052,"version":"build-2803163510"},"reference-count":120,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:p>\n                    Lutetium-177 (\n                    <jats:sup>177<\/jats:sup>\n                    Lu)\u2013based Radioligand Therapy (RLT) has emerged as an important modality in precision oncology, with demonstrated clinical benefit in selected malignancies. Its clinical relevance is underscored by regulatory approvals of Lutathera\u00ae for neuroendocrine tumours and Pluvicto\u00ae for metastatic castration-resistant prostate cancer. However, despite these advances, the field faces significant challenges that limit broader clinical translation and optimisation. In this review, we provide a critical and balanced evaluation of the current\n                    <jats:sup>177<\/jats:sup>\n                    Lu RLT landscape, integrating evidence from clinical trials, emerging targets, and translational studies. We highlight that much of the existing evidence is derived from small, non-randomised studies with inherent risk of bias, limiting the strength of clinical conclusions. Key challenges include the lack of standardised and clinically actionable dosimetry, insufficient predictive biomarkers beyond target expression, vulnerability of isotope supply chains, and the development of drug-evasive traits in malignant cells. In addition, heterogeneity in trial design and limited long-term safety data further constrain clinical implementation. We propose a strategic roadmap to advance\n                    <jats:sup>177<\/jats:sup>\n                    Lu RLT toward a more rigorous, reproducible, and equitable precision oncology framework, emphasising the transition from empiric application to evidence-based personalisation.\n                  <\/jats:p>","DOI":"10.3389\/fphar.2026.1907065","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T11:50:36Z","timestamp":1788781836000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Lutetium-177 radiopharmaceuticals in cancer care: progress and challenges"],"prefix":"10.3389","volume":"17","author":[{"given":"Weirong","family":"Shi","sequence":"first","affiliation":[{"name":"Health Science Center, Yangtze University","place":["Jingzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Limin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Jingzhou Hospital of Traditional Chinese Medicine","place":["Jingzhou, China"]},{"name":"The Third Clinical Medical College of Yangtze University","place":["Jingzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyue","family":"Feng","sequence":"additional","affiliation":[{"name":"Health Science Center, Yangtze University","place":["Jingzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiayu","family":"Liu","sequence":"additional","affiliation":[{"name":"Health Science Center, Yangtze University","place":["Jingzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinru","family":"Li","sequence":"additional","affiliation":[{"name":"Health Science Center, Yangtze University","place":["Jingzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueming","family":"Dong","sequence":"additional","affiliation":[{"name":"School of Biological Sciences, Nanyang Technological University","place":["Singapore, Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Li-Ann Wong","sequence":"additional","affiliation":[{"name":"Cancer Science Institute of Singapore, National University of Singapore","place":["Singapore, Singapore"]},{"name":"Yong Loo Lin School of Medicine, NUS Center for Cancer Research (N2CR), National University of Singapore","place":["Singapore, Singapore"]},{"name":"Department of Haematology-Oncology, National University Cancer Institute","place":["Singapore, Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoguang","family":"Chen","sequence":"additional","affiliation":[{"name":"Health Science Center, Yangtze University","place":["Jingzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingzhi","family":"Wang","sequence":"additional","affiliation":[{"name":"Cancer Science Institute of Singapore, National University of Singapore","place":["Singapore, Singapore"]},{"name":"Yong Loo Lin School of Medicine, NUS Center for Cancer Research (N2CR), National University of Singapore","place":["Singapore, Singapore"]},{"name":"Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore","place":["Singapore, Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boon-Cher","family":"Goh","sequence":"additional","affiliation":[{"name":"Cancer Science Institute of Singapore, National University of Singapore","place":["Singapore, Singapore"]},{"name":"Yong Loo Lin School of Medicine, NUS Center for Cancer Research (N2CR), National University of Singapore","place":["Singapore, Singapore"]},{"name":"Department of Haematology-Oncology, National University Cancer Institute","place":["Singapore, Singapore"]},{"name":"Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore","place":["Singapore, Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"78","DOI":"10.2174\/18744710113069990017","article-title":"Comparing high LET 227Th- and low LET 177Lu-trastuzumab in mice with HER-2 positive SKBR-3 xenografts","volume":"6","author":"Abbas","year":"2013","journal-title":"Curr. Radiopharm."},{"key":"B2","doi-asserted-by":"publisher","first-page":"352","DOI":"10.2967\/jnumed.125.271268","article-title":"Nuclear medicine and external beam radiation therapy in prostate cancer: a synergistic approach","volume":"67","author":"Abdel-Wahab","year":"2026","journal-title":"J. Nucl. Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"255","DOI":"10.3322\/caac.21768","article-title":"Radiotheranostics in oncology: making precision medicine possible","volume":"73","author":"Aboagye","year":"2023","journal-title":"CA Cancer J. Clin."},{"key":"B4","doi-asserted-by":"publisher","first-page":"973820","DOI":"10.1155\/2012\/973820","article-title":"Prostate-specific membrane antigen-based therapeutics","volume":"2012","author":"Akhtar","year":"2012","journal-title":"Adv. Urol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/j.cbpa.2021.04.006","article-title":"Ligand engineering for theranostic applications","volume":"63","author":"Altmann","year":"2021","journal-title":"Curr. Opin. Chem. Biol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1371","DOI":"10.1007\/s00259-020-05094-1","article-title":"HER2-directed antibodies, affibodies and nanobodies as drug-delivery vehicles in breast cancer with a specific focus on radioimmunotherapy and radioimmunoimaging","volume":"48","author":"Altunay","year":"2021","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1522","DOI":"10.2967\/jnumed.125.270317","article-title":"Combining PSMA-targeted radiopharmaceutical therapy with immunotherapy","volume":"66","author":"Altunay","year":"2025","journal-title":"J. Nucl. Med."},{"key":"B8","doi-asserted-by":"publisher","first-page":"374","DOI":"10.1259\/0007-1285-33-390-374","article-title":"The treatment of myelomatosis with lutecium 177","volume":"33","author":"Anderson","year":"1960","journal-title":"Br. J. Radiol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1363","DOI":"10.1007\/s11912-023-01458-6","article-title":"Towards improving the efficacy of PSMA-targeting radionuclide therapy for late-stage prostate cancer-combination strategies","volume":"25","author":"Arbuznikova","year":"2023","journal-title":"Curr. Oncol. Rep."},{"key":"B10","doi-asserted-by":"publisher","first-page":"2560","DOI":"10.7150\/thno.93249","article-title":"Exploring the role of combined external beam radiotherapy and targeted radioligand therapy with [177Lu]Lu-PSMA-617 for prostate cancer - from bench to bedside","volume":"14","author":"Arbuznikova","year":"2024","journal-title":"Theranostics"},{"key":"B11","doi-asserted-by":"publisher","first-page":"111195","DOI":"10.1016\/j.radonc.2025.111195","article-title":"A preliminary study on the safety and efficacy of 177Lu-FAP-2286 in gastrointestinal tumours with positive FAP expression","volume":"213","author":"Bai","year":"2025","journal-title":"Radiother. Oncol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"1407","DOI":"10.1007\/s00259-009-1115-z","article-title":"Peptide receptor radionuclide therapy with (90)Y-DOTATOC in recurrent meningioma","volume":"36","author":"Bartolomei","year":"2009","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"B13","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1038\/s41416-019-0642-z","article-title":"Carbonic anhydrase IX and acid transport in cancer","volume":"122","author":"Becker","year":"2020","journal-title":"Br. J. Cancer"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1636","DOI":"10.2967\/jnumed.122.264373","article-title":"Combined targeted radiopharmaceutical therapy and immune checkpoint blockade: from preclinical advances to the clinic","volume":"63","author":"Bellavia","year":"2022","journal-title":"J. Nucl. Med."},{"key":"B15","doi-asserted-by":"publisher","first-page":"914","DOI":"10.2967\/jnumed.114.147413","article-title":"Preclinical evaluation of a tailor-made DOTA-conjugated PSMA inhibitor with optimized linker moiety for imaging and endoradiotherapy of prostate cancer","volume":"56","author":"Bene\u0161ov\u00e1","year":"2015","journal-title":"J. Nucl. Med."},{"key":"B16","doi-asserted-by":"publisher","first-page":"15172","DOI":"10.1073\/pnas.1918744117","article-title":"Genetic signature of prostate cancer mouse models resistant to optimized hK2 targeted \u03b1-particle therapy","volume":"117","author":"Bicak","year":"2020","journal-title":"Proc. Natl. Acad. Sci. U. S. A."},{"key":"B17","doi-asserted-by":"publisher","first-page":"907","DOI":"10.2967\/jnumed.117.205161","article-title":"Somatostatin receptor imaging of neuroendocrine tumors: from agonists to antagonists","volume":"59","author":"Bodei","year":"2018","journal-title":"J. Nucl. Med."},{"key":"B18","doi-asserted-by":"publisher","first-page":"800","DOI":"10.1007\/s00259-012-2330-6","article-title":"The joint IAEA, EANM, and SNMMI practical guidance on peptide receptor radionuclide therapy (PRRNT) in neuroendocrine tumours","volume":"40","author":"Bodei","year":"2013","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"B19","doi-asserted-by":"publisher","first-page":"534","DOI":"10.1038\/s41571-022-00652-y","article-title":"Radiotheranostics in oncology: current challenges and emerging opportunities","volume":"19","author":"Bodei","year":"2022","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"7911","DOI":"10.7150\/thno.56639","article-title":"A perspective on the radiopharmaceutical requirements for imaging and therapy of glioblastoma","volume":"11","author":"Bolcaen","year":"2021","journal-title":"Theranostics"},{"key":"B21","doi-asserted-by":"publisher","first-page":"17","DOI":"10.3978\/j.issn.2304-3865.2014.05.05","article-title":"Functional and molecular imaging in cancer drug development","volume":"3","author":"Bollineni","year":"2014","journal-title":"Chin. Clin. Oncol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"1500","DOI":"10.2967\/jnumed.117.190801","article-title":"An overview of PET radiochemistry, part 2: radiometals","volume":"59","author":"Brandt","year":"2018","journal-title":"J. Nucl. Med."},{"key":"B23","doi-asserted-by":"publisher","first-page":"229","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J. Clin."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1611","DOI":"10.7150\/thno.15132","article-title":"Comparison between three promising \u00df-emitting radionuclides, (67)Cu, (47)Sc and (161)Tb, with emphasis on doses delivered to minimal residual disease","volume":"6","author":"Champion","year":"2016","journal-title":"Theranostics"},{"key":"B25","doi-asserted-by":"publisher","first-page":"5106","DOI":"10.7150\/thno.26585","article-title":"Theranostic pretargeted radioimmunotherapy of internalizing solid tumor antigens in human tumor xenografts in mice: curative treatment of HER2-positive breast carcinoma","volume":"8","author":"Cheal","year":"2018","journal-title":"Theranostics"},{"key":"B26","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1001\/jamaoncol.2022.7826","article-title":"Estimates and projections of the global economic cost of 29 cancers in 204 countries and territories from 2020 to 2050","volume":"9","author":"Chen","year":"2023","journal-title":"JAMA Oncol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1016\/j.nucmedbio.2021.03.010","article-title":"Methods and techniques for in vitro subcellular localization of radiopharmaceuticals and radionuclides","author":"Costa","year":"2021","journal-title":"Nucl. Med. Biol."},{"key":"B28","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1016\/j.jconrel.2021.03.006","article-title":"Bioevaluation of glucose-modified liposomes as a potential drug delivery system for cancer treatment using 177-Lu radiotracking","volume":"332","author":"Cvjetinovi\u0107","year":"2021","journal-title":"J. Control Release"},{"key":"B29","doi-asserted-by":"publisher","first-page":"94","DOI":"10.2174\/1874471008666150313114644","article-title":"Theranostic applications of Lutetium-177 in radionuclide therapy","volume":"9","author":"Das","year":"2016","journal-title":"Curr. Radiopharm."},{"key":"B30","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1016\/s2468-1253(24)00267-x","article-title":"Emerging evidence-based role for external-beam radiation therapy in hepatocellular carcinoma","volume":"10","author":"Dudzinski","year":"2025","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"B31","doi-asserted-by":"publisher","first-page":"688","DOI":"10.1021\/bc200279b","article-title":"68Ga-complex lipophilicity and the targeting property of a urea-based PSMA inhibitor for PET imaging","volume":"23","author":"Eder","year":"2012","journal-title":"Bioconjug Chem."},{"key":"B32","doi-asserted-by":"publisher","first-page":"2314","DOI":"10.3390\/molecules25102314","article-title":"Methods to enhance the metabolic stability of peptide-based PET radiopharmaceuticals","volume":"25","author":"Evans","year":"2020","journal-title":"Molecules"},{"key":"B33","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1016\/s1470-2045(23)00158-4","article-title":"Health-related quality of life and pain outcomes with [177Lu]Lu-PSMA-617 plus standard of care versus standard of care in patients with metastatic castration-resistant prostate cancer (VISION): a multicentre, open-label, randomised, phase 3 trial","volume":"24","author":"Fizazi","year":"2023","journal-title":"Lancet Oncol."},{"key":"B34","doi-asserted-by":"publisher","first-page":"4740","DOI":"10.1158\/1078-0432.ccr-23-1983","article-title":"Fibroblast activation protein-targeted radioligand therapy with 177Lu-EB-FAPI for metastatic radioiodine-refractory thyroid cancer: first-in-human, dose-escalation study","volume":"29","author":"Fu","year":"2023","journal-title":"Clin. Cancer Res."},{"key":"B35","doi-asserted-by":"publisher","first-page":"1415","DOI":"10.1158\/1078-0432.ccr-24-3918","article-title":"177Lu-LNC1004 radioligand therapy in patients with end-stage metastatic cancers: a single-center, single-Arm, phase II study","volume":"31","author":"Fu","year":"2025","journal-title":"Clin. Cancer Res."},{"key":"B36","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1007\/s12032-025-03061-0","article-title":"Theranostics in nuclear medicine: the era of precision oncology","volume":"42","author":"Gandhi","year":"2025","journal-title":"Med. Oncol."},{"key":"B37","doi-asserted-by":"publisher","first-page":"1218670","DOI":"10.3389\/fchem.2023.1218670","article-title":"Developments in 177Lu-based radiopharmaceutical therapy and dosimetry","volume":"11","author":"George","year":"2023","journal-title":"Front. Chem."},{"key":"B38","doi-asserted-by":"publisher","first-page":"e290","DOI":"10.1097\/rlu.0000000000005817","article-title":"Significant 99mTc-FAPI-46 uptake in 2 cases of TENIS syndrome with negative Tc-OCTREOTIDE scan, a new hope in theranostic applications","volume":"50","author":"Ghahraman","year":"2025","journal-title":"Clin. Nucl. Med."},{"key":"B39","doi-asserted-by":"publisher","first-page":"e414","DOI":"10.1016\/S1470-2045(17)30379-0","article-title":"Targeted radionuclide therapy in combined-modality regimens","volume":"18","author":"Gill","year":"2017","journal-title":"Lancet Oncol."},{"key":"B40","doi-asserted-by":"publisher","first-page":"985","DOI":"10.2967\/jnumed.111.099408","article-title":"A compartmental model for biokinetics and dosimetry of 18F-choline in prostate cancer patients","volume":"53","author":"Giussani","year":"2012","journal-title":"J. Nucl. Med."},{"key":"B41","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1053\/j.semnuclmed.2019.07.006","article-title":"Targeted radionuclide therapy: a historical and personal review","volume":"50","author":"Goldsmith","year":"2020","journal-title":"Semin. Nucl. Med."},{"key":"B42","doi-asserted-by":"publisher","first-page":"146","DOI":"10.2174\/1871520617666170725164530","article-title":"Effect of number of bifunctional chelating agents on the pharmacokinetics and immunoreactivity of 177Lu-labeled rituximab: a systemic study","volume":"18","author":"Guleria","year":"2018","journal-title":"Anticancer Agents Med. Chem."},{"key":"B43","doi-asserted-by":"publisher","first-page":"1292","DOI":"10.3390\/ph15101292","article-title":"[177Lu]Lu-PSMA-617 (Pluvicto(TM)): the first FDA-approved radiotherapeutical for treatment of prostate cancer","volume":"15","author":"Hennrich","year":"2022","journal-title":"Pharm. (Basel)"},{"key":"B44","doi-asserted-by":"publisher","first-page":"e146","DOI":"10.1016\/S1470-2045(19)30821-6","article-title":"Radiotheranostics: a roadmap for future development","volume":"21","author":"Herrmann","year":"2020","journal-title":"Lancet Oncol."},{"key":"B45","doi-asserted-by":"publisher","first-page":"2300","DOI":"10.1007\/s00259-022-05785-x","article-title":"Joint EANM, SNMMI and IAEA enabling guide: how to set up a theranostics centre","volume":"49","author":"Herrmann","year":"2022","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"B46","doi-asserted-by":"publisher","first-page":"4033","DOI":"10.1007\/s00259-025-07245-8","article-title":"PSMA-targeted radioligand therapy with [177Lu]Lu-LNC1011 for metastatic castration-resistant prostate cancer: a pilot study","volume":"52","author":"Hou","year":"2025","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"B47","doi-asserted-by":"publisher","first-page":"1374","DOI":"10.1158\/1078-0432.CCR-06-2436","article-title":"Optimization of radioimmunotherapy of solid tumors: biological impediments and their modulation","volume":"13","author":"Jain","year":"2007","journal-title":"Clin. Cancer Res."},{"key":"B48","doi-asserted-by":"publisher","first-page":"956","DOI":"10.1007\/s00535-025-02264-6","article-title":"Molecular imaging of gastrointestinal stromal tumor using anti-c-KIT antibody and its fragments","volume":"60","author":"Kashihara","year":"2025","journal-title":"J. Gastroenterol."},{"key":"B49","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1186\/s40658-025-00764-1","article-title":"Toward the standardization of radiopharmaceutical therapies: a technical note evaluating a clinical dosimetry workflow for single-time-point 177Lu SPECT\/CT-based therapies","volume":"12","author":"Kim","year":"2025","journal-title":"EJNMMI Phys."},{"key":"B50","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1038\/s41573-024-00896-6","article-title":"The present and future of bispecific antibodies for cancer therapy","volume":"23","author":"Klein","year":"2024","journal-title":"Nat. Rev. Drug Discov."},{"key":"B51","doi-asserted-by":"publisher","first-page":"893","DOI":"10.1007\/s00259-020-05022-3","article-title":"Biodistribution and dosimetry of a single dose of albumin-binding ligand [177Lu]Lu-PSMA-ALB-56 in patients with mCRPC","volume":"48","author":"Kramer","year":"2021","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"B52","doi-asserted-by":"publisher","first-page":"2830","DOI":"10.1007\/s00259-023-06255-8","article-title":"Joint EANM\/SNMMI procedure guideline for the use of 177Lu-labeled PSMA-targeted radioligand-therapy (177Lu-PSMA-RLT)","volume":"50","author":"Kratochwil","year":"2023","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"B53","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1186\/1748-717X-7-99","article-title":"Combination of peptide receptor radionuclide therapy with fractionated external beam radiotherapy for treatment of advanced symptomatic meningioma","volume":"7","author":"Kreissl","year":"2012","journal-title":"Radiat. Oncol."},{"key":"B54","doi-asserted-by":"publisher","first-page":"641","DOI":"10.1097\/rlu.0000000000003667","article-title":"Safety of fibroblast activation protein-targeted radionuclide therapy by a low-dose dosimetric approach using 177Lu-FAPI04","volume":"46","author":"Kuyumcu","year":"2021","journal-title":"Clin. Nucl. Med."},{"key":"B55","doi-asserted-by":"publisher","first-page":"2722","DOI":"10.1038\/s41591-025-03704-9","article-title":"Lutetium-177-PSMA-617 or cabazitaxel in metastatic prostate cancer: circulating tumor DNA analysis of the randomized phase 2 TheraP trial","volume":"31","author":"Kwan","year":"2025","journal-title":"Nat. Med."},{"key":"B56","doi-asserted-by":"publisher","first-page":"1296","DOI":"10.3390\/molecules30061296","article-title":"The advancement of targeted alpha therapy and the role of click chemistry therein","volume":"30","author":"Lacerda","year":"2025","journal-title":"Molecules"},{"key":"B57","doi-asserted-by":"publisher","first-page":"e236","DOI":"10.1016\/s1470-2045(24)00030-5","article-title":"Recent advances and impending challenges for the radiopharmaceutical sciences in oncology","volume":"25","author":"Lapi","year":"2024","journal-title":"Lancet Oncol."},{"key":"B58","doi-asserted-by":"publisher","first-page":"583309","DOI":"10.3389\/fchem.2020.583309","article-title":"New frontiers in molecular imaging using peptide-based radiopharmaceuticals for prostate cancer","volume":"8","author":"Li","year":"2020","journal-title":"Front. Chem."},{"key":"B59","doi-asserted-by":"publisher","first-page":"107341","DOI":"10.1016\/j.phrs.2024.107341","article-title":"Natural-source payloads used in the conjugated drugs architecture for cancer therapy: recent advances and future directions","volume":"207","author":"Li","year":"2024","journal-title":"Pharmacol. Res."},{"key":"B60","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.aaw8412","article-title":"Off-target toxicity is a common mechanism of action of cancer drugs undergoing clinical trials","volume":"11","author":"Lin","year":"2019","journal-title":"Sci. Transl. Med."},{"key":"B61","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1038\/s41571-024-00935-6","article-title":"Precision therapeutics and emerging strategies for HR-positive metastatic breast cancer","volume":"21","author":"Lloyd","year":"2024","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"B62","doi-asserted-by":"publisher","first-page":"761","DOI":"10.2967\/jnumed.123.266309","article-title":"Preclinical characterization of DPI-4452: a (68)Ga\/177Lu theranostic ligand for carbonic anhydrase IX","volume":"65","author":"Massi\u00e8re","year":"2024","journal-title":"J. Nucl. Med."},{"key":"B63","first-page":"266","article-title":"Bulk scale formulation of therapeutic doses of clinical grade ready-to-use 177Lu-DOTA-TATE: the intricate radiochemistry aspects","volume":"32","author":"Mathur","year":"2017","journal-title":"Cancer Biother Radiopharm."},{"key":"B64","doi-asserted-by":"publisher","first-page":"1629","DOI":"10.1038\/s41467-018-04107-w","article-title":"Feed-forward alpha particle radiotherapy ablates androgen receptor-addicted prostate cancer","volume":"9","author":"McDevitt","year":"2018","journal-title":"Nat. Commun."},{"key":"B65","doi-asserted-by":"publisher","first-page":"278","DOI":"10.2214\/AJR.18.19953","article-title":"Neuroendocrine tumor therapy: 177Lu-DOTATATE","volume":"211","author":"Mittra","year":"2018","journal-title":"Am. J. Roentgenol."},{"key":"B66","doi-asserted-by":"publisher","first-page":"83s","DOI":"10.2967\/jnumed.116.186940","article-title":"Theranostics using antibodies and antibody-related therapeutics","volume":"58","author":"Moek","year":"2017","journal-title":"J. Nucl. Med."},{"key":"B67","doi-asserted-by":"publisher","first-page":"124","DOI":"10.2967\/jnumed.112.107235","article-title":"DOTA conjugate with an albumin-binding entity enables the first folic acid-targeted 177Lu-radionuclide tumor therapy in mice","volume":"54","author":"M\u00fcller","year":"2013","journal-title":"J. Nucl. Med."},{"key":"B68","doi-asserted-by":"publisher","first-page":"3412","DOI":"10.3390\/cancers17213412","article-title":"Radioligand therapy in cancer management: a global perspective","volume":"17","author":"Ninatti","year":"2025","journal-title":"Cancers (Basel)"},{"key":"B69","doi-asserted-by":"publisher","first-page":"743","DOI":"10.2967\/jnumed.119.232934","article-title":"Imaging DNA damage repair in vivo after 177Lu-DOTATATE therapy","volume":"61","author":"O\u2019Neill","year":"2020","journal-title":"J. Nucl. Med."},{"key":"B70","doi-asserted-by":"publisher","first-page":"731","DOI":"10.1080\/14737140.2023.2213892","article-title":"Lutetium-177 PSMA for the treatment of metastatic castrate resistant prostate cancer: a systematic review","volume":"23","author":"Patell","year":"2023","journal-title":"Expert Rev. Anticancer Ther."},{"key":"B71","doi-asserted-by":"publisher","first-page":"e70744","DOI":"10.1002\/cam4.70744","article-title":"Relationship between best tumor shrinkage and progression-free survival and overall survival in patients with progressive midgut neuroendocrine tumors treated with [177Lu]Lu-DOTA-TATE: ad hoc analysis of the phase III NETTER-1 trial","volume":"14","author":"Pavel","year":"2025","journal-title":"Cancer Med."},{"key":"B72","doi-asserted-by":"publisher","first-page":"188529","DOI":"10.1016\/j.bbcan.2021.188529","article-title":"Radiolabeled nanobodies for tumor targeting: from bioengineering to imaging and therapy","volume":"1875","author":"Piramoon","year":"2021","journal-title":"Biochim. Biophys. Acta Rev. Cancer"},{"key":"B73","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1039\/c3cs60304k","article-title":"Matching chelators to radiometals for radiopharmaceuticals","volume":"43","author":"Price","year":"2014","journal-title":"Chem. Soc. Rev."},{"key":"B74","doi-asserted-by":"publisher","first-page":"869","DOI":"10.1038\/s41571-025-01069-z","article-title":"The molecular blueprint of targeted radionuclide therapy","volume":"22","author":"Primac","year":"2025","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"B75","doi-asserted-by":"publisher","first-page":"1906","DOI":"10.1007\/s00259-023-06144-0","article-title":"Fibroblast activation protein-targeted radionuclide therapy: background, opportunities, and challenges of first (pre)clinical studies","volume":"50","author":"Priv\u00e9","year":"2023","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"B76","doi-asserted-by":"publisher","first-page":"1219","DOI":"10.1158\/1535-7163.mct-24-0083","article-title":"Pretargeted radioimmunotherapy with the novel Anti-oxMIF\/HSG bispecific antibody ON105 results in significant tumor regression in murine models of cancer","volume":"23","author":"Puchol Tarazona","year":"2024","journal-title":"Mol. Cancer Ther."},{"key":"B77","doi-asserted-by":"publisher","first-page":"2111748","DOI":"10.1080\/19420862.2022.2111748","article-title":"Full-length recombinant antibodies from Escherichia coli: production, characterization, effector function (Fc) engineering, and clinical evaluation","volume":"14","author":"Rashid","year":"2022","journal-title":"MAbs"},{"key":"B78","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1007\/s002590050034","article-title":"Affinity profiles for human somatostatin receptor subtypes SST1-SST5 of somatostatin radiotracers selected for scintigraphic and radiotherapeutic use","volume":"27","author":"Reubi","year":"2000","journal-title":"Eur. J. Nucl. Med."},{"key":"B79","first-page":"67s","article-title":"Candidates for peptide receptor radiotherapy today and in the future","volume":"46","author":"Reubi","year":"2005","journal-title":"J. Nucl. Med."},{"key":"B80","doi-asserted-by":"publisher","first-page":"2431","DOI":"10.1007\/s00259-025-07102-8","article-title":"Biodistribution and dosimetry of [177Lu]Lu-SibuDAB in patients with metastatic castration-resistant prostate cancer","volume":"52","author":"Ritt","year":"2025","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"B81","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1007\/s00259-002-0982-3","article-title":"Safe and effective inhibition of renal uptake of radiolabelled octreotide by a combination of lysine and arginine","volume":"30","author":"Rolleman","year":"2003","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"B82","doi-asserted-by":"publisher","first-page":"5570","DOI":"10.3390\/cancers13215570","article-title":"Radioimmunotherapy in oncology: overview of the last decade clinical trials","volume":"13","author":"Rondon","year":"2021","journal-title":"Cancers (Basel)"},{"key":"B83","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1007\/s11864-025-01296-7","article-title":"Advances in PSMA-targeted radionuclide therapeutics","volume":"26","author":"Ruder","year":"2025","journal-title":"Curr. Treat. Options Oncol."},{"key":"B84","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.1056\/nejmoa2107322","article-title":"Lutetium-177-PSMA-617 for metastatic castration-resistant prostate cancer","volume":"385","author":"Sartor","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"B85","first-page":"2889","article-title":"Monoclonal antibody-based therapy of a human tumor xenograft with a 177Lutetium-labeled immunoconjugate","volume":"51","author":"Schlom","year":"1991","journal-title":"Cancer Res."},{"key":"B86","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1038\/s44276-024-00065-7","article-title":"Design issues with lutetium-177 PSMA-617 registration studies that bias the outcome of the experimental arm reflect an increasing misalignment of contemporary oncology trials with true patient benefit","volume":"2","author":"Schnog","year":"2024","journal-title":"BJC Rep."},{"key":"B87","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1038\/s41573-020-0073-9","article-title":"Radiopharmaceutical therapy in cancer: clinical advances and challenges","volume":"19","author":"Sgouros","year":"2020","journal-title":"Nat. Rev. Drug Discov."},{"key":"B88","doi-asserted-by":"publisher","first-page":"542","DOI":"10.2967\/jnumed.122.264816","article-title":"Cure of disseminated human lymphoma with [177Lu]Lu-Ofatumumab in a preclinical model","volume":"64","author":"Shim","year":"2023","journal-title":"J. Nucl. Med."},{"key":"B89","first-page":"81","article-title":"Prostate-specific membrane antigen expression in normal and malignant human tissues","volume":"3","author":"Silver","year":"1997","journal-title":"Clin. Cancer Res."},{"key":"B90","doi-asserted-by":"publisher","first-page":"1778","DOI":"10.1007\/s00259-022-05727-7","article-title":"EANM dosimetry committee recommendations for dosimetry of 177Lu-labelled somatostatin-receptor- and PSMA-targeting ligands","volume":"49","author":"Sj\u00f6green Gleisner","year":"2022","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"B91","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1007\/s00259-025-07390-0","article-title":"Targeted alpha therapy: a comprehensive analysis of the biological effects from \u201clocal-regional-systemic\u201d dimensions","volume":"53","author":"Song","year":"2025","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"B92","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1177\/1087057114564349","article-title":"Addressing the right targets in oncology: challenges and alternative approaches","volume":"20","author":"Stock","year":"2015","journal-title":"J. Biomol. Screen"},{"key":"B93","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1056\/nejmoa1607427","article-title":"Phase 3 trial of 177Lu-Dotatate for midgut neuroendocrine tumors","volume":"376","author":"Strosberg","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"B94","doi-asserted-by":"publisher","first-page":"2129","DOI":"10.7150\/thno.31179","article-title":"Preclinical efficacy of hK2 targeted [177Lu]hu11B6 for prostate cancer theranostics","volume":"9","author":"Timmermand","year":"2019","journal-title":"Theranostics"},{"key":"B95","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1038\/s41392-024-01899-w","article-title":"Therapeutic advances of targeting receptor tyrosine kinases in cancer","volume":"9","author":"Tomuleasa","year":"2024","journal-title":"Signal Transduct. Target Ther."},{"key":"B96","doi-asserted-by":"publisher","first-page":"87","DOI":"10.3322\/caac.21262","article-title":"Global cancer statistics, 2012","volume":"65","author":"Torre","year":"2015","journal-title":"CA Cancer J. Clin."},{"key":"B119","doi-asserted-by":"publisher","first-page":"2685","DOI":"10.1007\/s00259-025-07103-7","article-title":"Radiotheranostic landscape: A review of clinical and preclinical development","volume":"52","author":"Tran","year":"2025","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"B97","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1002\/jlcr.3622","article-title":"Aligning physics and physiology: engineering antibodies for radionuclide delivery","volume":"61","author":"Tsai","year":"2018","journal-title":"J. Label. Comp. Radiopharm."},{"key":"B98","doi-asserted-by":"publisher","first-page":"1110","DOI":"10.3390\/pharmaceutics15041110","article-title":"Lutathera(\u00ae) orphans: state of the art and future application of radioligand therapy with 177Lu-DOTATATE","volume":"15","author":"Urso","year":"2023","journal-title":"Pharmaceutics"},{"key":"B99","first-page":"634","article-title":"Pharmacokinetics and biodistribution of 111In- and 177Lu-labeled J591 antibody specific for prostate-specific membrane antigen: prediction of 90Y-J591 radiation dosimetry based on 111In or 177Lu?","volume":"46","author":"Vallabhajosula","year":"2005","journal-title":"J. Nucl. Med."},{"key":"B100","doi-asserted-by":"publisher","first-page":"1302","DOI":"10.1093\/bjr\/tqaf243","article-title":"Theranostics and molecular imaging are taking off- current situation, requirements and how to train more physicians to fill the gap. A perspective from three different continents","volume":"99","author":"Veit-Haibach","year":"2025","journal-title":"Br. J. Radiol"},{"key":"B101","doi-asserted-by":"publisher","first-page":"602668","DOI":"10.3389\/fcell.2020.602668","article-title":"Interplay of carbonic anhydrase IX with amino acid and acid\/base transporters in the hypoxic tumor microenvironment","volume":"8","author":"Venkateswaran","year":"2020","journal-title":"Front. Cell Dev. Biol."},{"key":"B102","doi-asserted-by":"publisher","first-page":"679","DOI":"10.2967\/jnumed.123.267006","article-title":"Clinical management of advanced prostate cancer: where does radiopharmaceutical therapy fit in the treatment algorithm?","volume":"65","author":"Viscuse","year":"2024","journal-title":"J. Nucl. Med."},{"key":"B103","doi-asserted-by":"publisher","first-page":"4745","DOI":"10.7150\/thno.84628","article-title":"A genome-wide CRISPR\/Cas9 screen identifies DNA-PK as a sensitiser to 177Lutetium-DOTA-octreotate radionuclide therapy","volume":"13","author":"Waldeck","year":"2023","journal-title":"Theranostics"},{"key":"B104","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1097\/coc.0000000000001072","article-title":"ACR-ACNM-ARS-ASTRO-SNMMI practice parameter for the performance of therapy with radiopharmaceuticals","volume":"47","author":"Wallner","year":"2024","journal-title":"Am. J. Clin. Oncol."},{"key":"B105","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1016\/s0140-6736(26)00604-5","article-title":"[177Lu]Lu-edotreotide versus everolimus for gastroenteropancreatic neuroendocrine tumours (COMPETE): a phase 3, multicentre, randomised, open-label, superiority trial","volume":"408","author":"Walter","year":"2026","journal-title":"Lancet"},{"key":"B106","doi-asserted-by":"publisher","first-page":"1107","DOI":"10.1021\/acsptsci.3c00081","article-title":"Druggability of targets for diagnostic radiopharmaceuticals","volume":"6","author":"Wang","year":"2023","journal-title":"ACS Pharmacol. Transl. Sci."},{"key":"B107","doi-asserted-by":"publisher","first-page":"414","DOI":"10.1124\/pharmrev.123.001026","article-title":"MDM2 inhibitors for cancer therapy: the past, present, and future","volume":"76","author":"Wang","year":"2024","journal-title":"Pharmacol. Rev."},{"key":"B120","doi-asserted-by":"publisher","first-page":"641","DOI":"10.1016\/S1875-5364(25)60887-9","article-title":"Advancements and applications in radiopharmaceutical therapy","volume":"23","author":"Wang","year":"2025","journal-title":"Chin. J. Nat. Med."},{"key":"B108","doi-asserted-by":"publisher","first-page":"6293","DOI":"10.7150\/thno.57177","article-title":"Perspectives on metals-based radioimmunotherapy (RIT): moving forward","volume":"11","author":"White","year":"2021","journal-title":"Theranostics"},{"key":"B109","doi-asserted-by":"publisher","first-page":"3262","DOI":"10.1200\/JCO.2002.11.017","article-title":"Treatment with ibritumomab tiuxetan radioimmunotherapy in patients with rituximab-refractory follicular non-Hodgkin's lymphoma","volume":"20","author":"Witzig","year":"2002","journal-title":"J. Clin. Oncol."},{"key":"B110","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1038\/s41392-023-01480-x","article-title":"Epigenetic regulation in the tumor microenvironment: molecular mechanisms and therapeutic targets","volume":"8","author":"Yang","year":"2023","journal-title":"Signal Transduct. Target Ther."},{"key":"B111","doi-asserted-by":"publisher","first-page":"015015","DOI":"10.1088\/2057-1976\/abd307","article-title":"Comparative study on application of 177Lu-labeled rituximab, tetulomab, cetuximab and huA33 monoclonal antibodies to targeted radionuclide therapy","volume":"7","author":"Zakaly","year":"2020","journal-title":"Biomed. Phys. Eng. Express"},{"key":"B112","doi-asserted-by":"publisher","first-page":"1280","DOI":"10.1007\/s00259-014-2713-y","article-title":"Radiation dosimetry and first therapy results with a (124)I\/ (131)I-labeled small molecule (MIP-1095) targeting PSMA for prostate cancer therapy","volume":"41","author":"Zechmann","year":"2014","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"B113","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1186\/s13550-020-00628-y","article-title":"Toxicity of a combined therapy using the mTOR-inhibitor everolimus and PRRT with [177Lu]Lu-DOTA-TATE in lewis rats","volume":"10","author":"Zellmer","year":"2020","journal-title":"EJNMMI Res."},{"key":"B114","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41392-024-02041-6","article-title":"Radiopharmaceuticals and their applications in medicine","volume":"10","author":"Zhang","year":"2025","journal-title":"Signal Transduct. Target Ther."},{"key":"B115","doi-asserted-by":"publisher","first-page":"7897","DOI":"10.1021\/jacs.4c18398","article-title":"A dual-targeted molecule for disease-activatable proteolysis targeting chimeras and targeted radionuclide therapy of cancer","volume":"147","author":"Zhang","year":"2025","journal-title":"J. Am. Chem. Soc."},{"key":"B116","doi-asserted-by":"publisher","first-page":"1764","DOI":"10.1007\/s00259-024-07033-w","article-title":"GD2-targeted theranostics of neuroblastoma with [(64)Cu]Cu\/[177Lu]Lu-hu3F8","volume":"52","author":"Zheng","year":"2025","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"B117","doi-asserted-by":"publisher","first-page":"876","DOI":"10.1016\/j.jconrel.2023.11.046","article-title":"Spatiotemporally sequential delivery of biomimetic liposomes potentiates glioma chemotherapy","volume":"365","author":"Zhou","year":"2024","journal-title":"J. Control Release"},{"key":"B118","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1186\/s12964-026-02700-x","article-title":"Combination therapy strategies in engineered 177Lu radiopharmaceuticals beyond single modality: design principles and application outlet","volume":"24","author":"Zhu","year":"2026","journal-title":"Cell Commun. Signal"}],"container-title":["Frontiers in Pharmacology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2026.1907065\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T11:50:40Z","timestamp":1788781840000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2026.1907065\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,7]]},"references-count":120,"alternative-id":["10.3389\/fphar.2026.1907065"],"URL":"https:\/\/doi.org\/10.3389\/fphar.2026.1907065","relation":{},"ISSN":["1663-9812"],"issn-type":[{"value":"1663-9812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,7]]},"article-number":"1907065"}}