{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:33:45Z","timestamp":1760060025492,"version":"build-2065373602"},"reference-count":100,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"RUDN University Scientific Projects Grant System","award":["033322-2-000"],"award-info":[{"award-number":["033322-2-000"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>Background\/Objectives. This manuscript presents an overview of advances in oncological radiotherapy as an effective treatment method for cancerous tumors, focusing on mechanisms of action within metabolite\u2013antimetabolite systems. The urgency of this topic is underscored by the fact that cancer remains one of the leading causes of death worldwide: as of 2022, approximately 20 million new cases were diagnosed globally, accounting for about 0.25% of the total population. Given prognostic models predicting a steady increase in cancer incidence to 35 million cases by 2050, there is an urgent need for the latest developments in physics, chemistry, molecular biology, pharmacy, and strict adherence to oncological vigilance. The purpose of this work is to demonstrate the relationship between the nature and mechanisms of past diagnostic and therapeutic oncology approaches, their current improvements, and future prospects. Particular emphasis is placed on isotope technologies in the production of therapeutic nuclides, focusing on the mechanisms of formation of simple and complex theranostic compounds and their classification according to target specificity. Methods. The methodology involved searching, selecting, and analyzing information from PubMed, Scopus, and Web of Science databases, as well as from available official online sources over the past 20 years. The search was structured around the structure\u2013mechanism\u2013effect relationship of active pharmaceutical ingredients (APIs). The manuscript, including graphic materials, was prepared using a narrative synthesis method. Results. The results present a sequential analysis of materials related to isotope technology, particularly nucleus stability and instability. An explanation of theranostic principles enabled a detailed description of the action mechanisms of radiopharmaceuticals on various receptors within the metabolite\u2013antimetabolite system using specific drug models. Attention is also given to radioactive nanotheranostics, exemplified by the mechanisms of action of radioactive nanoparticles such as Tc-99m, AuNPs, wwAgNPs, FeNPs, and others. Conclusions. Radiotheranostics, which combines the diagnostic properties of unstable nuclei with therapeutic effects, serves as an effective adjunctive and\/or independent method for treating cancer patients. Despite the emergence of resistance to both chemotherapy and radiotherapy, existing nuclide resources provide protection against subsequent tumor metastasis. However, given the unfavorable cancer incidence prognosis over the next 25 years, the development of \u201cpreventive\u201d drugs is recommended. Progress in this area will be facilitated by modern medical knowledge and a deeper understanding of ligand\u2013receptor interactions to trigger apoptosis in rapidly proliferating cells.<\/jats:p>","DOI":"10.3390\/medsci13030107","type":"journal-article","created":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T09:41:17Z","timestamp":1754300477000},"page":"107","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Novel Achievements in Oncological Metabolic Radio-Therapy: Isotope Technologies, Targeted Theranostics, Translational Oncology Research"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2147-8348","authenticated-orcid":false,"given":"Elena V.","family":"Uspenskaya","sequence":"first","affiliation":[{"name":"Department of Pharmaceutical and Toxicological Chemistry, Medical Institute, Peoples\u2019 Friendship University of Russia Named After Patrice Lumumba (RUDN University), 6 Miklukho-Maklaya St., Moscow 117198, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ainaz","family":"Safdari","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical and Toxicological Chemistry, Medical Institute, Peoples\u2019 Friendship University of Russia Named After Patrice Lumumba (RUDN University), 6 Miklukho-Maklaya St., Moscow 117198, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denis V.","family":"Antonov","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical and Toxicological Chemistry, Medical Institute, Peoples\u2019 Friendship University of Russia Named After Patrice Lumumba (RUDN University), 6 Miklukho-Maklaya St., Moscow 117198, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iuliia A.","family":"Valko","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology, Allergology and Adaptology, Faculty of Continuous Medical Education, Peoples\u2019 Friendship University of Russia Named After Patrice Lumumba (RUDN University), 21\/3 Miklukho-Maklaya St., Moscow 117198, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilaha V.","family":"Kazimova","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical and Toxicological Chemistry, Medical Institute, Peoples\u2019 Friendship University of Russia Named After Patrice Lumumba (RUDN University), 6 Miklukho-Maklaya St., Moscow 117198, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aleksey A.","family":"Timofeev","sequence":"additional","affiliation":[{"name":"Scientific and Educational Resource Centre \u201cInnovative Technologies of Immunophenotyping, Digital Spatial Profiling and Ultrastructural Analysis\u201d, Peoples\u2019 Friendship University of Russia Named After Patrice Lumumba (RUDN University), 6 Miklukho-Maklaya Street, Moscow 117198, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roman A.","family":"Zubarev","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical and Toxicological Chemistry, Medical Institute, Peoples\u2019 Friendship University of Russia Named After Patrice Lumumba (RUDN University), 6 Miklukho-Maklaya St., Moscow 117198, Russia"},{"name":"Division of Chemistry I, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, 17177 Stockholm, Sweden"},{"name":"Chemical Proteomics Unit, Science for Life Laboratory (SciLifeLab), 17165 Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,1]]},"reference":[{"key":"ref_1","first-page":"229","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. 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