Theranostics in Hematooncology
Open accessAbstract
In the early 2000s, major clinical trials provided evidence of a favorable outcome from antibody-mediated radioimmunotherapy for hematologic neoplasms, which then led to Food and Drug Administration approval. For instance, the theranostic armamentarium for the referring hematooncologist now includes 90Y-ibritumomab tiuxetan for refractory low-grade follicular lymphoma or transformed B-cell non-Hodgkin lymphoma, as well as 131I-tositumomab for rituximab-refractory follicular lymphoma. Moreover, the first interim results of the SIERRA phase III trial reported beneficial effects from the use of 131I-anti-CD45 antibodies (Iomab-B) in refractory or relapsed acute myeloid leukemia. During the last decade, the concept of theranostics in hematooncology has been further expanded by C-X-C motif chemokine receptor 4–directed molecular imaging. Beyond improved detection rates of putative sites of disease, C-X-C motif chemokine receptor 4–directed PET/CT also selects candidates for radioligand therapy using β-emitting radioisotopes targeting the identical chemokine receptor on the lymphoma cell surface. Such image-piloted therapeutic strategies provided robust antilymphoma efficacy, along with desired eradication of the bone marrow niche, such as in patients with T- or B-cell lymphoma. As an integral part of the treatment plan, such radioligand therapy–mediated myeloablation also allows one to line up patients for stem cell transplantation, which leads to successful engraftment during the further treatment course. In this continuing education article, we provide an overview of the current advent of theranostics in hematooncology and highlight emerging clinical applications.
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Iodine-131 tositumomab (Bexxar) targets the CD20 antigen expressed on B cells and B-cell lymphomas.
“Iodine-131 tositumomab (Bexxar) targets the CD20 antigen expressed on B cells and B-cell lymphomas.”
From Radiopharmaceuticals: navigating the frontier of precision medicine and therapeutic innovation (2024) · cites this paper as [23]
The RADIOIMMUNOTHERAPY > NHL section identifies iodine-131 tositumomab as an anti-CD20 antibody used against lymphoma, and the Abstract identifies it as Bexxar. The Concept and Targets section identifies CD20 as a target in B-cell lymphoma, but our copy does not state that CD20 is also expressed on nonmalignant B cells. (LLM, conf=0.82)
Experimental — accuracy not yet measuredActive targeting is effective in tailoring radiation therapy to specific cancer cells, marking a significant advancement in precision medicine.
“These examples showcase the effectiveness of active targeting in tailoring radiation therapy to specific cancer cells, marking a significant advancement in precision medicine.”
From Radiopharmaceuticals: navigating the frontier of precision medicine and therapeutic innovation (2024) · cites this paper as [23]
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Self-citation
- Authors
- Buck, A. K., Serfling, S. E., Kraus, S., Samnick, S., Dreher, N., Higuchi, T., Rasche, L., Einsele, H., & Werner, R. A.
- Affiliations
- Universitätsklinikum Würzburg (DE)
- Johns Hopkins University (US)
- Corresponding author
- Buck, Andreas K.
- ORCID
- Venue
- Journal of Nuclear Medicine
- Publisher
- Society of Nuclear Medicine
- Published
- 2023-06-08
- Volume
- 64
- Issue
- 7
- Pages
- 1009-1016
- ISSN
- 0161-5505 (ISSN-L)
- 2159-662X
- PMC
- PMC10315699
- OpenAlex
- W4379879337
- Cited by
- 25
- References
- 69
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 9 · 2023: 3
- FWCI
- 4.12
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by
- Locations
- Journal of Nuclear Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Amgen
- Pfizer
- Society of Nuclear Medicine and Molecular Imaging
- Deutsche Forschungsgemeinschaft (507803309, 453989101)
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiopharmaceutical Chemistry and Applications
- Health Sciences › Medicine › Pathology and Forensic Medicine › Lymphoma Diagnosis and Treatment
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Medical Imaging Techniques and Applications
- Keywords
- theranostics, hematologic malignancies, radioimmunotherapy, 90Y-ibritumomab tiuxetan, 131I-tositumomab, acute myeloid leukemia, radioligand therapy, follicular lymphoma, lymphoma, myeloablation, stem cell transplantation, bone marrow microenvironment
- MeSH terms
- Positron Emission Tomography Computed Tomography, Humans, Iodine Radioisotopes, Lymphoma, Follicular, Lymphoma, Non-Hodgkin, Yttrium Radioisotopes, Lymphoma, B-Cell, Radioimmunotherapy, Precision Medicine
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