Theranostics integrate molecular imaging and targeted radionuclide therapy for personalised cancer therapy. Theranostic treatments have shown meaningful efficacy in randomised clinical trials and are approved for clinical use in prostate cancer and neuroendocrine tumours. Brain tumours represent an unmet clinical need and theranostics might offer effective treatment options, although specific issues need to be considered for clinical development. In this Policy Review, we discuss opportunities and challenges of developing targeted radionuclide therapies for the treatment of brain tumours including glioma, meningioma, and brain metastasis. The rational choice of molecular treatment targets is highlighted, including the potential relevance of different types of targeted radionuclide therapeutics, and the role of the blood–brain barrier and blood–tumour barrier. Furthermore, we discuss considerations for effective clinical trial design and conduct, as well as logistical and regulatory challenges for implementation of radionuclide therapies into neuro-oncological practice. Rational development will foster successful translation of the theranostic concept to brain tumours.

中文翻译：

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将治疗诊断学概念转化为神经肿瘤学：打破障碍


治疗诊断学将分子成像和靶向放射性核素治疗相结合，以实现个性化的癌症治疗。治疗诊断治疗在随机临床试验中显示出有意义的疗效，并被批准用于前列腺癌和神经内分泌肿瘤的临床应用。脑肿瘤代表了未满足的临床需求，治疗诊断学可能提供有效的治疗选择，尽管临床开发需要考虑具体问题。在本政策审查中，我们讨论了开发靶向放射性核素疗法治疗脑肿瘤（包括神经胶质瘤、脑膜瘤和脑转移瘤）的机遇和挑战。强调了分子治疗靶点的合理选择，包括不同类型靶向放射性核素治疗的潜在相关性，以及血脑屏障和血肿瘤屏障的作用。此外，我们还讨论了有效临床试验设计和实施的考虑因素，以及将放射性核素疗法实施到神经肿瘤学实践中的后勤和监管挑战。理性发展将促进治疗诊断学概念成功转化为脑肿瘤。