Lakhasly

Outlook The systemic delivery of short-ranged potent radiation is an effective approach to treating patients with cancer, exhibiting a number of advantages over current therapeutic strategies.These advantages include the ability to image and calculate quantities that directly impact efficacy and potential toxicity such as absorbed dose, the ability to deliver radiation that is impervious to almost all conventional resistance mechanisms and the ability to combine RPT with radiotherapy in a rational and absorbed dose-driven manner so as to reduce the level of empiricism in clinical trials.Aside from establishing trained practitioners, the future growth of RPT will be fuelled by continued discovery of more-specific tumour-associated targets, improvements in radiochemistry, increased and low-cost availability of radionuclides (particularly ?-particle emitters) and expanded preclinical and clinical investigation of combination therapy with agents and treatment modalities that are complementary to RPT.

Outlook
The systemic delivery of short-ranged potent radiation is an effective approach to treating patients with cancer, exhibiting a number of advantages over current therapeutic strategies. These advantages include the ability to image and calculate quantities that directly impact efficacy and potential toxicity such as absorbed dose, the ability to deliver radiation that is impervious to almost all conventional resistance mechanisms and the ability to combine RPT with radiotherapy in a rational and absorbed dose-driven manner so as to reduce the level of empiricism in clinical trials. The field of RPT has been active and growing for nearly 40 years, and is attracting a high level of recognition and commercial interest (Table 2).

Aside from establishing trained practitioners, the future growth of RPT will be fuelled by continued discovery of more-specific tumour-associated targets, improvements in radiochemistry, increased and low-cost availability of radionuclides (particularly α-particle emitters) and expanded preclinical and clinical investigation of combination therapy with agents and treatment modalities that are complementary to RPT. The ability to image and quantitatively characterize the likely biological outcome of RPT through dosimetry and treatment planning is a major and unique strength of this treatment approach.

The question to be addressed is how does the field strike the right balance between using those features of RPT — imaging, dosimetry and treatment planning — that can help guide and optimize patient treatment and that provide an advantage over other cancer therapies versus the more expedient approach of adopting a chemotherapy dosing paradigm? The former is seen as too complicated, while the latter is already in use, is thought to work well enough and has already introduced commercially viable and beneficial agents to patients. The answer lies in early-stage clinical trials that incorporate imaging and dosimetry so that the value of these unique aspects of RPT may be rigorously evaluated and compared with existing therapeutic approaches.