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      Radiation nanomedicines for cancer treatment: a scientific journey and view of the landscape

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          Abstract

          Background

          Radiation nanomedicines are nanoparticles labeled with radionuclides that emit α- or β-particles or Auger electrons for cancer treatment. We describe here our 15 years scientific journey studying locally-administered radiation nanomedicines for cancer treatment. We further present a view of the radiation nanomedicine landscape by reviewing research reported by other groups.

          Main body

          Gold nanoparticles were studied initially for radiosensitization of breast cancer to X-radiation therapy. These nanoparticles were labeled with 111In to assess their biodistribution after intratumoural vs. intravenous injection. Intravenous injection was limited by high liver and spleen uptake and low tumour uptake, while intratumoural injection provided high tumour uptake but low normal tissue uptake. Further, [ 111In]In-labeled gold nanoparticles modified with trastuzumab and injected iintratumourally exhibited strong tumour growth inhibition in mice with subcutaneous HER2-positive human breast cancer xenografts. In subsequent studies, strong tumour growth inhibition in mice was achieved without normal tissue toxicity in mice with human breast cancer xenografts injected intratumourally with gold nanoparticles labeled with β-particle emitting 177Lu and modified with panitumumab or trastuzumab to specifically bind EGFR or HER2, respectively. A nanoparticle depot (nanodepot) was designed to incorporate and deliver radiolabeled gold nanoparticles to tumours using brachytherapy needle insertion techniques. Treatment of mice with s.c. 4T1 murine mammary carcinoma tumours with a nanodepot incorporating [ 90Y]Y-labeled gold nanoparticles inserted into one tumour arrested tumour growth and caused an abscopal growth-inhibitory effect on a distant second tumour. Convection-enhanced delivery of [ 177Lu]Lu-AuNPs to orthotopic human glioblastoma multiforme (GBM) tumours in mice arrested tumour growth without normal tissue toxicity. Other groups have explored radiation nanomedicines for cancer treatment in preclinical animal tumour xenograft models using gold nanoparticles, liposomes, block copolymer micelles, dendrimers, carbon nanotubes, cellulose nanocrystals or iron oxide nanoparticles. These nanoparticles were labeled with radionuclides emitting Auger electrons ( 111In, 99mTc, 125I, 103Pd, 193mPt, 195mPt), β-particles ( 177Lu, 186Re, 188Re, 90Y, 198Au, 131I) or α-particles ( 225Ac, 213Bi, 212Pb, 211At, 223Ra). These studies employed intravenous or intratumoural injection or convection enhanced delivery. Local administration of these radiation nanomedicines was most effective and minimized normal tissue toxicity.

          Conclusions

          Radiation nanomedicines have shown great promise for treating cancer in preclinical studies. Local intratumoural administration avoids sequestration by the liver and spleen and is most effective for treating tumours, while minimizing normal tissue toxicity.

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          Most cited references140

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          Radiotherapy plus Concomitant and Adjuvant Temozolomide for Glioblastoma

          Glioblastoma, the most common primary brain tumor in adults, is usually rapidly fatal. The current standard of care for newly diagnosed glioblastoma is surgical resection to the extent feasible, followed by adjuvant radiotherapy. In this trial we compared radiotherapy alone with radiotherapy plus temozolomide, given concomitantly with and after radiotherapy, in terms of efficacy and safety. Patients with newly diagnosed, histologically confirmed glioblastoma were randomly assigned to receive radiotherapy alone (fractionated focal irradiation in daily fractions of 2 Gy given 5 days per week for 6 weeks, for a total of 60 Gy) or radiotherapy plus continuous daily temozolomide (75 mg per square meter of body-surface area per day, 7 days per week from the first to the last day of radiotherapy), followed by six cycles of adjuvant temozolomide (150 to 200 mg per square meter for 5 days during each 28-day cycle). The primary end point was overall survival. A total of 573 patients from 85 centers underwent randomization. The median age was 56 years, and 84 percent of patients had undergone debulking surgery. At a median follow-up of 28 months, the median survival was 14.6 months with radiotherapy plus temozolomide and 12.1 months with radiotherapy alone. The unadjusted hazard ratio for death in the radiotherapy-plus-temozolomide group was 0.63 (95 percent confidence interval, 0.52 to 0.75; P<0.001 by the log-rank test). The two-year survival rate was 26.5 percent with radiotherapy plus temozolomide and 10.4 percent with radiotherapy alone. Concomitant treatment with radiotherapy plus temozolomide resulted in grade 3 or 4 hematologic toxic effects in 7 percent of patients. The addition of temozolomide to radiotherapy for newly diagnosed glioblastoma resulted in a clinically meaningful and statistically significant survival benefit with minimal additional toxicity. Copyright 2005 Massachusetts Medical Society.
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            Nanotubes from Carbon.

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              The abscopal effect of local radiotherapy: using immunotherapy to make a rare event clinically relevant.

              Recently, immunologic responses to localized irradiation are proposed as mediator of systemic effects after localized radiotherapy (called the abscopal effect). Here, we give an overview of both preclinical and clinical data about the abscopal effect in particular and link them with the immunogenic properties of radiotherapy.
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                Author and article information

                Contributors
                raymond.reilly@utoronto.ca
                Journal
                EJNMMI Radiopharm Chem
                EJNMMI Radiopharm Chem
                EJNMMI Radiopharmacy and Chemistry
                Springer International Publishing (Cham )
                2365-421X
                4 May 2024
                4 May 2024
                December 2024
                : 9
                : 37
                Affiliations
                [1 ]Department of Pharmaceutical Sciences, University of Toronto, ( https://ror.org/03dbr7087) Toronto, ON Canada
                [2 ]Princess Margaret Cancer Centre, ( https://ror.org/03zayce58) Toronto, ON Canada
                [3 ]Department of Medical Imaging, University of Toronto, ( https://ror.org/03dbr7087) Toronto, ON Canada
                [4 ]Joint Department of Medical Imaging, University Health Network, ( https://ror.org/042xt5161) Toronto, ON Canada
                [5 ]Leslie Dan Faculty of Pharmacy, University of Toronto, ( https://ror.org/03dbr7087) Toronto, ON M5S 3M2 Canada
                Author information
                http://orcid.org/0000-0003-1038-7993
                Article
                266
                10.1186/s41181-024-00266-y
                11069497
                38703297
                73f40734-4461-4c5e-b1cc-afa814d2c27b
                © The Author(s) 2024

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 31 January 2024
                : 22 April 2024
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000238, Brain Tumour Foundation of Canada;
                Award ID: Research Grant
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100000147, Canadian Cancer Society;
                Award ID: Innovation to Impact Award
                Award ID: Innovation Grant
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100000038, Natural Sciences and Engineering Research Council of Canada;
                Award ID: Discovery Grant
                Award ID: Polymer Nanoparticles in Drg Delivery (POND) CREATE Program
                Award Recipient :
                Funded by: World Gold Council
                Award ID: Funds Donated to the Canadian Cancer Society
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100002655, Terry Fox Foundation;
                Award ID: STARS21 Scholarship
                Award Recipient :
                Funded by: University of Toronto
                Award ID: MDS Nordion Scholarship in Radiopharmaceutical Sciences
                Award ID: MDS Nordion Scholarship in Radiopharmaceutical Sciences
                Award Recipient :
                Categories
                Review
                Custom metadata
                © Springer Nature Switzerland AG 2024

                radionuclides,cancer treatment,gold nanoparticles,liposomes,block copolymer micelles,dendrimers,convection-enhanced delivery,intratumoural injection,radiosensitization,nanomedicines

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