In recent years, a number of new developments in targeted
therapies using radiolabeled compounds have emerged. New developments and insights in radioiodine treatment of
thyroid cancer, treatment of
lymphoma and solid
tumors with radiolabeled
monoclonal antibodies (mAbs), the developments in the application of radiolabeled small receptor-specific molecules such as
meta-iodobenzylguanidine and
peptides and the position of locoregional treatment in malignant involvement of the liver are reviewed. The introduction of recombinant human
thyroid-stimulating hormone and the possibility to enhance
iodine uptake with
retinoids has changed the radioiodine treatment protocol of patients with
thyroid cancer. Introduction of radiolabeled mAbs has provided additional treatment options in patients with
malignant lymphoma, while a similar approach proves to be cumbersome in patients with solid
tumors. With radiolabeled small molecules that target specific receptors on
tumor cells, high radiation doses can be directed to
tumors in patients with disseminated disease. Radiolabeled
somatostatin derivatives for the treatment of
neuroendocrine tumors are the role model for this approach. Locoregional treatment with
radiopharmaceuticals of patients with
hepatocellular carcinoma or
metastases to the liver may be used in inoperable cases, but may also be of benefit in a neo-adjuvant or adjuvant setting. Significant developments in the application of targeted
radionuclide therapy have taken place. New treatment modalities have been introduced in the clinic. The concept of combining therapeutic
radiopharmaceuticals with other treatment modalities is more extensively explored.