Metabolomics and Target Heterogeneity in Radioligand Therapy

Dear Colleagues,

The success of two prospective randomized clinical trials in neuroendocrine tumor (NETTER-1) and prostate cancer (VISION) have finally proven the real potential of radioligand therapy (RLT). No wonder several phase 1–3 studies are now exploring the utility of RLT in other tumor entities and in different stages of tumor evolution. Apart from investigating treatment efficacy, tolerability, and adverse effects in controlled clinical trials, it is equally imperative to understand the basic mechanism(s) of action of the powerful radioligands, as not all patients respond well to RLT. One of the primary prerequisites for achieving a sufficient radiation dose in and around the tumor cells is the density of target expression on the tumor lesions. Indeed, different clones of tumor cells within tumor lesions are the primary driving force in regulating the expression of targets and determining their radiation sensitivity. For both neuroendocrine tumors as well as prostate cancer patients treated with radioligands, apart from the metabolism, e.g., glucose metabolism or serotonin metabolism, single-center retrospective clinical data as well as preclinical studies have shown predictive and prognostic values of receptor heterogeneity and shown promise in exploring the metabolic pathways to determine the inherent radiation sensitivity of tumor cells.

This Special Issue will focus on the integration of several heterogeneity parameters stemming from imaging and molecular markers to enhance and integrate research and researchers in the field of tumor heterogeneity and metabolomics. The final aims are to increase the efficacy of RLT via a) the selection of appropriate patients, b) a decreased treatment-related toxicity, and c) optimized sequence of treatment options.

Dr. Vikas Prasad
Dr. Nat P. Lenzo
Guest Editors

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