Abstract
Primary brain tumors (PBTs) are some of the most difficult types of cancer to treat, and despite advancements in surgery, chemotherapy and radiotherapy, new strategies for the treatment of PBTs are needed, especially for those with poor prognosis such as inoperable/difficult-to-reach lesions or relapsing disease. In regard to the last point, malignant primary brain tumors remain some of the most lethal types of cancer. Nuclear medicine may provide exciting new weapons and significant contributions in the treatment of PBTs. In this review, we performed literature research in order to highlight the possible role of peptide receptor radionuclide therapy (PRRT) in the treatment of PBTs with radiolabeled molecules that bind with high-affinity transmembrane receptors such as somatostatin receptors (SSTRs), neurokinin type-1 receptor and prostate-specific membrane antigen (PSMA). These receptors are overexpressed in some cancer types such as gliomas, meningiomas, pituitary tumors and medulloblastomas. A comprehensive overview of possible applications in this field will be shown, providing knowledge about benefits, feasibility, developments and limitations of PRRT in this type of tumor, also revealing new advantages in the management of the disease.
Highlights
Accepted: 27 August 2021Primary brain tumors (PBTs) make up about 2% of all cancers, and they may be divided into benign and malignant [1,2]
The aim of this review is to provide a comprehensive overview of the most used radiopeptides used in PBTs for therapeutic purposes, underlining theragnostic applications and highlighting possible advantages and drawbacks
Regarding peptide receptor radionuclide therapy (PRRT) in meningiomas with radiolabeled somatostatin analogs, important results have been demonstrated in a recent meta-analysis by Mirian et al in patients with treatment-refractory meningioma, PRRT allows disease control in 63% of patients, with promising results in one-year overall survival (88%, 71% and 52%, respectively, for World Health Organization (WHO)-I, II- and III-grade meningioma, respectively) [35]
Summary
Accepted: 27 August 2021Primary brain tumors (PBTs) make up about 2% of all cancers, and they may be divided into benign and malignant [1,2]. In 2016, this classification was revised and updated, adding molecular alterations of PBTs. Gliomas represent 75% of malignant gliomas [3], and glioblastoma multiforme is the most lethal form. The treatment of PBTs includes surgery, chemotherapy and radiotherapy, often combined [7]. It is well known that treatment of PBTs may be complicated due to multiple factors such as the blood–brain barrier (which prevents or slows down the arrival of chemotherapy drugs to the tumor mass) and the nature of the brain parenchyma itself, the removal of which (of the perilesional healthy tissue together with the tumor) must be limited as much as possible [8]. Taking into consideration the aforementioned context, and despite recent advances in surgery, radiotherapy and chemotherapy, new strategies for the treatment of PBTs are strongly needed. New possibilities to conventional therapies are represented by Published: 29 August 2021
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