Novel positron-emitting radiopharmaceuticals

Abstract

Over the past two decades, nuclear imaging has transformed cancer care. Positron emission tomography (PET) and single photon emission computed tomography (SPECT) can provide clinicians with functional and biochemical information about tumor tissue that complement the anatomical data acquired through magnetic resonance imaging (MRI) and computed tomography (CT). In this chapter, we highlight a number of emerging radiotracers in oncology that are currently employed in clinical trials in the USA and worldwide yet are awaiting regulatory approval in the USA. The radiotracers discussed range from small molecule probes that target cellular transport mechanisms and metabolic pathways to antibody- based agents that target cell-surface receptors. In order to help the reader appreciate the diversity and potential of each of these imaging agents, we present the underlying mechanisms of each agent's targeting and trapping in tumor tissue and provide examples of clinical studies in diverse cancer types as well as descriptions of the utility of each tracer for staging and treatment monitoring.