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Theranostic approach in liver cancer: an emerging paradigm to optimize personalized medicine

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Abstract

Purpose

This review aims to focus an update of the state-of-the-art theranostics approach in liver cancer using 131I, 32P, 90Y, 166Ho, and 186/188Re microspheres as well as some receptors including fibroblast activation protein (FAP), prostate-specific membrane antigen (PSMA), chemokine C-X-C motif receptor 4 (CXCR4), and somatostatin receptors (STR).

Methods

A literature search was performed using the PubMed/MEDLINE and Clinical Trials.gov database and “liver”, “theranostics”, “transarterial radioembolization (TARE)”, “prostate-specific membrane antigen (PSMA)”, “fibroblast activation protein (FAP)”, “hepatocellular carcinoma”, “32P”, “90Y”, “166Ho”, “131I” and “somatostatin receptor (STR)” as keywords. Both, preclinical and clinical studies were included in this review. The search was restricted to the English language.

Result

After exclusion of letters, editorials, comments and duplicates publications, remaining articles were included in this review.

Conclusion

There is growing evidence for applicability of theranostic approach in these patients to enhance early identification, patient evaluation, targeted treatment, restaging, follow-up, and palliation of symptoms or slow down tumor progression. However, this field requires multidisciplinary expertise and collaboration. The increased access to tracers, training multidisciplinary teams, using novel trial designs, and establishing initiatives to share and re-analyze data from clinical imaging studies can encourage the use of molecular nuclear imaging in both clinical research and practical. It is also well recognized that dosimetric recommendations should be considered to compare promising new theranostic agents and clarify the better or similar performance of these methods in hepatocellular carcinoma.

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Authors and Affiliations

  1. The Persian Gulf Nuclear Medicine Research Center, Department of Molecular Imaging and Theranostics, Bushehr Medical University Hospital, School of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran

    Narges Jokar, Esmail Jafari & Majid Assadi

  2. Department of Radiology (Division of Interventional Radiology), Shiraz University of Medical Sciences and Health Services, Shiraz, Iran

    Farzad Moradhaseli & Ali Reza Rasekhi

  3. Department of Nuclear Medicine, Klinikum Westfalen, Dortmund, Germany

    Hojjat Ahmadzadehfar

  4. Department of Hepatobiliary Surgery, Avicenna Transplant Hospital, Avicenna Center for Medicine and Organ Transplant, Shiraz University of Medical Sciences, Shiraz, Iran

    Saman Nikeghbalian

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  1. Narges Jokar
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MA: The idea for the article; NJ: The literature search and the first draft for manuscript; EJ: Data collection; HA, FM, SN, ARR, MA: The critically revised the work. All authors read and approved the final manuscript.

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This study was approved by ethical standards of the responsible committee and was carried out in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. The study was also approved by the Bushehr University of Medical Science Research Ethics Committee.

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Jokar, N., Moradhaseli, F., Ahmadzadehfar, H. et al. Theranostic approach in liver cancer: an emerging paradigm to optimize personalized medicine. Clin Transl Imaging 11, 51–70 (2023). https://doi.org/10.1007/s40336-022-00525-5

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