Current status of contemporary diagnostic radiotracers in the management of breast cancer: first steps toward theranostic applications

• Published in: EJNMMI research Vol. 13; no. 1; p. 43
• Main Authors: Altena, Renske, Tzortzakakis, Antonios, Af Burén, Siri, Tran, Thuy A., Frejd, Fredrik Y., Bergh, Jonas, Axelsson, Rimma
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 17.05.2023; Springer Nature B.V; SpringerOpen
• Subjects: Biomarkers; Breast cancer; Cardiac Imaging; Estrogens; Growth factors; Heterogeneity; Imaging; Medical imaging; Medicin och hälsovetenskap; Medicine; Medicine & Public Health; Molecular imaging; Nuclear Medicine; Oncology; Orthopedics; Positron emission; Predictive biomarker; Radioactive tracers; Radioisotopes; Radiology; Receptors; Review; Ribose; Molecular imaging; Breast cancer; Predictive biomarker
• ISSN: 2191-219X; 2191-219X
• DOI: 10.1186/s13550-023-00995-2

Background Expanding therapeutic possibilities have improved disease-related prospects for breast cancer patients. Pathological analysis on a tumor biopsy is the current reference standard biomarker used to select for treatment with targeted anticancer drugs. This method has, however, several limitations, related to intra- and intertumoral as well as spatial heterogeneity in receptor expression as well as the need to perform invasive procedures that are not always technically feasible. Main body In this narrative review, we focus on the current role of molecular imaging with contemporary radiotracers for positron emission tomography (PET) in breast cancer. We provide an overview of diagnostic radiotracers that represent treatment targets, such as programmed death ligand 1, human epidermal growth factor receptor 2, polyadenosine diphosphate-ribose polymerase and estrogen receptor, and discuss developments in therapeutic radionuclides for breast cancer management. Conclusion Imaging of treatment targets with PET tracers may provide a more reliable precision medicine tool to find the right treatment for the right patient at the right time. In addition to visualization of the target of treatment, theranostic trials with alpha- or beta-emitting isotopes provide a future treatment option for patients with metastatic breast cancer.