Patient Selection and Personalized Treatment Planning in Radioligand Therapy
Patient selection is a critical determinant of success in Radioligand Therapy (RLT). Because this treatment relies on specific molecular targets expressed by cancer cells, not all patients are suitable candidates. Personalized evaluation ensures that therapy is both effective and safe, aligning with the principles of precision medicine.
The first step in patient selection involves molecular imaging to confirm the presence and density of target receptors. Positron emission tomography (PET) or single-photon emission computed tomography (SPECT) scans using diagnostic radioligands allow clinicians to visualize receptor expression throughout the body. Only patients whose tumors demonstrate sufficient uptake are considered eligible for therapy.
Beyond receptor expression, overall disease burden and distribution play an important role. Radioligand Therapy is particularly effective in patients with metastatic disease, as the radioligand can reach cancer cells throughout the body. However, extensive involvement of critical organs may require careful dose adjustment or alternative treatment strategies.
Organ function assessment is another essential aspect of patient selection. Because radioisotopes are cleared through organs such as the kidneys and bone marrow, baseline laboratory tests are used to evaluate renal function and blood cell counts. Patients with compromised organ function may still receive RLT but often require modified dosing schedules.
Personalized treatment planning extends beyond eligibility. The choice of radioisotope, number of treatment cycles, and administered dose are tailored to each patient. Dosimetry calculations help estimate radiation exposure to tumors and healthy organs, optimizing therapeutic benefit while minimizing toxicity.
By integrating imaging, laboratory data, and clinical judgment, Radioligand Therapy becomes a highly individualized treatment approach that maximizes outcomes and patient safety.