Nuclear Therapy with ¹⁸⁸Re Based Radiopharmaceuticals in Oncology

¹⁸⁸Re is attractive isotope for therapeutic needs, due to its unique combination of nuclear-physical properties. It is safe for patients, personal and environment due to its relatively short half-life – 17 hours, high energy of β-particles (2.11 MeV) provides required absorbed doses in pathological foci. β-particles can reach tumor cells, because its average range in tissues is 3.1 mm, maximum range is 10.4 mm. ¹⁸⁸Re also has its γ-emission of 155 keV which can be registered and used for image acquisition. Generator produced ¹⁸⁸Re is very fitful for inhouse radiopharmacy: half-life of maternity ¹⁸⁸W is 69.4 days, so ¹⁸⁸W/¹⁸⁸Re generator can be used for several months. ¹⁸⁸Re obtained from the generator is source of different radiopharmaceuticals. Radiopharmaceuticals based on ¹⁸⁸Re can palliate painful bone metastases, the most common one is ¹⁸⁸Re‑HEDP. It is used nearly two decades and demonstrated efficacy in reducing of bone pain and good tolerability. There are some investigations revealed that repeated cycles of therapy may have an advantage in overall survival compared with single injection in cases of castration resistant prostate cancer. There is analogue of ¹⁸⁸Re-HEDP in Russia which is demonstrated very similar properties to the original one. New bone seeking radiopharmaceutical, ¹⁸⁸Re-zoledronic acid demonstrated preferable pharmacokinetics with relatively low absorbed doses to bone marrow. ¹⁸⁸Re-lipoidol can be used for radioembolization in cases of hepatocellular carcinoma or liver metastases. This kind of therapy is useful in developing countries with high incidence of hepatocellular carcinoma. Patches or cream with ¹⁸⁸Re is used for brachytherapy of skin cancer or keloids. This kind of non-traumatic procedure is an effective alternative to surgical intervention in sites like ear, nose or genitals. There are investigations in field of radioligand and peptide receptor therapy with ¹⁸⁸Re based radiopharmaceuticals, for example, ¹⁸⁸Re-PSMA.

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