Radionuclide Therapy in Brain Tumours

Glioblastoma multiforme (GBM), the most common primary brain tumour, is also the most aggressive neoplasm in the brain. It is characterized by a very poor prognosis with a median overall survival time of only 9-15 months. The infiltrating nature of the tumour cells, inter- and intra-tumoral molecular heterogeneity and the tumour’s propensity to hide behind the blood-brain barrier are the key causes of the insufficiency of the optimal available treatments (surgery, radiotherapy and chemotherapy). Furthermore, the best treatment strategy for patients with recurrent GBM remains uncertain and controversial yet. Despite applying state-of-the-art treatments in the majority of patients, the recurrence of the disease is common and the median survival after recurrence is 8.0-9.8 months. In order to avoid treatment insufficiencies, precision medicine-based therapeutics have emerged. An alternative method of treatment is targeted radionuclide therapy, which targets tumour-specified molecules on the surface of tumour cells. It has been shown that brain tumours overexpress several peptides on their surface, which may or may not be immunologically active, that can be used as a biologic target for the therapy. Radionuclide therapy involves the coupling of a peptide, which targets tumour-specific peptides, with a radionuclide payload to selectively irradiate tumour cells with negligible damage to the adjacent healthy tissue. This chapter discusses the use of radiolabelled conjugates for the treatment of brain tumours.