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Future Directions in the Treatment of Low-Grade Gliomas.

Cancer J

January 2025

Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL.

There is major interest in deintensifying therapy for isocitrate dehydrogenase-mutant low-grade gliomas, including with single-agent cytostatic isocitrate dehydrogenase inhibitors. These efforts need head-to-head comparisons with proven modalities, such as chemoradiotherapy. Ongoing clinical trials now group tumors by intrinsic molecular subtype, rather than classic clinical risk factors.

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Purpose: None of the antibody-drug conjugates (ADCs) targeting Claudin 18.2 (CLDN18.2) have received approval from regulatory authorities due to their limited clinical benefits.

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Strontium-90 plesiotherapy delivers high doses of radiation to superficial lesions (<3 mm depth) with excellent sparing of deeper tissues. The sealed-source applicator tip is circular and 8-10 mm in diameter. Larger treatment fields are treated with multiple overlapping fields.

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Background: PSMA PET/CT emerges as a pivotal technology in the diagnostic landscape of prostate cancer (PCa). It offers a suite of imaging interpretation criteria, notably the maximum standardized uptake value (SUVmax), the molecular imaging prostate-specific membrane antigen score (miPSMA score), and the PSMA reporting and data system (PSMA-RADS). Identifying the most valuable criteria for diagnosing PCa and standardizing imaging interpretation across various tracers is an unresolved question.

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Background: Gastrin releasing peptide receptor (GRPR)-directed radiopharmaceuticals for targeted radionuclide therapy may be a very promising addition in prostate and breast cancer patient management. Aiming to provide a GRPR-targeting theranostic pair, we have utilized the Tc-99m/Re-188 radiometal pair, in combination with two bombesin based antagonists, maSSS-PEG2-RM26 and maSES-PEG2-RM26. The two main aims of the current study were (i) to elucidate the influence of the radiometal-exchange on the biodistribution profile of the two peptides and (ii) to evaluate the feasibility of using the [Tc]Tc labeled counterparts for the dosimetry estimation for the [Re]Re-labeled conjugates.

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