Radiopharmaceuticals and their applications in medicine

Siqi Zhang; Xingkai Wang; Xin Gao; Xueyao Chen; Linger Li

doi:10.1038/s41392-024-02041-6

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Radiopharmaceuticals and their applications in medicine

Siqi Zhang, Xingkai Wang, Xin Gao, Xueyao Chen, Linger Li, Guoqing Li, Can Liu, Yuan Miao, Rui Wang, Kuan Hu

Springer Nature (2025) • Volume 10, Issue 1, Pages 1-1

SynthesisNarrativeReviewPDF AvailableGrade Eligible

Overall Assessment

Limited Methodological Quality

Assessment created by PaperScorers Medical AI v0.1.0 on Dec 21, 2025

D+

54/100

Key Takeaways

•Comprehensive overview of FDA‑approved and investigational radiopharmaceuticals.
•Highlights radiotheranostics (e.g., 68Ga/177Lu pairs) and alpha‑emitters’ promise.
•Discusses mechanisms of RPT‑induced cell death and immune effects.
•Identifies key bottlenecks: nuclide supply, targeting, retention, toxicity.
•Expands beyond oncology to neurodegeneration and cardiovascular imaging.

Conclusion

A broad, timely narrative review. High significance; limited methodological rigour due to non-systematic design.

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Quality Dimensions

Bias & Integrity

COI handling, outcome switching, selective reporting

B75

Methods Rigour

Protocol clarity, sampling, controls

D-30

External Validity

Generalisability, setting, population

C+65

Transparency & Reproducibility

Data/code/materials availability, preregistration

D-35

Significance & Novelty

Contribution vs prior art; context if known

A-85

Statistical Validity

Models, assumptions, multiplicity, CI priority

F25

Integrity & Transparency

Integrity checks

P-hacking risk?

?

None suspected

Signs of selective hypothesis testing or analysis choices that could inflate false positive rates.

Outcome switching?

?

None suspected

Evidence that primary outcomes were changed during or after the study, potentially distorting results.

Conflict of interest?

?

None suspected

Authors have financial or other relationships that could bias research findings.

Data integrity issues?

?

None suspected

Concerns about the accuracy, completeness, or authenticity of the reported data.

Open science signals

Research data

?

Not applicable

Raw data used in the analyses is publicly available or accessible upon request.

Analysis code

?

Not applicable

Code or scripts used to analyze the data are shared for reproducibility.

Study materials

?

Not applicable

Protocols, questionnaires, and other materials are publicly available.

Premise

Primary Research Question

What is the current landscape and future potential of radiopharmaceuticals and radiotheranostics across diseases?

Hypothesis is Falsifiable

—Not specified

Narrative review; no testable hypothesis.

PICO Framework

Population—Not specified

No participants; review article.

Intervention—Not specified

No interventions; review article.

Comparison—Not specified

No comparator; review article.

Outcome—Not specified

No predefined outcomes; review article.

Literature Positioning

Literature Review Balanced

Well covered

Wide coverage of approved and emerging agents with mechanisms and targets.

Evidence: Fig. 3; Table 3–4

Research Gap Clearly Stated

Well covered

Challenges in alpha nuclide supply, targeting, toxicity; calls for future work.

Evidence: Perspective and Conclusion

Stated Contribution Clear

Well covered

Aims to overview evolution, agents, mechanisms, and prospects.

Evidence: Introduction

Study Provenance

Peer reviewed venueGrant funding disclosedNo conflicts declared5 affiliations listed

Authors & Affiliations

Institute of Materia Medica, Chinese Academy of Medical Sciences & PUMC, Beijing; Lanzhou University, China.

Funding Statement

Multiple Chinese national and regional grants listed in Acknowledgements.

Conflicts of Interest

Authors declare no competing interests.

Peer Review

✓Signal Transduction and Targeted Therapy is a peer‑reviewed Nature journal.

Evidence: Journal masthead

Methodological Assessment

All design modules are marked as not applicable. Use the accordion below to review their details.

Modules without applicable checklist items (10)

These designs were fully marked as not applicable but remain available for reference.

Abstract

Radiopharmaceuticals involve the local delivery of radionuclides to targeted lesions for the diagnosis and treatment of multiple diseases. Radiopharmaceutical therapy, which directly causes systematic and irreparable damage to targeted cells, has attracted increasing attention in the treatment of refractory diseases that are not sensitive to current therapies. As the Food and Drug Administration (FDA) approvals of [ 177 Lu]Lu-DOTA-TATE, [ 177 Lu]Lu-PSMA-617 and their complementary diagnostic agents, namely, [ 68 Ga]Ga-DOTA-TATE and [ 68 Ga]Ga-PSMA-11, targeted radiopharmaceutical-based theranostics (radiotheranostics) are being increasingly implemented in clinical practice in oncology, which lead to a new era of radiopharmaceuticals. The new generation of radiopharmaceuticals utilizes a targeting vector to achieve the accurate delivery of radionuclides to lesions and avoid off-target deposition, making it possible to improve the efficiency and biosafety of tumour diagnosis and therapy. Numerous studies have focused on developing novel radiopharmaceuticals targeting a broader range of disease targets, demonstrating remarkable in vivo performance. These include high tumor uptake, prolonged retention time, and favorable pharmacokinetic properties that align with clinical standards. While radiotheranostics have been widely applied in tumor diagnosis and therapy, their applications are now expanding to neurodegenerative diseases, cardiovascular diseases, and inflammation. Furthermore, radiotheranostic-empowered precision medicine is revolutionizing the cancer treatment paradigm. Diagnostic radiopharmaceuticals play a pivotal role in patient stratification and treatment planning, leading to improved therapeutic outcomes in targeted radionuclide therapy. This review offers a comprehensive overview of the evolution of radiopharmaceuticals, including both FDA-approved and clinically investigated agents, and explores the mechanisms of cell death induced by radiopharmaceuticals. It emphasizes the significance and future prospects of theranostic-based radiopharmaceuticals in advancing precision medicine.

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Study Overview

Study Design

Narrative Review

Primary classification used to evaluate this research.

Population

Narrative review of radiopharmaceuticals across oncology, neurology, and cardiovascular disease, incl. FDA-approved and investigational agents.

Brief summary of who or what was studied.

Reviewer Notes

Narrative review; no systematic search, trial arms, or statistical analysis.

Publication Details

DOI

10.1038/s41392-024-02041-6

Published

January 2, 2025

Citations

113 citations

FWCI

519.00

External Resources

DOI Link OpenAlex

Disclaimer: This assessment is generated by AI and should not be the sole basis for clinical or research decisions. Always review the original paper and consult with domain experts.

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