DEPARTMENTS Book Review

Clinical Practice of Molecular Radiotherapy

S.M. Larson and E.P. Krenning, eds.

Reston, VA: Society of Nuclear Medicine; 2005, 204 pages, $54

This is the first supplement published by The Journal of of internal emitters. Other articles are dedicated to more Nuclear Medicine that is dedicated to the interesting topic traditional forms of , including 131I, of the clinical practice of molecular radiotherapy. This bone-seeking for therapy, and radiosynovec- supplement is timely, because updated monographic re- tomy. I most enjoyed reading the article that focused on the views of this expanding and growing field are not readily use of 131I in thyroid cancer, not only because the topic is available. relevant to my daily clinical practice, but also because the For me, it was a pleasure to read this supplement because article is an up-to-date, insightful, practical, and well- it was written by pioneers and world-class experts in the structured review of this subject. The relevance of the topic is field of molecular radiotherapy. Although the title of this reflected by the fact that the incidence of thyroid cancer is supplement suggests that the content is dedicated to current one of the most rapidly growing in the United States, having therapeutic nuclear medicine, it is also true that iodine 131I, been expected to increase 17% in 2005 over 2004, with about one of the first forms of targeted therapy in cancer medi- 30,180 new cases having been expected in 2006. cine, has been used by nuclear medicine specialists to treat Other articles are dedicated to the review of 131I- benign and malignant thyroid conditions for more than 5 metaiodobenzylguanidine, as well as of somatostatin re- decades. During this time, especially over the past 20 years, ceptor analogues and peptides for targeted radionuclide the accelerated growth in this field has been due, in part, to therapy in adults and in children. The most extensively a better understanding of pharmacokinetics, biodistribution, reviewed subject is peptide receptor radiotherapy, mainly , and the toxicity profiles of the various com- with 177Lu- and 90Y-somatostatin analogues. A total of 8 pounds used in targeted . Furthermore, articles provide an in-depth review of the indications, the fairly recent Food and Drug Administration approval of dosimetry, patient preparation, imaging, toxicities, compli- 2 radiolabeled monoclonal antibodies, 90Y-ibritumomab cations, results of prior trials, future therapy protocols, and tiuxetan (Zevalin; Biogen Idec) and 131I-tositumomab (Bexxar; possible future applications of this novel form of targeted GlaxoSmithKline), for the treatment of relapsed or refractory radionuclide therapy. Another article focuses on the use of non-Hodgkin’s lymphoma has created additional interest in the this type of therapy in differentiated thyroid cancer. Also of field. great interest is an article presenting a practical overview This monographic supplement to The Journal of Nuclear of patient treatment in the form of 3 patient cases, with Medicine is a collection of reviews and articles written by insightful commentaries in the discussion section. authors from the United States and Europe. It contains 26 Another subject to which 5 articles are dedicated is articles, beginning with one entitled ‘‘A Pragmatic Per- radiolabeled monoclonal antibodies, currently generating spective on Molecular Targeted Radionuclide Therapy,’’ extensive interest in clinical practice and medical research. written by the 2 editors of the supplement. In this initial These articles review the applications of radioimmunother- article, the authors explain that the supplement is ‘‘a prag- apy in hematologic malignancies, solid tumors, pediatric matic perspective intended to offer relevant advice to nu- malignancies, 131I-tositumomab in non-Hodgkin’s lym- clear medicine practitioners and other professionals who phoma, and even immuno-PET. may be actively involved in radionuclide therapy to provide This monographic supplement finishes with a collection them with a summary of suggested patterns of practice for of articles describing 68Ga-labeled peptides, radiotargeted common radionuclide now available.’’ These ob- gene therapy, radiation sensitizers, the induction of apoptosis jectives are met perfectly as the various forms of radionu- with hybrids of Arg-Gly-Asp molecules, and the antimitotic clide therapy, commercially available or in different stages effects of hybrids of cytostatic drugs and peptides; the final of research, are systematically reviewed. article reviews the potential of a-particle therapy. The initial articles discuss the principles of radionuclide The review articles are well structured, user friendly, and therapy and are followed by an explanation of the dosimetry straightforward. Despite the many authors contributing to this supplement, the result is consistent and fairly homo- COPYRIGHT ª 2007 by the Society of Nuclear Medicine, Inc. geneous.

BOOK REVIEW 325 I encountered one shortcoming in this supplement. tions are reaching an ever-increasing level of sophistication, Some topics in targeted radionuclide therapy were not this monographic review of molecular targeted radionuclide covered, such as the use of radiolabeled microspheres for therapy provides a timely, extensive, expert, and invaluable the treatment of hepatocarcinoma and liver metastasis from review. colorectal cancer, the application of radionuclides for Therefore, I recommend this supplement as an indis- selective therapy in coronary artery disease, and the pensable resource for nuclear medicine physicians, radiol- treatment of hyperthyroidism with 131I. ogists, and their residents, as well as for oncologists or any In conclusion, this supplement of The Journal of Nuclear other health care professional interested in the subject. Medicine is easy to read, has excellent-quality images and Monographic reviews such as this will help increase knowl- relevant tables, and provides a practical overview of the edge of, and interest in, this modern form of medical therapy current uses and possible future applications of this in- for the benefit of the patient. creasingly important medical therapy. Considering that our knowledge of cellular and molecular biology is accelerating Rodolfo Nun˜ez rapidly, that new targets for targeted therapy are continually M.D. Anderson Cancer Center being discovered, and that radiopharmaceutical formula- Houston, Texas

326 THE JOURNAL OF NUCLEAR MEDICINE • Vol. 48 • No. 2 • February 2007