Overview of the First NRG Oncology-National Cancer Institute Workshop on Dosimetry of Systemic Radiopharmaceutical Therapy

Emilie Roncali, Jacek Capala, Stanley H. Benedict, Gamal Akabani, Bryan Bednarz, Vikram Bhadrasain, Wesley E. Bolch, Jeffrey C. Buchsbaum, Norman C. Coleman, Yuni K. Dewaraja, Eric Frey, Michael Ghaly, Joseph Grudzinski, Robert F. Hobbs, Roger W. Howell, John L. Humm, Charles A. Kunos, Steve Larson, Frank I. Lin, Mark MadsenSaed Mirzadeh, David Morse, Daniel Pryma, George Sgouros, Sara St James, Richard L. Wahl, Ying Xiao, Pat Zanzonico, Katherine Zukotynski

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

In 2018, the National Cancer Institute and NRG Oncology partnered for the first time to host a joint workshop on systemic radiopharmaceutical therapy (RPT) to specifically address dosimetry issues and strategies for future clinical trials. The workshop focused on current dosimetric approaches for clinical trials, strategies under development that would optimize dose reporting, and future desired or optimized approaches for novel emerging radionuclides and carriers in development. In this article, we review the main approaches that are applied clinically to calculate the absorbed dose. These include absorbed doses calculated over a variety of spatial scales, including whole body, organ, suborgan, and voxel, the last 3 of which are achievable within the MIRD schema (S value) and can be calculated with analytic methods or Monte Carlo methods, the latter in most circumstances. This article will also contrast currently available methods and tools with those used in the past, to propose a pathway whereby dosimetry helps the field by optimizing the biologic effect of the treatment and trial design in the drug approval process to reduce financial and logistical costs. We also briefly discuss the dosimetric equivalent of biomarkers to help bring a precision medicine approach to RPT implementation when merited by evidence collected during early-phase trial investigations. Advances in the methodology and related tools have made dosimetry the optimum biomarker for RPT.

Original languageEnglish
Pages (from-to)1133-1139
Number of pages7
JournalJournal of nuclear medicine : official publication, Society of Nuclear Medicine
Volume62
Issue number8
DOIs
StatePublished - Aug 1 2021

Keywords

  • MIRD
  • cellular dosimetry
  • dosimetry
  • microdosimetry
  • radiopharmaceutical therapy (RPT)
  • targeted radionuclide therapy (TRT)

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