Development of indigenous radiopharmaceuticals for therapy: options and availability

Radionuclide therapy using radiopharmaceuticals is in existence for over sixty years for the treatment of thyroid cancer. Iodine-131 has been a successful radionuclide for targeted therapy and is in use for the last 69 years as a work-horse primarily due to its wide availability resulting from its ease of production for world-wide supply. Additionally, due to the unique biological mechanism of transportation to the thyroid, ¹³¹I will continue to be used in the treatment of thyroid cancer and hyperthyroidism. However, its emission of high energy gamma photons in high abundance (364 keV, 81.7%) provides undue radiation burden to non-target organs as well as to individuals coming in contact with the patients. This drawback has provided the necessary impetus to the growth of radiotherapy using other therapeutic radioisotopes for other non-thyroidal applications. At present, targeted radionuclide therapy finds applications in management of a multitude of other diseased states, ranging from bone pain palliation for improving the quality of life of cancer patients to locoregional applications for treatment of liver cancer and radiosynovectomy for patients with rheumatoid arthritis