A new review published in the Medical Journal of Peking Union Medical College Hospital provides an in-depth analysis of 15 years of progress in the field of radionuclide drug conjugates, summarizing current classifications, clinical development trends, and supportive policy frameworks. Radionuclide drug conjugates have emerged as transformative agents that integrate diagnosis and therapy into a single clinical workflow. By coupling radioactive isotopes with antibodies, peptides, or small molecules, these compounds enable precise tumor targeting, high diagnostic sensitivity, and effective localized radiotherapy.
The review, available at https://xhyxzz.pumch.cn/article/doi/10.12290/xhyxzz.2024-0577, highlights the expanding number of clinical trials, new therapeutic targets, and national-level guidance that are shaping the next generation of precision radiopharmaceuticals. Structurally, radionuclide drug conjugates are categorized into antibody-, peptide-, and small-molecule-based conjugates, each offering unique pharmacological advantages. The analysis emphasizes the rise of cyclic peptide conjugates, which exhibit low toxicity and high tumor selectivity.
Policy reforms including technical guidelines issued by regulatory agencies since 2020 have standardized clinical evaluation, non-clinical research, and radiochemical quality control, creating a more predictable environment for innovation. These developments position radionuclide drug conjugates as a cornerstone technology for achieving precision oncology through theranostic integration. Professor Hongyun Wang, senior author of the review, noted that these conjugates represent the only class of therapeutics capable of achieving true integration of diagnosis and treatment.
Despite challenges in radiochemical synthesis, stability, and regulatory alignment, researchers are witnessing unprecedented enthusiasm and cross-disciplinary collaboration in this field. With continued innovation in targeting ligands and isotope design, radionuclide drug conjugates will redefine approaches to tumor detection, treatment monitoring, and personalized therapy. These compounds hold vast potential to transform cancer management by enabling simultaneous imaging, treatment, and response monitoring within a single platform.
As aging populations and cancer incidence continue to rise globally, demand for next-generation radiopharmaceuticals will grow substantially. The review underscores the need for stronger innovation capacity, improved isotope supply chains, and streamlined approval processes to support translation from laboratory to clinical practice. Through coordinated scientific, industrial, and regulatory efforts, radionuclide drug conjugates are expected to become a central component of future oncology care, offering patients more accurate diagnoses and safer, more effective treatment pathways.
