兰州大学第二医院核医学科,甘肃 兰州 730030
李永昊,第一作者,研究方向:SPECT/CT影像诊断及核素治疗,E-mail:523281135@qq.com
收稿:2026-07-08,
修回:2026-09-08,
录用:2026-09-14,
纸质出版:2026-09-20
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李永昊,柳江燕.整合素靶向放射性核素治疗进展[J].中山大学学报(医学科学版),2026,47(05):799-808.
LI Yonghao,LIU Jiangyan.Progress in Integrin Targeted Radionuclide Therapy[J].Journal of Sun Yat-sen University(Medical Sciences),2026,47(05):799-808.
李永昊,柳江燕.整合素靶向放射性核素治疗进展[J].中山大学学报(医学科学版),2026,47(05):799-808. DOI: 10.11714/jsysu.med.YX20260102.
LI Yonghao,LIU Jiangyan.Progress in Integrin Targeted Radionuclide Therapy[J].Journal of Sun Yat-sen University(Medical Sciences),2026,47(05):799-808. DOI: 10.11714/jsysu.med.YX20260102.
整合素αvβ3是肿瘤显像与治疗的重要靶点,其在肿瘤新生血管内皮细胞及多种恶性肿瘤细胞表面高表达,而在正常组织及静息内皮细胞中几乎不表达。基于Arg-Gly-Asp(RGD)肽的正电子发射体层显像(PET)已广泛应用,但单靶点策略因肿瘤异质性而受限。β
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核素标记RGD肽则存在摄取不足和肾脏蓄积问题。本文综述两大前沿方向的临床前进展:双靶点策略通过将整合素αvβ3与前列腺特异性膜抗原(PSMA)或成纤维细胞活化蛋白(FAP)等靶点联合,构建的异二聚体探针。临床前及临床研究表明,双靶点探针的肿瘤摄取、靶/背景比及病灶检出率均显著优于单靶点对照,有效克服了肿瘤异质性,提升肿瘤摄取与检出率;α核素凭借高传能线密度与短射程,展现出优于β
-
核素的抗肿瘤疗效。临床转化方面,镥-177标记白蛋白结合-RGD二聚体
(
177
Lu-AB-3PRGD₂
)
已完成首次人体研究,初步验证了整合素靶向放射性核素治疗的临床可行性,但其抗肿瘤活性有限。未来方向包括基于分子影像的患者筛选、双靶向分子结构优化、α核素制剂开发。
Integrin αvβ3 is an important target for tumor imaging and therapy. It is highly expressed on tumor neovascular endothelial cells and various malignant tumor cells, while being nearly absent in normal tissues and quiescent endothelial cells. Positron emission tomography (PET) based on Arg-Gly-Asp (RGD) peptides has been widely applied, yet single-target strategies are limited by tumor heterogeneity. β
-
radionuclide-labeled RGD peptides exhibit problems of insufficient tumor uptake and renal accumulation. This review summarizes the preclinical progress in two frontier directions. Dual-targeting strategies combine integrin αvβ3 with prostate-specific membrane antigen (PSMA) or fibroblast activation protein (FAP) to construct heterodimeric probes. Preclinical and clinical studies have demonstrated that dual-targeting probes achieve significantly superior tumor uptake, target-to-background ratios, and lesion detection rates compared to single-target controls, effec
tively overcoming tumor heterogeneity and improving tumor uptake and detection rate. α radionuclides, by leveraging high linear energy transfer and short tissue range, demonstrate superior antitumor efficacy over β
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radionuclides. In terms of clinical translation, the albumin-binding RGD dimer labeled with lutetium-177 (¹⁷⁷Lu-AB-3PRGD₂) has completed a first-in-human study, preliminarily validating the clinical feasibility of integrin-targeted radionuclide therapy, albeit with limited antitumor activity. Future directions include molecular imaging-based patient selection, optimization of dual-targeting molecular structures, and development of α radionuclide formulations.
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