Authors : Eddahoumi Y.; Elqabissi O.; Mousannif S.; Bentaleb N.; Bouatia M.

Volume/Issue : Volume 10 - 2025, Issue 10 - October

Google Scholar : https://tinyurl.com/5n6pvkhz

Scribd : https://tinyurl.com/552etadb

DOI : https://doi.org/10.38124/ijisrt/25oct1065

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Abstract : Background The convergence of nanotechnology and radiopharmaceutical science represents a transformative approach in precision oncology. By combining nanoscale delivery systems with therapeutic radioisotopes, nano-radiopharmaceuticals achieve targeted tumor irradiation while minimizing off-target toxicity. Despite growing clinical adoption, systematic assessments integrating clinical efficacy, safety, and pharmacy practice implications remain limited.  Objective To systematically review the clinical applications, therapeutic efficacy, safety outcomes, and pharmacy practice considerations of nano-radiopharmaceuticals currently approved or in development for cancer treatment.  Methods A systematic search was conducted in PubMed, EMBASE, Cochrane Library, Web of Science, and ClinicalTrials.gov from January 2015 to August 2025, following PRISMA guidelines. Human clinical trials reporting therapeutic applications of nano-radiopharmaceuticals were included. Two reviewers independently screened and extracted data on study characteristics, efficacy outcomes, safety profiles, manufacturing requirements, and pharmacy practice implications.  Results Of 3,247 records screened, 89 studies involving 12,456 patients were included. Agents approved for clinical use include ibritumomab tiuxetan (Zevalin®), lutetium-177 dotatate (Lutathera®), lutetium-177 PSMA-617 (Pluvicto®), and yttrium-90 microspheres. Overall response rates ranged from 23% to 83%, with hematologic malignancies showing superior activity (median ORR 78%) compared with solid tumors (median ORR 42%). Grade 3–4 toxicities occurred in 15–45% of patients, mainly hematologic. Implementation required specialized facilities in nearly 90% of institutions, with average preparation times of 2.5–4.8 hours and costs per treatment course ranging from $15,000 to $85,000.  Conclusion Nano-radiopharmaceuticals have demonstrated substantial clinical efficacy with manageable toxicity profiles across multiple cancer types. Their integration into oncology practice demands significant pharmacy infrastructure, specialized training, and rigorous quality control. Continued research is needed to refine patient selection, enhance manufacturing efficiency, and establish cost-effectiveness frameworks.

Keywords : Nano-Radiopharmaceuticals, Systematic Review, Oncology Pharmacy, Targeted Radiotherapy, Cancer.

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