In developed countries, cancer is the second leading cause of death, being only surpassed
by cardiovascular diseases. To develop tumor-targeted tools to localize and treat cancer
at an early stage is a multidisciplinary area fuelled by the convergence of biology,
medicine, chemistry, physics and engineering. Chemists, in particular, play a critical
role in this effort, as they are continuously challenged to use innovative chemical
strategies to develop ‘smart drugs’. The in vitro
observation that peptide receptors are overexpressed in
certain tumors, as compared to endogenous expression levels, has prompted the use of such
receptors as targets and the design of radiolabelled peptide-based tools for targeted nuclear molecular imaging and therapy. Such
approach has gained increased interest over the last two decades, driven in particular by
the success of OctreoScan® and by the increasing knowledge concerning
overexpression of regulatory peptide receptors in tumor
tissues. Selected peptides that target a variety of disease
related receptors are in place and have been labeled with different radiometals, using
mainly the bifunctional approach. This review begins by summarizing some relevant aspects
of the coordination chemistry of the metals studied for labeling
peptides. Then, we provide an overview of the chemical
strategies explored to improve the biological performance of different families of
radiometallated peptides for nuclear molecular imaging
and/or targeted radionuclide tumor therapy.
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