Auger Electron-Emitting Radionuclides in Radiopharmaceutical Therapy

Radionuclides that emit Auger electrons have great potential for treating cancers for which other treatments are not successful, especially for targeting (or even preventing) disseminated, metastatic cancers. Because of their low energies, Auger electrons are deposited within a (sub)micrometre range of their source. As a result, these electrons mostly irradiate the cells in which they are emitted, theoretically leaving non-targeted cells completely unaffected. This tantalising approach to radiopharmaceutical therapy was pioneered by Professors James Adelstein and Amin Kassis at Harvard Medical School and has fostered a vibrant research community investigating how Auger electron-emitting radionuclides might be used to kill cancer cells and help increase the survival and quality of life of cancer patients. This chapter will (i) highlight a few key advances past and present that have created enthusiasm for the field and (ii) delve into key aspects that need to be considered when creating radionuclide therapies using Auger electron-emitters with the highest likelihood of making a clinical impact in future.