Clinical considerations for pharmacists regarding the use of radiopharmaceuticals in oncology

BackgroundRadiopharmaceutical therapy encompasses the targeted delivery of radioactive atoms to sites of malignancy within the body and represent a rapidly growing area of drug development in oncology. In comparison to cytotoxic chemotherapy, radiopharmaceutical therapy has the potential for fewer adverse effects and is able to produce a strong anti-cancer response in a wide range of malignancies.ObjectiveThis article reviews radiopharmaceutical therapy mechanisms and discusses four well-established agents that are used in clinical practice, their place in therapy, safety, utilization of concomitant therapies, and contact precautions for each agent.SourcesInformation presented in this article is sourced from the available literature on radiopharmaceutical development, oncology clinical practice guidelines, clinical trial results, and package insert data.SummaryRadiopharmaceuticals possess significant differences in drug mechanism and design from that of traditional cytotoxic chemotherapy agents. The basic functional and structural variances in combination with isotope selection drive the clinical efficacy of radiopharmaceutical therapy and inform pharmacists of the important considerations of each therapy's distribution, off-target effects, clearance, and toxicities.ConclusionThe drug and safety information presented in this article pertaining to select radiopharmaceuticals is pertinent to an oncology pharmacist's role in patient care as radioactive therapies continue to expand the complexity of the oncology treatment landscape.